Diet

While there is no cure-all ADHD diet, experts believe that brain-boosting foods may improve ADHD symptoms. At the very least, eating a balanced, vitamin-rich diet can help prescription medications work more effectively.

Can Caffeine Treat ADHD?

ADHD is characterized by lack of focus, the inability to sustain attention and, of course, hyperactivity. So it’s a bit of a paradox that the most common—and effective—treatments for the disorder are stimulants. The go-to prescription drug, methylphenidate (Ritalin), is a potent central nervous system stimulant, which has the opposite effect in people with ADHD; it enables them to remain relatively calm and focused. So it should come as no surprise that some experts suggest caffeine for the treatment of ADHD symptoms. 

Caffeine is a natural stimulant found in coffee, tea, and cocoa. In most individuals, it has been shown to increase alertness and reduce fatigue, while also improving vigilance during tasks that require sustained attention. Emerging research suggests that caffeine may also be a useful supplement for children and adults with ADHD.

Evidence in Animals

Spanish researchers recently published findings showing that animals whose brains were deliberately altered to induce ADHD-like effects responded positively to caffeine. Young animals given caffeine displayed improvements in attention compared to animals that did not receive caffeine. Earlier research appeared to show that caffeine given before testing improved spatial learning among test animals with an ADHD-like condition. Spatial learning involves the ability to remember details about one’s environment. Among laboratory animals, it usually involves the ability to learn the intricacies of a maze. In humans, this type of learning enables people to successfully navigate city streets, for example.  

Evidence in Humans

Few studies have examined the use of caffeine for the control of ADHD symptoms in children. One such study, conducted decades ago, found that objective measures of hyperactive behavior were reduced when children received 300 or 600 mg caffeine. The higher dose significantly controlled hyperactive symptoms, although it also produced some side effects. Results were similar to those obtained by giving ADHD children a dose of amphetamine. 

The data suggest that caffeine may represent an under-appreciated and under-investigated alternative therapy for ADHD. Although more research is needed, caffeine may have clinical value when taken alone or in combination with prescription psychostimulant drugs. It may even reduce the dosage of prescription drugs required to achieve a therapeutic effect. Unfortunately, there is insufficient information at this time to recommend caffeine for children with ADHD. 

Dietary Choline

Is there another way to influence the cholinergic systems of ADHD patients? Perhaps. Choline is a type of B-vitamin that’s also an essential nutrient. It’s necessary for proper acetylcholine synthesis in the brain. Ensuring that your child eats a diet rich in choline may improve the availability of acetylcholine in his or her central nervous system, although no clinical trials have proven that this specifically helps ADHD. 

Many common foods are good sources of choline. These include:

  • eggs (egg yolks are nature’s richest source of choline)
  • soybeans
  • liver (and other meats)
  • whey
  • tofu
  • beets
  • cauliflower
  • wheat germ
  • whole grains (oats, barley, corn)
  • flax seed
  • salmon
  • nuts (cashews, pistachios, almonds, peanut butter)
  • lentils
  • bananas
  • oranges 

Daily Choline Requirements

The Institutes of Medicine, Food and Nutrition outline the following daily requirements:

  • children 1-3 years old: 200 mg
  • children 4-8 years old: 250 mg
  • children 9-13 years old: 375 mg.
  • teens 14-18 years old: 550 mg (boys), 400 mg (girls)
  • adults 19 and older: 550 mg (men), 425mg (women)

It’s easy to reach this daily quota. For instance, one large, cooked egg provides slightly less than the daily requirement of choline for an adult man.

Don’t Forget Other B-Vitamins

Studies show that other essential nutrients are also necessary to maintain adequate choline levels in the body. Among these are the B-vitamin folate and an essential amino acid, methionine. Methionine is found in eggs, fish, meats, and some nuts and seeds—many of the same foods rich in choline.

Can Sugar Cause ADHD?

