Role of Nutrition in ADHD

Kate Hilliard, MS, RD, LD, CDE

About Me

Breastfeeding: First Line of Defense?

• Children with ADHD are less likely to have been breastfed and/or breastfed as long as non-ADHD children

• Dr. Mimouni-Bloch Study: Groups 3 months 6 monthsADHD 43% 29%Siblings of ADHD group (w/o dx):

69% 50%

Non- related kids (w/o dx):

73% 57%

Source: Duration of breastfeeding and ADHD. Mimouni-Bloch, et. Journal Breastfeeding Medicine. Retrieved 2017 www.everydayheatlth.com

Breastfeeding

Preschoolers BreastfedADHD 54%Non-ADHD 78%

Groups Nurse <1 mo. 1-5 mos. 6+ mos.ADHD 57% 20% 22%Non-ADHD 26% 28% 46%

Dr. Adesman Study's:

Source: Adesman, A., et. Pediatric Academic Societies. 2013. Data drawn from 2007 National Health Survey Retrieved 1/2017 www.everydayheatlth.com

Essential Fatty Acids - DHA

• Docosahexanoic Acid: cannot make internally• Matures and stabilizes cortical circuits, synaptogenesis,

myelin development• Preterm delivery assoc. deficits in myelin integrity sugg. >

risk for ADHD

Source: Role of perinatal long-chain omega-3 fatty acids in cortical circuit maturation: Mechanisms and implications for psychopathy McNamara, Vannest, Valentine. World J Psychiatry. 2015 Mar 22; 5(1): 15-34

Malnutrition: Gluten Allergy

• Damaged villi cannot properly process • Vitamin B6, B12• Folate• Iron• Vitamin D & K• Calcium & Magnesium

• Tryptophan and other monoamine precursors needed for the production of key neurotransmitters in the brain (serotonin, dopamine and norepinephrine)

Exercise

• Regular physical activity programs at school showed important enhancement of cognitive performance and brain function

• Exercise programs for kids remain underfunded and under prioritized in many school curriculum

• Exercise releases dopamine and serotonin• Does intensity or duration matter?

Your Brain on Exercise

Electrophysiological plots representing brain processing

• 12-week program improved kids math and reading test scores in all kids, but especially in those with signs of ADHD

• Just 26 minutes of daily physical activity for 8-weeks significantly relieved ADHD symptoms in grade-school kids

Source: Pilot Physical Activity Intervention Reduces Severity of ADHD Symptoms in Young Children. Alan L. Smith, Betsy Hoza, Kate Linnea, et. First Published August 25, 2011

Food Dyes

Food colors used:• 2 REDS – red 3, red 40• 2 BLUES – blue 1, blue 2• 2 YELLOWS – yellow 5, yellow 6• GREEN – green 3

ADHD and Red #40• For these children consuming this food coloring can

increase behavioral issues and lead to:hyperactivity attention problems irritability learning problems aggressiveness restlessness.

• Elimination diets can help up to 60% of children experiencing these symptoms

Foods Containing Red #40SprinklesFruit Snacks, Gummy Bears, Swedish FishHard Candies, Jolly Ranchers, Skittles, StarburstsCheetosGatoradeFruit Punch, Hi-C, Hawaiian PunchMountain Dew Code Red, Sunkist Orange, Cherry and Berry Yogurts

Breakfast Cereals: Lucky Charms, Fruity Pebble, Fruit Loops, TrixGelatinStrawberry Ice Cream Bars (Good Humor Strawberry Shortcake)Salad Dressings (Kraft Catalina)Hamburger Helper Lasagna Cake Mixes, Pre-made cakes and cookies

Are Food Dyes Necessary?

How Much is Too Much?

Feingold Diet

• He was aware of the historic change in prevalence of disease and behavioral problems in children during the early 1960s

• Eliminate synthetic colors, synthetic flavors and the preservatives BHA, BHT – and also a group of foods containing a natural salicylate radical.

• High salicylate foods: tomatoes, cucumbers, peppers, oranges, apples, berries, grapes, almonds, certain spices.

The Real World

Nutrition Recommendations• Fruits and Vegetables• Whole grains (unless Celiac’s or gluten intolerant) • Healthful unsaturated fats (emphasize omega 3) – olive oils, nuts,

fish • Good sources of protein – eggs, chicken, turkey, beans• go easy on unhealthy saturated and trans fats, rapidly digested

carbohydrates, and fast food• Plenty of physical activity

“Real World” Recommendations

• Individualize!!!• Parents may be desperate, open to more “extreme” diet• Encourage healthy eating throughout lifecycle • Rule out Celiac’s and gluten intolerance first• Eliminate artificial food dyes (esp. Red 40)• Get TONS of exercise – recess, sports, afterschool