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Symptoms of ADHD
Inattention and/or hyperactivity-impulsivity are considered hallmarks of Attention Deficit Hyperactivity Disorder (ADHD).
According to the CDC, symptoms of ADHD may include:
- trouble holding attention on tasks or play activities
- trouble organizing tasks and activities
- “on the go” acting as if “driven by a motor”
- runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
What about what we EAT?
Does what we eat impact attention and focus?
Since nutrition plays a role in brain development, structure & function, I believe that the answer is YES.
How Nutrition Impacts Attention & Focus
Below is a brief summary of some nutritional interventions that might be worth a try.
Protein at Breakfast
Waffles, bagels & cereal are easy…but might cause a quick crash in attention and focus. In order to create dopamine, a neurotransmitter important to attention & memory (source), we need enough of the amino acid tyrosine from protein-rich foods. In a group of 15 healthy male subjects, a breakfast meal with equivalent amounts of carbohydrate and protein improved attention and decision times over the course of the morning, compared to a carbohydrate-only breakfast (source).
Short-term Elimination Diets
The goal of an elimination diet is to see how the absence and reintroduction of those foods impact symptoms.
Nigg & Holton (2014) outline a list of food additives which could worsen ADHD symptoms:
- Artificial colors and flavors
- Artificial sweeteners, including aspartame, acesulfame K, neotame, saccharin & sucralose
- Sodium benzoate
- Butylated hydroxyanisole and Butylated hydroxytoluene
- Monosodium or monopotassium glutamate
- Any hydrolyzed, textured, or modified protein
A review published by Stevens et al. (2010) concluded that a “trial elimination diet is appropriate for children who have not responded satisfactorily to conventional treatment “, quoting two large studies indicating behavioral sensitivities to artificial food colors and benzoate.
In 2011, The Impact of Nutrition on Children with ADHD (INCA) study with 100 children 4-8 years old utilized a restricted elimination diet over five weeks. ADHD symptoms worsened in 63% of children (19/39) during the food reintroduction and challenge phase. However, this study did not find that IgG food sensitivity results via food were a helpful guide.
Nutritional risks of an elimination diet include lower intake of B Vitamins, calcium, and/or vitamin D: seek out the guidance of a trained & knowledgeable Registered Dietitian trained in whole foods based therapies. Consider using the the Integrative and Functional Nutrition Academy’s ‘IFNA Graduate Directory’ to find a trained nutrition professional.
A host of nutrients are involved in formation of the cortex and hippocampus. Nutrients also influence impact neurotransmitter concentration in different parts of our brain (source).
Some nutrients involved in brain development and function include:
- Long-chain Omega-3 Fatty Acids
- Vitamin A
- Vitamin B6
- Vitamin B12
- Vitamin D
- Vitamin C
A trial of 100 patients showed that the “nutritional status in the ADHD group was significantly lower (P < .05) than in the control group”. Among the ADHD study group participants, consumption of protein, carbohydrate, fat, fiber, calcium, iron, magnesium, zinc, selenium, phosphorus, thiamine, vitamin B6 & folate intake was significantly lower in the ADHD group than in the control group.
Zinc deficiency has been linked to ADHD symptoms for more than 20 years, and impaired concentration is a known symptom of zinc deficiency.
Zinc status impacts structure and function of the brain, and indirectly affects dopamine metabolism. In order for our pre-frontal cortex to work optimally, including for self-regulation, we need the right amount of dopamine to be present (source). High dose and prolonged zinc supplementation can cause impairment of iron and copper metabolism, so the safest first bet might be to focus on intake of Zinc rich foods (source).
Over the course of eight weeks, 52 children aged 6-14 received zinc glycinate (15mg twice per day) supplementation or placebo. A 37% reduction in amphetamine optimal dose was achieved in the children receiving zinc supplements (source).
Good sources of zinc include oysters, black beans & red meat.
Choline is a building block for acetylcholine, a major neurotransmitter system involved in attention, memory, and motivation (source).
Good sources of dietary choline include egg yolks and full-fat soy.
B-vitamins, including folate, are known to influence a process called brain-based DNA methylation and to impact neuronal function (source).
Having enough folate during pregnancy is important to brain development: adequate folate in pregnancy is linked to improved verbal, motor, and verbal-executive scores in 4-year-olds (source).
Good sources of folate include green leafy vegetables, beef liver, beans & lentils.
The nutrient Magnesium is involved in several neurotransmitter systems, and is used frequently for stress-related conditions (source).
In a group of magnesium deficient children, eight weeks of weight based dosing of B6 & Magnesium was followed by lower hyperactivity and aggressiveness as well as better school performance (source).
Good sources of Magnesium include green leafy vegetables, nuts & seeds.
Omega-3 Fatty Acids
Did you know that a large portion of the dry matter of your brain is made up of essential fatty acids that our body cannot make by itself?
Fatty membranes in our brain are enriched with high levels of the long-chain Omega-3 fatty acid DHA, which helps to maintain membrane fluidity and healthy neurotransmitter communication (source).
Omega-3 deficiencies correlate with behavioral problems including conduct disorder, hyperactivity-impulsivity, anxiety, temper tantrums, and sleep difficulties).
Low Omega-3 levels may lead to changes in ‘functional connectivity’, the ability for our brains to make connections within regions that support executive function (prefrontal cortex), memory (hippocampus), and emotion (amygdala) (source). Lower serum docosahexaenoic acid (DHA) levels have been found in ADHD adults compared to control (source).
Good sources of Omega-3 fatty acids include mackerel, herring & sardines.
Designing a Nutrient-Dense Diet
First and foremost, work to build your nutritional foundation with a whole foods based diet. One of my favorite ways to track nutrition in what I am eating is through the CronOMeter app.
Supplementation of some nutrients in excessively high dosage has the potential to disrupt balance of other nutrients, while nutrient supplementation does not offer the same array of nutrient compounds that whole foods would.
If you are looking for strategies to supplement your diet, please consult your healthcare provider*. With your healthcare provider, consider use of a well-designed multivitamin and/or Omega-3 supplement. Two possible products are below.
This comprehensive multiple vitamin/ mineral supplement contains 28 highly bioavailable essential nutrients. Bioactive forms of folate, B12, and B6 are included along with naturally sourced carotenes, vitamin E, and D for optimal nutrient absorption and utilization. VitaSpectrum® is free of common allergens, including milk/casein, fish, shellfish, tree nuts, peanuts, wheat/ gluten, and yeast.
Nordic Naturals ProOmega® 2000 Jr.
ProOmega® 2000 Jr. features high-concentration triglyceride-form omega-3 oil, providing intensive support for heart, brain, and immune health.* It’s ideal for children, older adults, and anyone wanting high-intensity omega-3s in a great-tasting, smaller soft gel that is easy to swallow or chew.
*The statements made herein have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure, or prevent disease. If you have any concerns about your own health, you should always consult with a physician or healthcare professional.