It’s a popular belief that sugar + kids = hyperactive behavior. Take a roomful of kids and give them sugary soft drinks, cake, or candy and they’ll go wild. Yet studies have not found a strong connection between sugar consumption and ADHD. Nevertheless, it still might be helpful for your ADHD child to cut back on sugar to be healthier and it may reduce some ADHD symptoms. 

Sugar and the Brain

Recently, researchers at the University of Colorado revisited the question of a possible link between sugar and ADHD, and speculated that sugar consumption may play a role in altering dopamine brain-signaling. ADHD patients’ brains typically show evidence of these alterations in dopamine signaling. A recent Australian study examined the relationships among sleep, diet, and behavior in children with ADHD. Parents reported more sleep disturbances among children who ate more sugar, which suggests that diet might play a role in this aspect of ADHD. While intriguing, the results were not definitive. 

Other research has hinted at a stronger link between ADHD and diet. A study of nearly 2,000 children born in Australia recently concluded that eating a “Western” style diet was associated with a diagnosis of ADHD, while eating a “healthy” diet was not. The Western diet is defined as a diet high in red meat, refined sugar, fats, and processed foods, and low in whole grains, fresh fruits, and vegetables. Another large study, conducted in the UK, found that children who regularly ate “junk food” at age four were significantly more likely to be hyperactive at age seven. 

Sugar as the Villain

While the results of these studies are enticing, it is difficult to draw conclusions about the direct effects of sugar consumption on ADHD; many other dietary factors are also involved. Still, there are other reasons to curb your child’s sugar intake. Excess sugar consumption is linked to an increased risk of a number of conditions, including type 2 diabetes, obesity, and heart disease. Even drinking sugar-sweetened soft drinks is linked to higher risks of developing these chronic diseases.

The Feingold Diet for ADHD

The Feingold diet was pioneered more than 30 years ago by doctor Ben F. Feingold. Used to help improve the symptoms of ADHD, among other complaints, the diet is based on Feingold’s theory that food additives—especially artificial food colorings—adversely affect the nervous systems of susceptible children. Feingold, a pediatrician and allergist, introduced the hypothesis that some growing brains are sensitive to certain synthetic chemicals in food.

The Feingold diet is an elimination diet that removes the following:

  • artificial food colorings
  • artificial flavorings
  • artificial preservatives (e.g. BHT, BHA, TBHQ)
  • aspartame-based artificial sweeteners (e.g. Nutrasweet) 

How it Works

Individual foods that contain any of these “banned” ingredients are removed one at a time, according to a predetermined schedule. Parents then note any changes in the child’s behavior or other symptoms. Removed foods may be reintroduced to confirm a suspected relationship between the food in question and the ADHD symptoms. If symptoms reappear, the food is eliminated permanently from the child’s diet. If not, it may be returned to the menu. This is a trial-and-error approach, and it can take time to locate your child’s possible trigger foods.

Fact or Fiction?

Even after more than three decades, the medical community remains divided about the diet’s effectiveness. Some doctors dismiss the notion that ADHD can be treated through diet alone, while others find the evidence—and grateful parents’ tales of success—convincing. Once out of fashion, the diet has experienced a resurgence in popularity, with the well-publicized release of studies that seem to show a link between food dye consumption and ADHD. In 2008, the Center for Science in the Public Interest petitioned the FDA to ban a number of synthetic food dyes, based on mounting evidence that these unnecessary food additives trigger hyperactivity in susceptible children. The British government took this step in 2009; the United States has yet to do so.  

Is Feingold Right for Your Child?

While the medical community has not universally embraced this approach, many people feel it’s made a difference in their lives. The decision is ultimately up to you and your physician. Up to one-half of patients with ADHD symptoms have reportedly responded favorably to the diet, so it may be worth the effort. Consult with a doctor or dietician for guidance to ensure that your child continues to receive adequate, complete nutrition. For more details, visit www.feingold.org.

A Gluten-Free Diet for ADHD

Gluten is a protein found in wheat, barley, rye and some oat products. It is also added to some foods, such as ice cream, as a thickening agent. In recent years, it’s made the news due to increased awareness of Celiac disease (sometimes called gluten intolerance), a relatively rare autoimmune disease, and gluten sensitivity, a condition in which people experience allergy symptoms after eating products containing gluten.

