Diet and Other Health Factors May Contribute to ADHD Problems in Children - Recent Scientific Findings

How and what health issues such as diet, sleep, and exercise may contribute to ADHD behavior in children.

An Interview with Joel Nigg, PhD author of Getting Ahead of ADHD

What does science now say about diet and ADHD?

Despite some weaknesses in the data, I think we have an emerging consensus on the following points about diet and ADHD:

  1. Omega-3 fatty acid supplementation in the diet can provide a partial help to ADHD symptoms, although it is unclear if this is only in children with low blood levels to start with.
  2. Avoiding synthetic food additives in the child's diet — synthetic colors, preservatives — can provide a partial help to a subset of children with ADHD.
  3. A subset of children with ADHD - perhaps as many as 25% - will benefit from a dietary intervention, ranging from avoiding synthetic additives to avoiding all allergenic foods. For any restriction diet attempted, be sure to obtain professional support — a nutritional expert, and a behavioral counselor if child is reluctant to try the changes.
  4. It is important to recognize that while these steps may bring partial help for a subset of children, we can not yet predict for whom. In any case diet changes should not be seen as a substitute for standard care but rather a supplemental action that may further support progress and health.

What other health factors can impact ADHD?

The big health factors aggravating ADHD are: sleep, exercise, and stress management. Most children (like most adults) don’t get enough sleep. A majority of children with ADHD have behavioral-related sleep problems (e.g., trouble getting to get on time or transitioning), that will respond to behavioral counseling. A minority have an endogenous sleep disorder that should be considered if behavioral counseling does not help with sleep problems.

Exercise and fitness is now well known to support healthy brain development and attention and academic progress in children, but it is not yet demonstrated that this specifically helps for children with ADHD. Nonetheless, it is a sensible piece to add. Try for 60 minutes of moderate activity per day (elevated breathing and heart rate) in at least 15 minute increments. Make it something fun (vigorous outdoor play counts).

Do these cause ADHD?

None of these factors is usually a sole cause of ADHD. These can be seen as aggravating risk factors that can make it harder to recover from ADHD and can worsen symptoms. In only a minority of cases, diet sensitivity or sleep problems will fully account for the problem.

How is epigenetics (modification of gene expression) involved?

Epigenetics is part of the picture because food, sleep, exercise, and stress have epigenetic effects. We only know this from animals but we suspect similar effects occur in humans. Epigenetic effects are important for future medical care as they will potentially help us identify sensitivities or predict response, or become targets for new medicines.

What is the most important thing a parent can do for their child who also has ADHD?

I think we get here into the relationship — maintaining faith in the child and a loving respectful relationship between you and the child. This is the most important thing.

Start with healthy home and healthy lifestyle, with positive emotional home environment, love, respect, and healthy food and sleep, before investing in expensive high tech alternative treatments. Obtain counseling to help establish this emotionally and physically healthy baseline if needed. Recognize it is hard to do it all and just do what you can. Even doing some of these things will be of some value. Do not overburden yourself. Consider these basic health steps a valuable adjunct to standard medical and psychological care for your child and family. When they are in place, in some instances the intensity of the standard care may be able to be reduced.

Joel Nigg, PhD is a Professor, Department of Psychiatry and Director, Division of Psychology at Oregon Health and Science University. He is the author of the science-based, parent helpful book on ADHD, Getting Ahead of ADHD.