Nutrition can negatively impact ADHD (Attention Deficit Hyperactivity Disorder) by contributing to poorly regulated blood sugar, deficiencies in key nutrients, and exacerbating food sensitivities and inflammation. (Remember from other posts about ADHD and ADHD treatment, that I don’t like the word "disorder" to describe ADHD).
Nutrition and ADHD are closely related. It is important to understand the linkages between blood sugar, nutrient deficits, food sensitivities and ADHD.
Nutritional counseling should be a part of any holistic treatment plan for ADHD.
As a rule of thumb, medication-only treatment approaches for ADHD are less successful than comprehensive plans that address ADHD from a root-cause perspective.
Just to recap, people with ADHD may have difficulty with attention, impulsivity, and hyperactivity, which can significantly impact their daily lives. Medication is often used to manage ADHD symptoms, but optimizing nutrition can also play a role in improving ADHD symptoms. As an integrative provider, I never recommend a medication-only approach, especially for ADHD.
We should always be looking for root causes and using all the tools at our disposal to holistically treat things like ADHD. I believe the most effective treatment approach, including for ADHD always start with comprehensive evaluation that helps us create an individualized treatment map. From there we may use medication, like stimulants or non-stimulants, but we will also talk about how therapy, lifestyle optimization, exercise, and nutrition are critical to long-term success.
Yes, nutrition is an integral factor in the management of ADHD.
A quick discussion on nutrition
When we talk about nutrition, we are talking about the quality and type of food we eat. But we are also talking about how well our bodies are able to process, use, and absorb that nutrition. Mental health as a whole, including ADHD, depression, and anxiety can be heavily influenced by our diets.
Our food intake should be rich in quality, nutritiously dense foods. Think lots of veggies, lean meats, whole grains, and fruits. We want food that is as close to how it can be found in nature as possible – this means as little processing, within reason. One way to decipher processing is shelf life and packaging. If it comes in a box and doesn’t expire for four years, it’s probably highly processed.
Let me be clear, though, I do not endorse diets that exclude any single food group or diets that count calories. Nutrition and mental health is about how we feel, not an obsession with numbers. So, yes, you can indulge in the donut or ice cream, we just don’t want that to be the bulk of our diet. And, if you have a sensitivity to a certain food, it’s probably best to avoid it most of the time. As a rule of thumb, I sat let’s try to limit HAT foods (here and there). HAT foods are things like alcohol, highly refined and processed foods, and synthetics foods that contribute to things like inflammation, nutritional deficiencies, and energy surplus.
How can nutrition impact ADHD?
Believe it or not, ADHD (and depression and anxiety, among other things) is closely linked to nutrition. It is important to remember not everyone has the same experience with ADHD, so making nutritional changes may be highly effective for some, and less impactful for others. As with all of healthcare, what works for one person, may not work for another. So, this post was written to educate on the linkages between ADHD and nutrition, and not as a diagnostic tool.
ADHD and blood sugar levels
Blood sugar levels are closely linked to ADHD symptoms. Fluctuations of blood sugar level can have a direct impact on an individual’s cognitive capacity - if you have ever gone without eating for just a bit too long and have become hangry, you know what I am talking about. A diet high in refined sugars and carbohydrates can cause spikes in blood sugar levels, leading to hyperactivity and inattention. These sugar spikes can also cause crashes, which can cause fatigue and difficulty concentrating. This can create vicious cycle where our body is constantly operating at the extremes. So it is no wonder that things like ADHD-related procrastination more difficult to manage when we are subconsciously and physically on edge.
Assuming there aren’t underlying concerns like diabetes, management of blood sugar can be relatively straightforward. A diet high in protein, healthy fats, and complex carbohydrates can help stabilize blood sugar levels, leading to better focus and attention. Think of it this way: if your body is preoccupied with critical operations like finding food and processing food, then it will have less capacity for higher level executive functioning.
If we take this one step more and incorporate sound nutrition with exercise, the benefits for ADHD can be overwhelming. In fact, one study found that kids who adhered to diets that didn’t adversely affect blood sugar and exercised five days a week reduced symptoms of ADHD by 70%, effectively eliminating the need for medication for most participants.