In people with Celiac disease, consuming gluten triggers an autoimmune reaction that can damage the lining of the small intestines. This causes symptoms ranging from abdominal pain, bloating, and gas, to constipation, loss of appetite, diarrhea, vomiting, and unexplained weight loss. As damage to the intestines progresses, the digestive tract loses the ability to absorb nutrients. This may lead to secondary problems associated with malnutrition. The only treatment for people diagnosed with Celiac disease is a life-long gluten-free diet.

The Celiac/ADHD Hypothesis

What does this have to do with ADHD? According to an emerging theory, there is a possible link between Celiac disease and a number of neuropsychiatric disorders, including ADHD. Proponents note that many people with undiagnosed Celiac disease also exhibit symptoms of ADHD. Furthermore, the symptoms of ADHD fade when these individuals begin a gluten-free diet.

ADHD is known to involve a disorder in the serotonin signaling system in the brain. Serotonin, like dopamine, is a brain chemical made from compounds obtained through the diet. Among these is tryptophan, a fundamental amino acid and an essential nutrient used to make serotonin. According to the Celiac/ADHD theory, people with Celiac disease do not absorb adequate tryptophan from the foods they eat, and so are unable to make enough serotonin. This results in ADHD symptoms. 

While the relationship between Celiac disease and ADHD remains controversial, a recent study conducted by German researchers suggests that a gluten-free diet may dramatically improve symptoms of ADHD among children with undiagnosed gluten intolerance. Researchers examined the blood of 67 subjects with ADHD for antibodies to gluten. Finding these antibodies is the best way to diagnose Celiac disease. They found that Celiac disease is “markedly overrepresented” in this group, which at least suggests a link between the two conditions. 

Going Gluten-Free

Although Celiac disease was once considered very rare, new information suggests that the number of people with gluten sensitivity, gluten allergies, and gluten intolerance is growing. The association between gluten and ADHD is still under investigation. Given the promising results of recent preliminary trials, however, it may be worthwhile to explore a gluten-free diet if you or your child has been diagnosed with ADHD.

Adopting a gluten-free diet requires avoiding all products containing gluten: breads, pasta, cakes, seasoned snack foods, soups and soup bases, malt vinegar, etc. The challenge is to get enough fiber, vitamins, and minerals for complete nutrition. Since many grain products are enriched with vitamins and minerals, eliminating these foods may reduce your intake of these important nutrients.

Grocery stores are now stocked with all types of gluten-free products (although not all are healthy), so going gluten-free can be less of a challenge. Still, the diet takes dedication and consistency to maintain. If you believe a gluten-free diet may be an option for you or your child, first speak with your doctor or a dietician.

ADHD Cookbooks

  • Recipes for the Specific Carbohydrate Diet: The Grain-Free, Lactose-Free, Sugar-Free Solution to IBD, Celiac Disease, Autism, Cystic Fibrosis, and Other Health Conditions. Raman Prasad with Niloufer Moochhala. 2008; Rockport Publishers. 
  • The Low-Carb Cookbook: The Complete Guide to the Healthy Low Carbohydrate Lifestyle. Fran McCullough. 1997; Hyperion.
  • The Feingold Cookbook for Hyperactive Children (and others with problems associated with food additives and salicylates). Ben F. Feingold M.D. and Helene S. Feingold. 1979; Random House. 
  • The Autism & ADHD Diet: A Step-by-Step Guide to Hope and Healing by Living Gluten Free and Casein Free (GFCF) and Other Interventions. Barrie Silberberg. 2009; Sourcebooks, Inc.
  • The Kid-Friendly ADHD & Autism Cookbook, Updated and Revised: The Ultimate Guide to the Gluten-Free, Casein-Free Diet. Pamela Compart M.D., Dana Laake R.D.H M.S. L.D.N. 2009; Fair Winds Press.