Diet and ADHD

Some children with Attention Deficit/Hyperactivity disorders (AD/HD) experience food sensitivity to a number of foods. In these children, dietary modification can result in improvements in some of the associated symptoms & behaviours such as inattention, distractability, moodiness, impulsivity, hyperactivity, sleep disturbances and/or gastrointestinal symptoms (unexplained tummy pain, constipation, diarrhoea). There is no evidence to suggest that substances within the diet cause these problems in the first place, but rather they aggravate the underlying condition in susceptible children.

These adverse responses to foods are often called food sensitivity, food chemical sensitivity or food intolerance.

Which foods?

The original focus with ADHD was on food additives such as colours and preservatives and their effects on hyperactivity. But it is now evident that a wide variety of food substances can trigger a range of unwanted effects in susceptible children with ADHD.

The food chemicals involved in food sensitivities are found in many different foods. They include many of the additive chemicals found in junk foods and some healthy packaged foods, plus some of the natural chemicals found in healthy foods such as fruits and vegetables. Limiting junk foods and packaged foods is a good starting point, but for some children this will not be enough.

Over the past 10-20 years there has been a vast increase in packaged and processed foods, a move away from eating fruit and vegetables seasonally, and an increase in highly concentrated forms of certain foods such as sauces and fruit juices. This has meant that many children today receive a much higher “body load” of additive & natural food chemicals than ever before and for some children this is bad news.

Food additives

Food additives which may trigger unwanted behaviours or symptoms in children include

  • artificial colours
  • preservatives
  • flavours

To view the Official Shopper's Guide to Food Additives & Labels click here.

For more information on these additives click here.

Natural Chemicals in foods

Some of the natural chemicals found in common foods, including organic foods, can also trigger problems in some children. These natural chemicals include

  • salicylates in many fruits, fruit juices & vegetables
  • amines in foods such as chocolate, citrus fruits & mature cheeses
  • glutamates in foods such as tomatoes, mushrooms & soy sauce

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These natural chemicals are an important part of foods as they add flavour or smell to foods, are involved in the ripening process or provide natural pesticide defence in the case of fruits and vegetables. But for some children they trigger unwanted symptoms or behaviours, particularly if eaten in large quantities.

Wheat and milk

In children who are particularly food sensitive, problem behaviours or symptoms may be aggravated by whole foods such as wheat or milk. It is important to consult the dietitian before excluding these foods long term as nutritional problems can occur.

Sugar

Sugar frequently gets bad press as it is incorrectly reported to be linked to adverse behaviour in children. There is very little evidence to support this connection but it is easy to see how the confusion arises because many high sugar foods also contain additive colours, flavours, salicylates or amines which are the more likely suspects. Of course, whether sugar affects behaviour or not, most children should eat fewer sugary foods for nutrition reasons.

Which children?

Not all children with ADHD have food sensitivities and it is not yet clear what percentage of children are adversely affected by food substances.

It is also not yet possible to predict the likelihood that food sensitivity is aggravating the underlying condition in a particular individual, although there is some evidence that a child is more susceptible to food sensitivity if

  • There is a history of allergies or food intolerance in the child or immediate family
  • There is eczema, migraine, or irritable bowel syndrome present in the child or immediate family
  • The parent/s can give a specific example of food causing a definite change in symptoms or behaviour of their child at some time

Some children without this history will also benefit from dietary investigation

Food sensitivity is not always obvious

Most parents are unaware that food is playing an aggravating role in their child’s condition for the following reasons

  • Children with food sensitivities often have problems with a number of food substances
  • If the offending foods areeatenregularly the symptoms or behaviours can appear to be chronic
  • Reactions often do not occur immediately and can occur until up to 72 hours after eating the food/s
  • Individuals havetheir own "threshold" of tolerance so may not react every time the food is eaten

All these factors make identification of specific food triggers difficult for parents.

Fussy Eaters

Some children with ADHD are fussy eaters and this may be exacerbated by undiagnosed food sensitivities. Once the offending foods have been identified and excluded from the diet, some children experience improved eating habits and accept a wider range of foods.

Restrictive eating can affect nutritional intake so it is important to consult the dietitian for nutritional assessment and advice on strategies to encourage a greater variety of food. Some guided changes can make a difference over time.

For more information on Fussy Eaters click here.

Where to start

A good starting point is to limit junk foods and packaged foods which means more foods prepared in the home. By doing this you will decrease the body load of food chemicals, particularly additive food chemicals.

For some childrenitwill benecessary to consider a wide range of food substances. Food sensitive individuals vary in their reactions to different foods and food chemicals, so there is no simple diet that suits everyone. This means that all children respond differently, regardless of their presenting issues, so it is essential to identify the specific dietary triggers for your child to avoid unnecessarily over-restrictive diets which can lead to nutrtion problems.This is best done with the help of dietitian experienced in this area.

For more on the Food Sensitivity Assessment Program click here.

To make an appointment with the Dietitian please click here.

In a recent article in the Courier Mail, Professor Andrew Kemp from the Children's Hospital at Westmead, in Sydney, said there was good scientific evidence that preservatives and colourings increased hyperactive behaviour. Click here to read the full article on the website