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Diet and ADHD

A number of special diets, and diet therapies, have been suggested for children with ADHD. The modern approach to the dietary treatment of ADHD consists of the following:

1) Balanced diet
All members of the family should follow a balanced diet and stick to regular meals. Good wholesome food and an emphasis on whole, unprocessed cereals, wholewheat bread, pasta, brown rice, legumes (dry beans, peas and lentils), low-fat milk and dairy products, large helpings of raw, fresh fruit and vegetables, and moderate intakes of lean meat, chicken, fish and eggs will supply plenty of carbohydrate to meet energy needs, dietary fibre, and protective vitamins, minerals and trace elements, and a moderate fat intake.

Some children will respond well to a diet based on foods with a low glycaemic index (GI), as such diets will ensure that blood sugar and insulin levels are kept constant. This will prevent pronounced dips and peaks in these values, which can make children fractious and irritable.

If in doubt about GI, consult a clinical dietician to help you work out a diet that provides your child with the nutrients he needs, while keeping blood sugar levels constant.

2) Supplements
Children with ADHD and their parents often require additional nutrients (calcium, magnesium, potassium, zinc, selenium, B vitamins, beta-carotene, vitamins E and C, and essential fatty acids such as omega-6 and omega-3) to help them cope with the additional stress their bodies and nervous systems are exposed to.

Use a complete vitamin and mineral supplement, which contains omega-6 (evening primrose oil) and omega-3 (salmon oil), and eat foods that are enriched with omega fatty acids (such as omega-3 enriched eggs, milk and bread, which should be available in good supermarkets).

3) Elimination diets
Such diets should only be used under the supervision of a clinical dietician to prevent the child from developing nutrient deficiencies, and for the purpose of determining if the child’s condition deteriorates when she eats food containing certain colouring agents, flavourings and/or preservatives.

Research has determined that only a very small subgroup of children with ADHD react to sugar. If your child has been on a supervised elimination diet and you have been able to identify a specific additive and/or sugar as triggers of hyperactive behaviour, such foods should be avoided.

4) Sugar
Regarded for many years as the prime food trigger of hyperactivity, sugar has to a great extent been exonerated by well-controlled clinical studies. It is often the additives in foods with a high sugar content (e.g. colourants in cold drinks) that cause the reaction and not sugar per se.

There are also indications that high-carbohydrate diets, which include some table sugar, are beneficial to ADHD children for two reasons: carbohydrates are a good source of energy to meet the increased needs of ADHD children because they are so active, and high-carbohydrate diets help to increase one of the brain chemicals (serotonin) that is believed to play a crucial role in ADHD.

5) Eating habits
ADHD children often develop aversions to, or cravings for certain foods. They also tend to have a great need for liquids and may drink litres of water every day.

The most important thing to remember when dealing with these eating habits is that mealtimes should never be turned into a battlefield. If your ADHD child won’t eat peas and insists on having five slices of bread with every meal, and drinks water all day long, don’t make an issue of this.

Accept that there will be certain foods that your child will not eat. Only if the child avoids a vital food component such as milk, do you need to make contingency plans (provide another source of calcium like yoghurt or cheese, or use a calcium supplement to ensure that the child gets the calcium he requires for rapid growth of bones and teeth).

6) The role of medication
There is probably no more emotive subject in the treatment of ADHD than the use of medications, such as Ritalin. Volumes have been written about its dangers and ill effects. The decision to use, or not use, Ritalin for the treatment of a child with ADHD should be left to an expert (a child psychiatrist).

It is important that the child psychiatrist monitors the child’s growth when she is taking Ritalin, because this drug can depress the appetite and cause growth retardation.

If such growth failure occurs, consult the child psychiatrist. He/she may suggest reducing the dose, discontinuing treatment, or substituting with another medication.

7) The role of exercise
Exercise is one of the most therapeutic things you, your ADHD child, and the rest of the family can do. Regular exercise uses up some of the excess ADHD energy your child is bubbling over with, it improves muscle and eye coordination, keeps the body healthy, prevents depression, and helps the child relax.

Parents also benefit from regular exercise which promotes relaxation, combats depression, and increases vitality, thus making you more fit to handle the physical, mental and emotional demands of your child. Let the whole family subscribe to a gym, or join ‘Walk/Run for Life’.

If your child suffers from ADHD, you can do a great deal to normalise your family situation by keeping dietary interventions to a minimum and by preventing mealtimes from developing into a battle ground.

– (Dr I.V. van Heerden)

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