Tics are a common symptom in children with a wide variety of neurodevelopmental disorders.
What are tics?
They consist of repetitive movements, twitches, and/or sounds, and can vary in frequency and intensity over time. Tourette Syndrome is the diagnosis given when multiple motor and vocal tics have been present for at least a year. Many children with Tourette Syndrome or tics have other neurodevelopmental conditions such as ADHD, obsessive-compulsive disorder, learning disabilities, and autism spectrum disorder. In this article, we will detail some dietary interventions for Tics and Tourette Syndrome.
What are some typical treatments for tic disorders?
Typical treatments include psychiatric medication and habit reversal therapy. While some children improve with these treatments, the majority of children continue to struggle with symptoms over time. The medications used for patients with tics, such as Risperdal and Abilify, can cause significant negative side effects including fatigue, depression, anxiety, weight gain, diabetes, and permanent movement disorders.
Could changing the diet help?
There is research on nutrition as treatment for many neurodevelopmental conditions, but few have looked at nutrition (or dietary intervention) as a treatment for tic disorders. The few case studies and papers that have been published show the potential for food and nutrients to positively impact symptoms, and point to the need for larger scale studies to look at these issues. Many parents and patients report improvements in tics and other symptoms with various dietary changes.
Parents are often interested in exploring non-medication options for their children that actually treat the root causes of the disorder without side effects. While we wait for more studies to be conducted in this area, here are several research-supported dietary strategies parents may want to consider for children with tics:
Reduce refined sugars:
Sugar has been shown to worsen many symptoms of neurodevelopmental disorders, as it causes blood sugar instability that can lead to mood swings, inattention, hyperactivity, and more. Research has shown that sugar intake increases dopamine in the brain, which then causes the brain to reduce dopamine production and receptor function. This is an important issue to consider for tic disorders, as they are associated with dysfunction in the dopamine system in the brain. Children who consume more refined sugars in their diets may experience increased tics.
A study looking at the impact of various foods and beverages on adults with tic disorders showed that increased sugar consumption worsened tics. Specifically, the adults in this study noted that drinking Coke and/or ingesting foods made with white sugar significantly worsened tic symptoms. Reducing or eliminating refined sugar intake is a safe and appropriate strategy that parents can implement to assess symptom response in children. This article goes into a bit more depth on the effects of sugar and brain health.
Caffeine is a stimulant commonly consumed in coffee, tea, and energy drinks. Stimulants, including stimulant medications such as Ritalin, have been found to increase tics in some people. A study of adult-reported responses to foods and drinks found that caffeine significantly worsened tic symptoms. Parents are advised to restrict caffeine intake in children as a general health recommendation. For children with tic disorders, it is wise to avoid caffeine given the negative impact it can have on symptoms.
Tics are associated with gluten consumption in some children and adults. Tourette Syndrome specifically, and tic symptoms more generally, can be caused or exacerbated by consumption of gluten even when celiac disease is not present. Celiac disease and wheat allergy are connected to many neuropsychiatric conditions and symptoms. However, it is now recognized that non-celiac gluten sensitivity (NCGS) is a more common problem. NCGS is the term used to describe the presence of symptoms caused or exacerbated by gluten exposure in people who do not have celiac disease or an allergy to wheat. It is estimated that 5-10% of the population develop gut and neurological symptoms related to gluten without testing positive for celiac disease. Symptoms of NCGS are very similar to celiac and can include abdominal pain, irritable bowel symptoms, bloating, rashes, headaches, and many other neurological issues.
While there are no large-scale studies of gluten-free diets in children or adults with tic disorders, published case study results show that a gluten-free diet can reduce or eliminate symptoms in some children with tics. Based on reports from parents, and published case studies, a gluten-free diet trial makes sense in cases where other approaches have not improved symptoms.
Increase Omega-3 Fatty Acids:
There are many studies showing the benefits of increased Omega-3 fatty acid intake in children with neurodevelopmental disorders. The one study that has been done to date on children with Tourette’s Disorder showed an improvement in tic-related symptoms, although not all children experienced a reduction in tics. Given the research evidence that Omega-3 fatty acids support brain health and function in children with a wide range of neurological symptoms, increasing Omega-3 consumption is a logical nutritional approach that parents can try. Dietary sources of Omega-3 fatty acids include foods such as salmon, tuna, sardines, flax seeds, walnuts, and grass-fed beef. Here’s a more in-depth article on foods that are high in Omega-3’s. Omega-3 supplements with DHA and EPA allow for the higher dosing that many children require for symptom reduction.
Tics can negatively impact a child’s ability to function in all areas of life. Since medications and specific counseling approaches generally do not fully resolve symptoms (and may cause significant negative side effects), parents are wise to consider alternative options that are safe and potentially effective. Dietary strategies hold significant promise for addressing not only tics but the other symptoms these children often exhibit.
Have you used any dietary interventions to treat your child’s tics? What have you found helpful or unhelpful? Please share your experiences in the comments below so other families can benefit.