This week’s question is from Monica,
“My seven-year-old son has been diagnosed with ADHD, and I do recognize that the diagnosis describes the symptoms he has: poor attention, especially in school, problems managing his emotions and behaviors, he doesn’t think before he acts a lot of the time. But he’s also very smart and quite talented with art, and he really enjoys playing sports. I’m considering all of the treatment options, and want to try as many non-medication supports as I can before deciding if we want to try prescription medication. I’ve heard about food changes that can improve symptoms of ADHD, but I’m not sure what information to believe or really where to start. I trust you as a source of accurate information, so I’d love your thoughts on this.”
In this episode, I will address the important role nutrition and diet play in ADHD or any type of behavior challenges. Plus you’ll learn my 5 key food strategies to start improving symptoms. You may want to take notes. It helps to try these things in a stepwise approach rather than trying everything all at once.
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Food Effects on Brain Function
- Food, no matter the age, plays a significant role in every aspect of brain function and mental health
- That has been shown repeatedly in the research literature for the general population as well as those with neurodevelopmental challenges
- Food provides nutrient building blocks for every process in the brain and body from neurotransmitters and hormones that play a role in mood, anxiety, executive function, behavior, to allowing our metabolism and detoxification systems to work properly
- Research has also shown that some symptoms of ADHD can either be caused directly by the food that we’re eating, or exacerbated/worsened by foods, especially with specific added chemicals in foods that many kids are eating today
Research-Based Food Approaches for Mental Health
- The condition that we call ADHD has a lot of underlying factors that contribute to causing those symptoms, but regardless, proper nutrition is a foundational building block to support all aspects of mental health and brain function
- Resolution of ADHD symptoms depends on a whole host of individual factors, however, the significance food plays is a massive part and should not be overlooked
- Focus on increasing the amount of nutrient-dense whole foods in the diet, i.e., foods in their natural form: such as an apple, piece of steak, a carrot, etc.
- Research shows increasing the amount of these nutrient-dense whole foods in a child’s diet is associated with a lower risk of ADHD symptoms as well as improvements in those diagnosed
- Not all processed foods are “off-limits”. There are some healthy processed foods in bags, boxes, and cans that are nutrient-dense and even organic; less processing the better.
Reducing Ultra-Processed Foods
- Ultra-processed foods provide calories for energy, but they don’t provide any nutritional information that the brain and the body needs
- Ultra-processed foods don’t provide many of the nutrients our brains and bodies need: often stripped of macronutrients, fibers, vitamins, and minerals, and instead added chemicals and sugars to improve shelf-life and palatability
- Companies often add multiple types of sugar into processed foods such as high fructose corn syrup, corn syrup, glucose syrup, etc.
- Tip: Reduce the overall amount of ultra-processed by reading the nutrition fact panel and ingredient list:
- Check total sugars and added sugars; reduce or eliminate the added sugars
- Avoiding products with artificial food dyes, artificial sweeteners, and chemical preservatives
- These three ingredients are most often found in the research to be tied to ADHD symptoms
Connection Between Food Allergies and Sensitivities
- Some kids depending on their bio-individuality, their genetics, their bodies, specific foods can cause immune reactions that negatively impact brain function -It doesn’t need to be a frank allergy to food
- Can show up in their behavior, sleep, as hyperactivity or poor attention
- Negative reactions to foods may be delayed and may not have any physical symptoms such as digestive upset or rashes
- The most common food culprits that cause neurological symptoms are wheat and gluten, dairy/cow dairy, eggs (primarily chicken), corn, food dyes, a food category called salicylates
- Examples of foods that contain salicylates: honey, almonds, several types of fruits and vegetables, some spices such as cinnamon
- Some kids can have sensitivities to those, especially in higher amounts, this has been shown in research
- Is your child eating or constantly craving a lot of any of the aforementioned foods?
- Constant cravings may be a tip-off to having some negative immune reaction to that food. Why? The proteins in that specific food are essentially creating an addictive cycle in their brain.