Nutrient deficiencies and ADHD
Research has found that individuals with ADHD are more likely to have nutrient deficiencies than those without ADHD. Deficiencies in omega-3 fatty acids, iron, zinc, and magnesium have been linked to ADHD symptoms. Omega-3 fatty acids are essential for brain function and have been shown to improve cognitive function and reduce ADHD symptoms. Iron is necessary for the production of dopamine, a neurotransmitter that is essential for attention and focus. Zinc and magnesium are also important for brain function and can help improve ADHD symptoms.
So what do we do here? First thing we want to do is lab work to identify any areas of concern. If there are any areas that need to be addressed, we supplement with high quality supplements. This intervention alone can have tremendous benefits for ADHD. For starters, I recommend every patient to take fish oil supplements that are high in EPA/DHA. We’re talking about higher quality than you get at CVS, because quality here matters. This can help with the inflammation that may contribute to mental health issues, but also generally helps with cognitive function and cardiovascular health.
Food sensitivities and ADHD
Some individuals with ADHD may be sensitive to certain foods, such as dairy, gluten, or artificial food additives. Eliminating these foods from the diet may help improve ADHD symptoms. Studies have shown that individuals with gluten and casein sensitivity can reduce hyperactivity and improve social interaction by limiting gluten and casein. It's really essential to identify any food sensitivities and eliminate them from the diet to improve overall health, as well as ADHD symptoms.
There are tests we can run for this, but sometimes they don’t give us the information we need. For this reason, I typically recommend trying something like Whole30 to identify sensitivities. Remember, this is different than avoidance of food groups. Think of this as a trial period to identify specific foods to which an individual may be intolerant, not a fad diet.
Gut health and ADHD
Research has shown that individuals with ADHD can have different gut microbiome profiles than those without ADHD. The gut microbiome plays a crucial role in brain function and mental health. Improving gut health through a healthy diet may help improve ADHD symptoms. Sometimes probiotics can help balance the gut microbiome, but I start with nutrition first. That being said, sometimes adding a probiotic can help reduce inflammation, which can help improve brain function and reduce ADHD symptoms. Interestingly enough, women with ADHD are more likely to experience gastrointestinal symptoms concurrently with ADHD, though a link has not been well studied.
But there’s more to the story of gut health. Diets that are full of highly processed foods don’t feed our individual microbiomes the fuel they need to flourish, leading to an imbalanced gut bacteria that contributes to inflammation and further dysregulates the gut-brain axis. Eating quality, colorful, whole foods is the best way to nourish our microbiome. So don't reach for the probiotics first. Let’s get our nutrition right and then see if we need to make additional changes.
Caffeine (and stimulants) and ADHD
Caffeine and other stimulants can have a positive effect on ADHD symptoms by increasing alertness and improving focus. Stimulant medications, such as methylphenidate and amphetamines, are often used to treat ADHD. However, they can also have negative side effects, such as anxiety, irritability, and sleep disturbances. Also, caffeine and stimulants should never be viewed as the fuel for our car. Instead, these should be thought of as performance enhancements. Relying too heavily on these enhancements can be costly if our engine isn't running optimally beforehand.
Caffeine, while not as potent as prescription stimulants, can also help improve focus and attention in individuals with ADHD. However, it's important to use caffeine with caution. Coffee tends to lead to spikes in energy and subsequent crashes. Swop coffee for tea or matcha for a more stable, consistent response. It's also more common in individuals with ADHD to have an increased metabolism to caffeine, making caffeine essentially ineffective.
Summary: Nutrition’s impact on ADHD
In summary, nutrition can have a significant impact on ADHD symptoms. Making holistic changes can be an incredibly effective treatment for individuals with ADHD. In integrative psychiatry, we work to build comprehensive treatment plans that address root causes. This is particularly important for complex and dynamic issues like ADHD. As always, it's important to work with a mental health provider to help determine the best course of action.
If you have any additional questions about ADHD medications or integrative psychiatry in general, shoot me an email or reach out through my website. If you're looking for a provider and you're in the Washington, DC area, I'd love to help you on your treatment journey!