"You are what you eat,” as the old adage goes.
Now, researchers from the Children's Memorial Hospital have found that a healthy diet may have a noticeable effect on children with attention-deficit hyperactivity disorder (ADHD). The findings will be published in the February issues of Pediatrics.
ADHD is a neurobiological condition that causes inattentiveness, restlessness and impulsive behaviour thought to affect between 5 and 8 per cent of school-aged children in the US. Research supports the use of medications, but parents may prefer to use alternative approaches without medications, sometimes because of concerns about side effects.
Several diets have been tested among children with ADHD, including sugar restrictions, avoiding food additives and preservatives (the Feingold diet), avoiding foods to which people are commonly allergic (the hypoallergenic diet), and supplementing with micronutrients, such as omega-3 fatty acids.
The researchers’ review of the medical literature shows that there is little evidence to support the Feingold or the influence of sugar or sweeteners on children’s behaviour. There is, however, mixed evidence on the effectiveness of the hypoallergenic diet, which would require cutting out cow's milk, cheese, wheat cereal, eggs, chocolate, nuts and citrus foods, says author, Dr. J. Gordon Millichap, in USA Today. By the same token, hypoallergenic diets are difficult for both children and families to manage effectively.
The findings on sugar are particularly interesting, given the public perception of sugar’s exacerbation of hyperactive behaviour. Studies linking sugar consumption and ADHD have faced methodological compromise. One study cited gave children sugar or placebo alongside a high-carbohydrate meal, potentially causing a reaction to sugar. A study in which children consumed the sugar alongside a protein meal, on the other hand, did not cause hyperactive behaviour.
Other studies indicate that attention has been improved by omega-3 or iron supplements. Australian researchers, for instance, found that children consuming healthy diets rich in fish, veggies, fruit and grains with enough fiber, folate and omega-3 fatty acids were less at risk of ADHD that children eating high-sugar and fat—“Western”—style diets.
Omega-3 fatty acids are one of the “good” fats common in fish and plant oils, such as salmon or flax. Getting your daily recommended intake can help reduce the risk of cardiovascular health problems, among other benefits.
Still, "in almost all cases, for treatment to be managed effectively, medication is also required," the researchers note. "The beneficial effects of omega-3 and omega-6 supplements are not clearly demonstrated … Supplemental diet therapy is simple, relatively inexpensive, and more acceptable to patient and parent.”
Dr. Roberto Lopez-Alberola is the Chief of Paediatric Neurology at the University of Miami School of Medicine.
“I am a firm believer that we ultimately are what we eat, and unfortunately as a result of our poor Western diet, we see this in the increase in the rate of obesity, particularly in the young population,” he said in USA Today. This would also have neurodevelopmental impact, he added.
Last month, Ontario’s Ministry of Education affirmed that children with ADHD are entitled to special learning supports if their condition interferes with their learning. ADHD affects about 5 per cent of the province’s 2.1 million school-aged children, but had not generally been regarded as a learning disability meriting special education.
According to the memorandum issued, “Some of the areas in which a student with ADD/ADHD may have demonstrable learning needs include (but are not limited to) attention/focus, organization, processing speed, working memory, executive functioning weaknesses, mathematical processes and skills, and expressive and receptive language.”
"This is definitely a step in the right direction,” said Heidi Bernhardt, National Director of the Centre for ADHD Awareness Canada, in the Toronto Star.