- Tip: If you are curious if there is a connection between specific foods/food categories and your child’s symptoms, try an elimination diet
- Often parents and kids benefit from professional support around implementing an elimination diet to really do it well and to figure out really what’s going on
Stabilizing Blood Sugar is Critical
- When blood sugar levels are spiking and crashing throughout the day, which is typically the result of eating a high sugar, low nutrient-dense diet, it negatively impacts the ability to focus, learn, and manage emotions and behaviors
- Common breakfast examples that would cause this include flavored milks, muffins, juices, etc.
- Symptoms of blood sugar dysregulation in children may look like hyperactivity, impulsivity, foggy-headed, crashing 60-90 minutes later, irritability, resistance, moodiness, fatigue, lack of focus, etc.
- Tip: Make sure all meals and snacks are a combination of fiber, protein, healthy fats and avoid/reduce added sugars
- Set them up for success by starting at breakfast to give them the nutritional building blocks to focus at school. Examples like eggs, whole grain toast with nut butter, protein shake, etc.
Improve Omega 3 Fatty Acid Levels
- Research shows that kids with ADHD and those types of symptoms tend to have lower levels of omega 3’s that are needed for proper brain structure and function
- Focus especially on foods high in DHA and EPA
- Incorporate more fatty, cold water fish like salmon, tuna, sardines, grass-fed beef
- There’s an article on my website, search “omega 3” with tips to get your child to eat them
- For vegetarian/vegan options try chia seeds, flax seeds, and some nuts. Although, they are not DHA and EPA, but the body can convert some of them
- Supplementing with quality fish oil or omega 3 supplements can also be helpful
How To Learn More About Food and Nutrition-Focused Tools
- Check out my new Better Behavior Diet Workshop on my website: drnicoleworkshops.com
- The workshop can be applied to the entire family but it focuses on food/nutrition tools to support your child’s brain function, improve their symptoms (mood, anxiety, attention, etc.), overall behavior, and school performance
Episode Intro … 00:00:30
Food Effects on Brain Function … 00:02:30
Research-Based Food Approaches for Mental Health … 00:05:50
Reducing Ultra-Processed Foods … 00:10:40
Connection Between Food Allergies and Sensitivities … 00:14:50
Stabilizing Blood Sugar is Critical … 00:18:35
Omega 3 Fatty Acid Levels … 00:23:08
Episode Wrap up … 00:26:40
Dr Nicole Beurkens:
Hi everyone, welcome to the show. I’m Dr. Nicole, and today I’m answering a question from one of you. I get a lot of questions about nutrition and supporting kids in general, as well as how to use nutrition for specific symptoms and conditions. So today in this episode, we’re going to focus on food and ADHD symptoms. This information is relevant to any of you with a child of any age, diagnosed with ADHD. But it’s also really relevant for any of you who have kids with any type of challenge with attention and focus, impulsivity, hyperactivity, executive function, managing emotions and behaviors, even if they don’t have a diagnosis or you don’t feel like the problems rise to the level of needing some kind of specific evaluation or intervention. Honestly, everything that I’m going to share with you on this topic is appropriate and important for all kids, if we’re interested in helping them be as healthy as possible, both physically and mentally.
Okay, so let’s dive in with today’s question which comes from Monica. She writes: “My seven-year-old son has been diagnosed with ADHD, and I do recognize that the diagnosis describes the symptoms he has: Poor attention, especially in school, problems managing his emotions and behaviors, he doesn’t think before he acts a lot of the time. But he’s also very smart and quite talented with art, and he really enjoys playing sports. I’m considering all of the treatment options, and want to try as many non-medication supports as I can before deciding if we want to try prescription medication. I’ve heard about food changes that can improve symptoms of ADHD, but I’m not sure what information to believe or really where to start. I trust you as a source of accurate information, so I’d love your thoughts on this.”
