There is a lot of exciting research being done regarding nutritional interventions for mental health, specifically in the area of neurologically related disorders ( 1). ADHD is no exception to that ( 2). I have talked about the overlap of nutrition regarding both mental health and the devleopment of children in my (free) ebook series. In my clinical opinion ADHD is grossly over diagnosed. Be that as it may, the reported numbers by the CDC suggest that per capita diagnosis are declining (from 2011 to 2016)( 3). What is also intriguing (and quite telling) about the CDC’s reporting is that over 60% of children diagnosed with ADHD are also diagnosed with another mental health disorder ( 3). But, I digress…
Children and Adults with Attention-Deficit/Hyperactivity Disorder ( CHADD) does mention nutrition in a couple places. It’s general recommendations ( 4) refer to “healthy eating” to which you’re directed to their “Cookbook for Busy Minds” ( 5); a production of the CDC. Frankly, I didn’t make it past the third page(!). Their “high protein” breakfast ideas were:
- natural peanut butter on whole grain bread
- whole grain cereal with milk
- plain yogurt with fresh fruit
- grilled cheese sandwich made with whole grain bread
- mixed unprocessed nuts or seeds, fresh fruit, glass of milk or orange juice
- hard-boiled eggs, whole grain toast, and fruit
- oatmeal with berries and nuts or granola
Let’s look at this more critically:
- fat, marginal protein, inflammatory whole grains (6, 7, 8, 9)
- inflammatory whole grains with inflammatory dairy (marginal protein)
- reactionary dairy (10, 11, 12) and sugar
- reactionary diary and inflammatory whole grains
- PUFAs (13), marginal protein, sugar, and inflammatory dairy or more sugar
- protein, fat, inflammatory whole grains, sugar
- inflammatory whole grains, PUFAs
Notice a trend? Don’t worry, we’ll come back to that. To their credit though, CHADD does have a page dedicated to omega-3 and omega-6 fatty acids ( 14); though they recommend them in supplement form. Some of those recommendations I’m more agreeable to:
- PUFAs are essential fatty acids, necessary to health. Like vitamins and minerals, only small amounts per day are needed. There may be some risk to large amounts, especially if not accompanied by antioxidant vitamins such as E and C.
- The 3 main omega-3 PUFAs are EPA (20 carbons long), DHA (22 carbons long), and alpha-linolenic acid (ALA, 18 carbons). The first two are mainly found in marine oils (fish, krill, seal, whale). ALA is in some vegetable oils, such as flaxseed oil.
- Theoretically, human metabolism should be able to make EPA and DHA from ALA, but there is some suspicion that some persons have a deficiency in that metabolism. Therefore, the emphasis has been on taking EPA and DHA directly.
- The most promising results have been with a combination of EPA, DHA, and one of the omega-6 PUFAs called gamma-linolenic acid (GLA). But the most important of these may be EPA. One meta-analysis found a dose-response for EPA.
Then, you have Harvard Medical downplaying the efficacy of nutritional interventions and (of course) recommending supplements over whole foods ( 15). Though even they acknowledge that ADHD symptoms can be exacerbated by nutritional deficits in:
Of course, what is equally abhorrent to Harvard (and their anti-meat constituents) is the fact that red meat and beef liver are superior (and more bioavailable) sources of those nutrients than, say, carrots or apples (per 100g)( 18). Red meat is also relatively rich in those above mentioned omega-3 fatty acids. I only rarely (less than once per week) eat sardines or oysters and get plenty of omega-3 from a diet of red meat, organs, and eggs.
Now, the last thing we need to tie up are those “heart healthy whole grains.” Fasted blood sugar has been shown to not have a significant relationship with ADHD symptoms, however, HbA1c does ( 19). This suggests that overall blood sugar control (rather than just the fasted value) is relevant (e.g. no huge spikes or long elevated plateaus).
Hopefully, the image that’s taking fold here is that an “anti-ADHD” diet doesn’t look like high-carb, low-fat, plant-based, and heavily supplemented. Rather, it should be:
- rich in red meat and organs
- contain fish or other omega-3 rich food sources (you will get some omega-6 from here as well)
- be rich in calcium, magnesium, zinc, and copper
- contain direct sources of EPA and DHA (preferred to ALA)
What does all of those? An animal based diet focusing on high fat content!