It can often be overwhelming when making decisions on what to feed your child with ADHD while overcoming fussy eating habits and behavioural issues. Meal times should not be difficult and stressful, so here is some practical advice on what to include and certain foods to consider avoiding.
Neurodevelopmental disorders such as ADHD may have a genetic influence (1), however nutrition for the brain can have a significant effect on various factors such as concentration and mood. There is increasing evidence from clinical trials to show that children with ADHD can experience a huge reduction in symptoms simply from dietary changes.
Foods to feed the brain
To optimise your child’s brain function, the priority should be to concentrate on foods to feed the brain; without adequate nutrition, the brain may struggle to function properly.
The neurotransmitters in the brain are the chemical messengers which help to transmit information to cells required for proper brain function. Children with neurodevelopmental problems often have low uptake and synthesis of neurotransmitters dopamine and serotonin, which may be due to genetic changes in neurotransmitter pathways (2). Dopamine and serotonin are important in motivation, reward, movement, mood, memory and learning.
Neurotransmitters are synthesised from amino acids which are found in the diet in protein-rich foods such as meat, fish, dairy, eggs, pulses, nuts and seeds, so be sure to include plenty of these foods in variety.
Essential fatty acids
Children with ADHD often have very low blood levels of essential fatty acids, in particular the long-chain omega-3 fatty acid EPA (3). Not only does the brain require these fatty acids for structure, growth and development, it also requires them to function well, as they are needed for the synthesis and functions of brain neurotransmitters. As a result of low levels of fatty acids, children with ADHD often have decreased volume in the areas of the brain which are associated with controlling movement, learning, memory and attention (4).
The important long-chain fatty acids are found in oily fish such as mackerel, salmon and herring. Other essential fats can be obtained from nuts and seeds. Sufficient levels may be difficult to obtain just from the diet for some children, so use of EPA fatty acid supplements – consistently shown in clinical trials to improve ADHD symptoms – may prove helpful (3).
Important vitamins and minerals
Key vitamins and minerals required for neurotransmitter synthesis and function include zinc, magnesium and vitamin B6. Providing the brain with foods rich in these specific nutrients is vital for your child’s brain function.
Zinc is essential for neurotransmitter function and can be found at good levels in wheat germ, liver, beef, pumpkin seeds and dark chocolate (very high % cocoa powder).
Magnesium (Mg) is a mood balancer; it supports sleep and is required for the proper functioning of the enzyme that facilitates the absorption of vitamin B6. Good food sources of magnesium include dark green leafy vegetables (spinach, kale), nuts, seeds, fish, beans, lentils, whole grains and avocados.
Vitamin B6 supports serotonin production, is required for transport or accumulation of Mg in cells and tissue and is found in high quantities in seeds, nuts, fish, yeast extract spread (Marmite), herbs and spices, rice and wheat bran.
Digestive complaints such as bloating and discomfort are common amongst children with neurodevelopmental problems. If large molecules of undigested food manage to pass through the intestinal wall and into the bloodstream, this may result in sensitivity or an immune response. Digestive issues may also reduce the absorption of essential nutrients required for optimal brain health.
To improve digestive health and therefore the gut/brain connection, it is important to promote a balance of beneficial bacteria. An overgrowth of harmful bacteria, which feed on sugar, may cause intestinal permeability and therefore may increase risk of food sensitivities. Probiotics, on the other hand, are beneficial bacteria which improve digestion and immune health and can be found in live yoghurts or probiotic supplements. Beneficial bacteria feed on prebiotic-containing foods such as artichoke, onions, leeks, garlic and asparagus.
Foods to consider avoiding
If a child eats a diet rich in nutrients to feed the brain, but still has symptoms of ADHD, they may also have problems with certain foods. Unfortunately there are foods that may cause more harm than good. Once these sensitivities or allergies have been identified and eliminated from the diet, behaviour and concentration can often completely change, so it may be worth investigating if there are certain foods that may affect your child.
A diet high in refined carbohydrates, including foods such as sugar and white bread, can result in a blood sugar roller coaster, with glucose being released very quickly into the blood followed by a release of various stress hormones, highs and lows in energy levels, and an increase in inflammation. Refined carbohydrates can affect mood and concentration (5), so for a child with ADHD, these foods should be limited as much as possible. Carbohydrates found in vegetables, pulses and wholegrain foods such as oats are generally better as they are more slowly absorbed and are nutrient dense.
Not only do refined carbohydrates cause blood sugar issues, they are also low in nutrients, so the body uses up B vitamins to process these foods. Sudden peaks in blood sugar delivered to the brain can also influence behaviour and anxiety. Choosing foods with a low glycaemic index (GI) ensures that blood glucose levels stay more constant.
Gluten and casein
Gluten is a protein found in wheat, barley and rye and casein is a protein found in milk and other dairy products. It is common for children with ADHD to have difficulties with breaking down these foods properly in the gut, which can result in large food particles passing through the gut wall, and allergic reactions. It is also considered that opioid peptides formed from undigested gluten and casein may cross the blood brain barrier, resulting in emotional and behavioural changes (6). Eliminating gluten and / or casein from your child’s diet may be of benefit, however this is only evident for some individuals (7), so should be considered only after the diet has been improved to optimise nutrition.
Artificial food additives
Synthetic food colour additives have a significant negative effect on a small number of children with ADHD, often those who are particularly sensitive and may have other food allergies (8), however there is limited evidence to say that eliminating additives for the majority of children is of any benefit (9). Having fresh unprocessed food is the easiest way to ensure that your child is free from artificial additives, which is also beneficial for health in many other ways.
ADHD diet overview
The key points to remember when considering your child’s diet:
Concentrate on foods that feed the brain, which are therefore rich in protein, high in essential fats and nutrient dense;
Include plenty of fish, nuts, seeds and green leafy vegetables;
Choose whole grains over refined grains and sugar, and also keep digestion healthy with probiotic and prebiotic foods.
Identifying particular food sensitivities or allergies may be beneficial for some, but not necessary for all. It is important to remember that every individual is different and therefore dietary needs vary for each child.
Diet really can make such a difference to your child’s symptoms, and if these healthy dietary habits can be followed by the rest of the family for healthy brains all round, the easier it will be to help your child to enjoy these foods.
3. Bloch MH, Qawasmi A. Omega-3 fatty acid supplementation for the treatment of children with attention-deficit/hyperactivity disorder symptomatology: systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry. 2011;50(10):991-1000.
4. Frodl T, Skokauskas N. Meta-analysis of structural MRI studies in children and adults with attention deficit/hyperactivity disorder indicates treatment effects. Acta Psychiatr Scand. 2012 Feb;125(2):114-26.
6. Shattock P, Whiteley P. Biochemical aspects in autism spectrum disorders: updating the opioid-excess theory and presenting new opportunities for biomedical intervention. Expert Opin Ther Targets. 2002 Apr;6(2):175-83.
8. Sonuga-Barke EJ, Brandeis D, Cortese S, Daley D, Ferrin M, Holtmann M, Stevenson J, Danckaerts M, van der Oord S, Döpfner M, Dittmann RW, Simonoff E,Zuddas A, Banaschewski T, Buitelaar J, Coghill D, Hollis C, Konofal E, Lecendreux M, Wong IC, Sergeant J; European ADHD Guidelines Group. Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry. 2013 Mar 1;170(3):275-89.
9. Nigg JT, Lewis K, Edinger T, Falk M. Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives. J Am Acad Child Adolesc Psychiatry. 2012 Jan;51(1):86-97.