Well, Monica, thank you for trusting me to provide you information on this topic. I appreciate that and hope that I can give you some research-based ideas and tools that will be helpful. So let’s focus on food here as it relates to brain function in general, and understand the foundational big picture principle here, which is that the food that we eat, the food that our children eat, does play a significant role in every aspect of brain function and mental health. That has been shown repeatedly in the research literature on both the general population of children and adults, as well as for children, teens and adults with specific, either neurodevelopmental or mental health conditions. So that is not in question anymore. We completely know and have a research basis that shows that the food that we eat has a major impact on how our brain functions and the symptoms that we might be experiencing at the level of the brain. So it’s important to understand that. Now, what’s really going on there? Why does it play that big of a role? Well, food provides the nutrient-building blocks that we need for every process in the brain and the body to work properly. So that includes everything from making things like neurotransmitters and hormones that play a role in mood, anxiety, executive function, behavior, those kinds of things, to allowing our metabolism to work properly, to allowing our detoxification systems to work properly. Every single function that our brain and our body need to do on a moment-to-moment basis is fueled by the nutrient building blocks in the food that we’re eating. And a lot of people are not eating diets that provide enough of those nutritional building blocks through their food. And when we don’t do that, our health and our functioning suffer. That’s a really important principle to understand. Kids can be eating food all day long, but depending on what the food is, the quality of the food, the quality of nutritional information, those nutrient building blocks, they may have the building blocks that they need to allow their brain to function optimally, or they may not. So we need to really be thinking about that. Research has also shown that some symptoms of ADHD can either be caused directly by the food that we’re eating or can be exacerbated or worsened by foods, especially specific chemicals and things like that in foods that many kids are eating today. So we’ll talk a little bit more about specifically what those chemicals are later, but these are the big picture things to understand here, that even if your child isn’t struggling with any specific symptoms, food plays a big role in allowing their brain to function optimally and in supporting their mental health. And if your child is having symptoms, difficulties, challenges — even more of a reason to focus in on food as at least one of the factors that may be contributing to the symptoms, or at least can help improve those symptoms. So food is a really important thing to be looking at.
So let’s talk about some of the research-based approaches around food that you can take to support your child’s mental health and brain function, and to potentially reduce ADHD symptoms, and I say potentially because there are so many root causes of ADHD symptoms. The condition that we call ADHD has lots and lots and lots of underlying factors that contribute to causing those symptoms, and honestly, they can be so different from one child or one person to the next. I say potentially because I think that food and nutrition is a foundational building block to support all aspects of mental health and brain function, but whether or not it’s going to completely resolve your child’s ADHD, that depends on lots of individual factors, but it certainly is an important foundation to work on, regardless of what those individual factors are. So what’s the number one thing that the research shows us can make a positive difference for kids with ADHD and related kinds of symptoms and issues? It is to increase the amount of nutrient-dense whole foods in the diet. So let’s break that down a little bit. What are we talking about with whole foods? We are talking about foods in their natural form. So whole foods are things like a piece of steak, a piece of fish, a shrimp, an apple, a banana, carrots, peppers, whole grains, these are whole foods. They are foods that have not undergone lots of processing, don’t have added ingredients and things to them. They are foods in as close to their natural form as possible. Obviously, with some of these things, we do some processing to them, even in the cooking of them, but we are talking about foods in as close to their natural form as possible because those are the most nutrient-dense. The more we process foods, the more ingredients and things we add to them, the more we are taking away from how nutrient-dense, or the quality of those nutrients. So whole foods are foods eaten in their natural form, and those are the most nutrient-dense foods. So an example would be thinking about an apple, your child eating an apple, that’s a nutrient-dense whole food, it’s got all of the vitamins, all of the phytonutrients and antioxidants, all of the fiber, all of those things in the apple itself. Compare that to maybe a processed apple juice, or an apple-flavored fruit snack, which may have apples in the ingredient list somewhere, but are also going to have a lot of other things added to it, or even in the case of a natural or organic apple juice where literally they’re just using the juice and the natural sugar from the apple itself, you’ve now stripped away all of the fiber from those apples that really is important for helping to balance the amount of sugar that is naturally in an apple. So it’s important to think about that. We want as many of the benefits and the nutrient density that comes in those whole foods as possible because remember, the whole foods do contain those nutrient building blocks that your child’s brain relies on to function properly, and we know from studies that have been done that when we increase the amount of these nutrient-dense whole foods in a child’s diet, that is associated with a lower risk of ADHD symptoms. So kids who eat a more nutrient-dense, more whole foods-focused diet are far less at risk of having ADHD symptoms. We also know that when we take kids who are exhibiting symptoms of ADHD, and we shift them to a more whole foods nutrient-dense kind of diet, their symptoms tend to improve. So that’s where you want to focus here, whole foods. Now that doesn’t mean that you can’t have any processed food in your child’s diet. In fact, there are some processed foods out there, foods in bags and boxes and cans and things, that actually are nutrient-dense or even organic now, that are good convenient options. But we want to be mindful of staying away from foods that are not as nutrient-dense. Another example, I think, that comes up a lot is in terms of bread kinds of products. Thinking about a bread that has whole grains in it, which has all of the fiber and a lot more of the nutrient density than something like white bread which has a lot of the fiber stripped away, a lot of the nutrients and things that would naturally occur in the grain stripped away. So again, we’re looking at the less processing the better.
