From the time he was 15 months old, Shaun Barton exhibited behaviors that went far beyond standard attention deficit–hyperactivity disorder (ADHD). He banged his head against the wall, he hit, he kicked, he screamed. By age 2, he became so violent he couldn’t be in the same room with other kids, claims Shaun’s mother Lisa Barton. “He would attack anyone—bigger, smaller, it didn’t matter.” The culprit? His diet.
Foods contain active ingredients that essentially work like opiate-like peptides that can change mood and behavior, says Dana Laake, MS, RD, co-author of The Kid-Friendly ADHD & Autism Cookbook (Fair Winds Press, 2006). Take the obvious a.m. sugar and java jolt, for example. You’d be hard pressed to find anyone, ADHD or not, who doesn’t lack focus a few hours after a Krispy Kreme and coffee breakfast. For the 3 to 5 percent of children who have ADHD, however, the repercussions of a poor diet are much more severe than in children without attention difficulties. The trick, claim experts, is to learn which foods impact your child positively and which send him into a hyperactive tailspin.
A solid base
Managing symptoms of ADHD requires stabilizing blood sugar levels and feeding the brain the right foods (complex carbohydrates and protein) at the right times (every three to five hours). Unfortunately, the typical American child eats nothing but deep-fried foods, mac ’n’ cheese, and bread, claims Laake—all of which send blood sugar levels soaring and give their little brains too much glucose to chew on at once. In a child with ADHD, whose brain is less efficient at sending and receiving messages, that becomes a recipe for disaster.
A child uses more than half of the dietary glucose she breaks down to process information in the brain. To keep blood sugar levels in check, and attention focused, children with ADHD need a steady supply of energy from a balanced diet of protein, carbohydrates, and fat.
“Every meal should have protein—fish, poultry, meat, eggs, beans, nuts, or seeds—even dairy products, if they’re tolerated,” says Laake. So instead of loading your child with carbohydrates for breakfast (think waffles drowned in syrup), spread peanut butter on toast, or add ground flaxseeds to quick breads. Better yet, send him to school with a couple of hard-boiled eggs and a banana or give him granola with plain yogurt for breakfast on the go. The combination of protein and fiber-rich carbohydrates will maintain steady blood sugar levels and keep your child alert.
In addition to sugar overload, many children lack vital nutrients like magnesium, vitamin B6, and essential fatty acids. Of particular concern is magnesium, since studies show that when a child’s brain doesn’t get enough of the mineral, neural transmissions suffer, causing ADHD-like symptoms such as hyperactivity, restlessness, and irritability.
And their beloved snacks—processed treats and sodas—get part of the blame. Food-manufacturing techniques like processing and refining strip the magnesium from foods. What’s more, the large amounts of salt in packaged foods can deplete the body of the minerals it needs to keep messages traveling to and from the brain in a healthy, controlled manner.
“But that’s not a license to load up on magnesium supplements,” says Roberta Anding, MS, RD, clinical dietitian at Texas Children’s Hospital. “Food first is the best approach since there is an upper tolerable limit for magnesium (110 mg a day for children ages 4 through 8), after which negative side effects, even death, may occur.”
To keep your child’s levels up to snuff, trade in his salty tortilla chips, pretzels, and other processed snacks for whole grains and dark, leafy green vegetables. Sure, these foods may not be your child’s first choice, but sneaking spinach or broccoli in with foods he likes (think quick breads, smoothies, and casseroles) is easier than you think (see “Boost Your Child’s Attention Quotient” below).
Nuts, nut butters, and fortified breakfast cereals are also rich in magnesium, and most children will happily gobble them up—and get a good mix of other important nutrients to boot. Nuts, seeds, and their respective oils and butters also boast essential fatty acids (EFAs), which the brain requires for proper development.
“ADHD is thought to be caused by an imbalance of brain chemicals called neurotransmitters,” says Jennifer Shu, MD, pediatrician and co-author of Food Fights: Winning the Nutritional Challenges of Parenthood Armed with Insight, Humor, and a Bottle of Ketchup (AAP, 2007). “These chemicals help the brain send and receive messages between nerve cells throughout the body.” And since about two-thirds of the brain is made up of fat, omega-3 and omega-6 essential fatty acids (EFAs) lubricate the pathway to the brain so nerve cells can communicate properly.
In fact, several studies report that children with attention disorders are deficient in EFAs and that symptoms of ADHD diminish following supplementation with these important nutrients. Add some antioxidants to the mix and you have a powerful cocktail that can yield calming results. One study found that ADHD children who took 200 mg of flax oil combined with 25 mg of vitamin C for two months showed improvement in symptoms of restlessness, impulsiveness, inattention, and self-control. B vitamins found in whole grains, leafy greens, nuts, milk, and eggs, may also help since these nutrients are required to synthesize certain brain chemicals, including those linked to stress and anxiety.
In a six-month study of 28 children, researchers discovered that when the children took a fish oil supplement, in addition to healthful school meals (lower in salt, trans fats, sugar, preservatives, and additives than their traditional fare), ADHD-like outbursts dropped from 127 incidents to 65. And the biggest impact was seen in students who had previously been the most disruptive. But like magnesium, parents should exercise caution with supplementation and consult a physician for the appropriate dosage.
When all else fails, eliminate
For Shaun, EFA and vitamin supplementation didn’t work. He falls within a small subset of children with severe food intolerances. Early on, Barton noticed that her son’s outbursts were worse after he ate something red. “Even though his behavior was consistently bad, if he ate something with red dye in it, he would attack within 10 to 15 seconds,” she says. As a result, she started him on a more dramatic intervention called the Feingold diet.
More than 30 years ago, Benjamin Feingold, MD, suggested that food additives—colorings, flavorings, and related substances—have a pharmacological effect and may play a role in the growing rates of hyperactivity in children. He put his patients on strict elimination diets—no dairy, no yellow foods (except bananas because the edible part is actually white), no junk foods (if it comes in a wrapper, it’s prohibited), no fruit juices, and no processed meats, aspartame, or MSG (the list goes on, of course).
“When I cleared out my kitchen of everything that was not Feingold approved, I had 17 bags of food that I couldn’t use,” says Barton.
Although Feingold claimed that up to 50 percent of his hyperactive patients improved on his diet, an independent study found that in a group of 15 children with ADHD, only four showed any benefits from following Feingold’s plan. After reviewing a series of studies, the National Institutes on Health concluded that food additives affect only a small proportion of children with behavioral problems.
Work with your child’s doctor to determine whether he is in that subset before treating him with an elimination diet, claims Robert Kleinman, MD, chief of the Division of Pediatric Gastroenterology and Nutrition Unit at Massachusetts General Hospital and professor of pediatrics at Harvard Medical School. “Otherwise, you can end up with a diet that’s totally inappropriate for a growing child.” The big risk is malnutrition since both dairy and gluten are included in so many foods. A diet void of these components may lack certain critical nutrients like calcium and B vitamins—the very nutrients associated with alleviating symptoms of ADHD.
If your child does have food intolerances though, appropriate dietary interventions (under the guidance of a health professional) can produce miraculous results. “For the first time since Shaun was three years old, he’s not medicated or under the care of a psychiatrist,” says Barton, “That’s nothing short of amazing.”
Amy Paturel, MPH, is a health, food, and nutrition writer in Seal Beach, California.