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The Nutritional Link to ADHD
Attention Deficit Hyperactivity Disorder (ADHD) is a particularly important issue effecting children and adults. Evidence suggests that there is an association between ADHD and obesity. In 2014, approximately 5% of children and adolescents presented with an ADHD diagnosis (1). Similarly, obesity is a universal public health issue; in 2012, about 31.8% of children were overweight or obesity (2).
One article found that children with ADHD are more likely than other children to have loss of control eating syndrome (LOC-ES), a condition similar to Binge Eating Disorder (BED) (3). Researchers found that children with ADHD were 12x more likely to have LOC-ES in comparison with children that did not. Conversely, children who were overweight or obese and had LOC-ES were 7 times more likely to also have ADHD. This study followed a previous study that demonstrated an association between obese and overweight children with ADHD and Binge Eating Disorder (3).
This is not the first time we have seen the link between ADHD and food. A large study concluded
that color additives may have an effect on hyperactive behavior in children, with a small subset showing more extreme behaviors than others (4). However, some researchers have suggested that since food dyes are typically found in processed foods, so it is the removal of the processed foods that may actually decrease hyperactivity.
For those with ADHD, restriction and elimination diets as a treatment method have been proposed and studied for nearly 40 years. These diets suggest that the elimination of a wide range of foods for a temporary period followed by a process of adding foods back into the diet one at a time could help identify potential trigger foods (5). While there is no uniform approach to this alternative treatment modality, it demonstrates the role of food in illnesses not typically perceived as diet contingent (such as the nutrition interventions for: diabetes and heart/kidney diseases). The alleviation of ADHD symptoms through the diet evokes the food-as-medicine model, an ever-growing approach in the medical field. It is important that we continue to explore these options in order to promote food’s ability to heal or treat life-challenging conditions.
Despite these clinical findings, ADHD is commonly misdiagnosed in children and results in unnecessarily prescribed medications. Behavioral difficulties may be a result of the over or under consumption of particular foods. For example, foods with high sugar content (such as fruit juice or candy) or starchy carbohydrates will increase blood sugar and may lead to hyperactive behaviors. Once the blood sugar is taken up by insulin, the child may experience hypoglycemia, or low blood sugar, which can lead to other issues like fatigue, anxiety, or trouble concentrating. These peaks and valleys in blood sugar, often a result of the consumption of processed foods with added sugars, can yield symptoms that closely resemble ADHD. Other causes of an ADHD misdiagnosis could be a result of a gluten insensitivity or omega-3 deficiency. Research has shown that kids low in omega-3 fats (which come from fish, some nuts, and vegetable oils) are more likely to be hyperactive, struggle with
learning disorders, and display behavioral problems (6). Also, a gluten insensitivity may cause physical discomfort causing a child to act out or have trouble focusing in school.
While the underlying mechanism between ADHD and eating disorders has not been fully explored, researchers suggest that impulsivity control may be a link between ADHD and overeating. Additionally, clinicians should screen children for uncontrolled eating behaviors alongside ADHD until further research is conducted. The potential exists for new treatment strategies to help target children and
adolescents who present with both eating disorders and ADHD.
Samantha Mogil, Nutrition Intern