This brings us to strategy number two for how we can use food to support ADHD symptoms, and that is to reduce the amount of ultra-processed foods in your child’s diet. Now, what is ultra-processed food? Ultra-processed foods are those packaged kinds of foods, they’re made in factory kinds of settings, that have lots of ingredients added to them, that have lots of things stripped away from the grains and things that are used in them, usually contain a lot of chemicals and artificial ingredients, and the whole point behind that, the reason companies do that is to make them shelf-stable for long periods of time without spoiling. So if you pick up a product, and it’s got like a two year expiration date, you’re probably going to look at the list of ingredients on there and see a lot of chemical preservatives and a lot of other things that are making it shelf-stable for that long. So ultra-processed foods — again sort of draws the distinction between more minimally processed foods and the really problematic ones, because as I said, there are more and more companies making convenience-type packaged foods. They are processed, but they aren’t what we would consider ultra-processed, where they’ve got all of these extra chemicals, ingredients and things, and very, very low nutrient density. So the issue with these ultra-processed foods is that they really don’t provide many of the nutrients our brains and bodies need. They are okay from an energy standpoint, kids and adults can survive and live on them. In fact, many do, because they have calories in them. They provide a lot of sugar for energy. But from a nutrient building block standpoint, which is what we’re focused on here, they really don’t bring much to the table. They have a lot of the fibers and other important macronutrients even stripped away from them, they’re not providing a good amount of that, and they’ve got a lot of the vitamins and minerals stripped away. And then they have a lot of added chemicals, which can create problems. So important to be thinking about that. Also, a lot of them have a ton of added sugar, whether that’s high fructose corn syrup, or now, food companies are getting smart to the fact that people are staying away from high fructose corn syrup, so they’re adding any number of other things: Corn syrup, glucose syrup, lots of sweeteners and things, and these really create problems because, yeah, they provide calories for energy, but they don’t provide any of that nutritional information that the brain and the body needs. So specifically, we want to be looking at the sugars and the chemicals in these kinds of foods, and looking to reduce the overall amount of ultra-processed foods in our child’s diet, but really looking to lower the amount of added sugars. So looking at the nutrition facts label, and where it says total sugars and then added sugars, really trying to reduce or eliminate those added sugars. That’s a great starting point and number on those labels to be focused on, but also looking at the ingredient list and avoiding things that have artificial food dyes in them, artificial sweeteners, chemical preservatives. Why these three? Because these are the three, most often in the research literature, that have been tied, to connected to ADHD symptoms. We know that some kids have major sensitivities to food dyes, to these artificial sweeteners like aspartame, acesulfame, potassium, those kinds of things, and chemical preservatives, things like sodium benzoate, and other types of preservative chemicals. So we really want to limit or avoid those altogether, and luckily today there are many more, as I said, convenience, kid friendly kinds of products that are being made without these dyes, sweeteners, and chemical preservatives. So that’s what you want to watch for because there’s so much research connecting ultra-processed food intake to virtually every kind of physical and mental health problem in kids and adults. So we really want to look at reducing those.
Also, another thing here to be thinking about, our third strategy or topic around food and ADHD symptoms, is to be thinking about the connection between food allergies and sensitivities, and these kinds of symptoms. There absolutely are specific foods that in some kids depending on their bio-individuality, their genetics, their bodies, can cause immune reactions that negatively impact brain function. So thinking about that. Sometimes kids do have food allergies that have never been identified because people think about allergy as being something like developing immediate hives or breathing issues or things like that, but a child can have a frank allergy to a food, and it can show up neurologically. It can show up in their behavior, in their inability to sleep, in their hyperactivity, in poor attention, those kinds of things. So you want to be aware of that. But even kids who don’t have allergies may have sensitivities where their body is having a delayed negative reaction, and it’s showing up in the brain, because you need to know that you can have negative neurological responses to foods without any obvious physical symptoms. A lot of times people say, “Well, I don’t think my child has any food allergies or sensitivities because they poop fine, they don’t complain of having bloating or stomach pain, any of those things. So it must not be an issue. They don’t have rashes.” Well, those are one of the ways that food allergies and sensitivities show up, but they can also show up in those neurological symptoms, and the most common culprits in my experience, working with kids now around this for many years are wheat and gluten, dairy, cow dairy — so, milk, cheese, those kinds of things. Eggs, primarily chicken eggs, corn, food dyes, and a category of foods called salicylates, which are things like honey, almonds, several types of fruits and vegetables, cinnamon and some other spices. Salicylates is one that we have some research on showing that kids can have sensitivities to those, especially in higher amounts, and it can lead to significant ADHD issues, mood and behavior problems, those kinds of things. So those are the most common ones that I see. If your child is eating a lot of things in one of those categories, one of the tip-offs to me is if a child craves something like dairy. If they’re drinking all the milk, they want cheese, they want yoghurt all the time, or a lot of carbs, which are primarily made with wheat or corn, those carb products. They want to eat all the cereal, all the pastas with butter all the time, those kinds of things. Those are tip-offs that your child may be having some negative immune reaction to that. It’s creating almost this addictive cycle in their brain with the proteins in those foods. So some things to think about there. You want to consider if there’s categories or specific foods your child eats really regularly, and then you want to consider what might happen with their ADHD symptoms, with their behavior, with their brain function in general, if you reduced the amount of those in the diet or avoided them all together for a period of time. There is a specific approach that we use for this called an elimination diet that can be helpful. I will say that often, very often, parents and kids benefit from professional support around implementing an elimination diet to really do it well and to figure out really what’s going on there. So that’s something important for you to be aware of that there may be connections between specific foods or categories of foods, and your child’s symptoms.
Okay. Number four, thinking about food and symptoms, is the importance of stabilizing your child’s blood sugar levels. I’ve talked about this in a few episodes before. I’ve got several videos and things available on my website around this. You have to understand that when kids are having blood sugar levels that are spiking and crashing throughout the day, which is typically the result of eating a high sugar, low nutrient-dense diet, it absolutely negatively impacts their ability to focus, learn, manage their emotions and behaviors in all environments. So what’s an example of that? Well, a child who maybe eats cereal or a pop tart or a muffin or a sugary protein bar or something like that for breakfast, maybe they have juice with their breakfast too, or flavored milk or something like that, their blood sugar is going to spike, which may feel really good in the moment to them, but for some kids, that makes them very hyperactive, very impulsive, very foggy-headed, but they have this blood sugar spike, and then 60 to 90 minutes later, when the body has worked through managing with that huge amount of sugar that got dumped into the system, then they have a crash, because foods that are high in those simple starches and those sugars, they don’t stay with you. So then you crash and then you have irritability, resistance, moodiness, fatigue, fogginess, inability to pay attention, those kinds of things. And so then they may be eating a sugary kind of snack or a simple carb-focused snack or something like that, and again, they just go all day long in this blood sugar roller coaster, which we know from the research absolutely has a negative impact on all aspects of brain function and behavior. So one of the simplest and best ways we can support focus and attention, more even-keeled mood, more even-keeled behavior is to keep those blood sugar levels stable throughout the day. That means reducing or avoiding foods with high amounts of added sugars. Got to get rid of all those things that have big amounts of the added sugars. And then you want to think about blood sugar-stabilizing snacks and meals as a combination of protein, fiber, and healthy fats. That’s your magic combo there to keep those blood sugar levels stable. That combination helps the body more evenly and slowly burn through the food that kids are putting in their bodies so that they can function in a more stable and consistent way.
So what would be some examples of that, let’s say like for snacks? So some blood sugar-stabilizing snacks would be things like apples with nut butter. We’ve got fiber in the apples, we’ve got protein and healthy fat in the nut butter. Something like guacamole with carrots or guacamole with whole-grain chips or crackers. Guacamole, we’ve got some protein but we’ve got a good amount of healthy fat, and then in the carrots, we’ve got some of our carbs, but they’re slow-burning carbs. We’ve got whole grain chips or crackers. Again, they’ve got the fiber in them that’s going to allow the body to burn through them slower. Or something like a trail mix with whole-grain granola, pumpkin seeds, raisins, nuts, and coconut chips. Nice blend thereof slower-burning carbs, because they’re whole grains, we’ve got fiber in lots of those components of that, we’ve got some protein in there, there in our pumpkin seeds and our raisins. So that’s how we’re thinking about building snacks and meals to stabilize blood sugar. And there’s lots of examples of how to do that. But I just wanted to throw those out there for you. The goal is to keep your child off the blood sugar rollercoaster as much as possible by feeding them nutrient-dense, balanced options, especially important in the morning before school. Starting the day with protein and those blood sugar-balancing foods gives kids the building blocks they need to focus and learn in the classroom. So important to think about that, instead of the sugary cereals and the muffins and the toaster pastries, and all those kinds of things that kids like to eat in the morning, focusing on whole-grain toast with nut butter, focusing on eggs, sausages. For older kids may be on the go, a nutrient-dense, low sugar protein bar, or even a protein shake, something like that. We have got lots of ideas, recipes, tips, and stuff on my website that you can access around that.
Okay, last strategy here: Improving omega 3 fatty acid levels, especially the omega 3 that’s called DHA and EPA. Research has shown that kids with ADHD and those types of symptoms tend to have lower levels of omega 3’s that are needed for proper brain structure and function. So when we increase these levels, the research has also shown that the symptoms can improve. And there have been many studies done on this now. So how do you increase these specific omega 3 fatty acid levels in your child’s diet? You incorporate more fatty, cold water fish like salmon, tuna, sardines, those types of things. Now, you might be thinking, “Dr. Nicole, my child is not going to eat sardines.” Okay, I get it. There is an article on my website that you can go to, if you just type “omega 3” in the search bar, I have lots of tips for incorporating these high omega 3 foods into your child’s diet so they will eat them. So we’re looking at, again: The salmon, tuna, sardines, and also grass-fed beef has a good amount of these omega 3’s. And then we can also support healthier omega 3 levels with chia seeds, flax seeds, and some nuts. Those are ALA types. They are not DHA and EPA, but the body can convert some of them. So putting chia seeds or flax seeds in granola or trail mix, or a protein smoothie, or sprinkling it on oatmeal, or applesauce, or something like that is a way to boost that as well. So those are ways we can do that through food, and then obviously there are fish oil supplements and omega 3 supplements that I use quite often as well. That’s the topic for a different episode because we’re focusing on food here, but again, I want you to be aware that these foods are shown in the research to really support your child’s brain function, and particularly around reducing ADHD kinds of symptoms.
So those are the five key food strategies that I wanted to cover with you today. If you’re interested in learning more about food tools, nutrition-focused tools to support your child’s attention, anxiety, mood, behavior, all of those kinds of things, you might be interested in checking out my Better Behavior Diet Workshop, which is on my website. You can go to drnicoleworkshops.com, and you can access that. I get into a lot more of the specifics around foods, nutrients, and also the how to eat. Because it’s not just what to eat. There’s how to eat, and there are strategies around how we feed kids, both in terms of the timing and consistency of when we present the food, as well as how we are having them approach eating and routines and those kinds of things. So regardless of your child’s diagnosis or age, these tips and strategies that I talk about in the Better Behavior Diet Workshop are applicable to the whole family. I also give tips and information on actually being able to implement them with less power struggles, what the roles are that you as parents need to focus on, and then what you need to let your kids handle, so being clear about that and the boundaries around that, and even some things for picky eaters as well. So this is a really good foundational workshop if you want to understand how to use food to support your child’s brain function, to improve their symptoms, their overall behavior, school performance, all of those things, check out that Better Behavior Diet Workshop. I hope that the information in today’s episode has been helpful for Monica and all the rest of you looking at how to use food to support your child’s brain function and mental health. Remember, if you have a question you’d like to hear answered on a future show, email it to email@example.com, and we will cover that on a future episode. Thank you, as always, for listening, and I will catch you back here next time.