You may remember the controversial studies linking food coloring and additives to hyperactivity in kids. Or you may know parents who have pinned their hopes on an elimination diet to improve their kids' rowdy behavior.
"When [elimination] diets fail, parents can feel they've failed," says Linda Brauer, coordinator of the Grand Rapids chapter of the advocacy group Children and Adults with Attention Deficit/Hyperactivity Disorder. She remembers feeling guilty when her son's symptoms did not improve. But now she says the science is on her side.
A review paper published today in the journal Pediatrics evaluated the evidence from many studies on this topic. And it concludes that changing a child's diet is usually not enough to effectively treat attention deficit hyperactivity disorder.
"Elimination diets may help in a very small percentage of patients," whereas stimulant medications are generally very effective, writes J. Gordon Millichap, a neurologist at Children's Memorial Hospital in Chicago who authored the paper.
Now, before all of the we-are-what-we-eat believers among us dismiss this, you should know that experts don't deny the importance of diet. Far from it.
"[Diet's] main role in my clinical practice is as a complementary treatment," Benjamin Prince, a psychiatrist at Massachusetts General Hospital tells us. That means kids with ADHD usually need medicine and good diets.
But what makes a good diet? Here are three tips for kids on the ADHD spectrum from the experts:
- Eat a protein-rich breakfast. Kids with ADHD tend to burn lots of calories and can often be too overstimulated to sit down to eat. In addition, medication often suppresses their appetites. Put all of these factors together, and kids with ADHD are prone to feeling "hangry," Prince says. (The term — a cross between angry and hungry — was coined by Prince's friend.) The solution? Keep the calories coming. Complex carbohydrates, like whole grains, and foods rich in protein can help kids feel full longer. "So if you can have a glass of milk and a peanut butter sandwich, that's going to help carry you through the day," says Prince.
- Cut back on sugary treats and processed foods. Australian researchers tracked patterns of eating among children with ADHD. They found that diets rich in sugary snacks, processed foods, red meat and high-fat dairy correlate with higher levels of ADHD. "Try to cut down on those foods," recommends lead author Wendy Oddy of the University of Western Australia. (Note: She didn't say eliminate.) And Millichap agrees. "We conclude that adherence to a 'healthy' diet (fish, vegetables, fruit, whole wheat and low-fat dairy) should be advised," Millichap wrote to us.
- Fish oil and omega-3 supplements. There has been a lot of interest and research on the value of omega-3s from fish oil — or long-chain, polyunsaturated fatty acids. "We think there's some link between having low amounts of long-chain, polyunsaturated fatty acids and ADD," says Prince. So he says adding healthy amounts of fish to the family diet — or taking fish oil supplements — are both fine. But he stresses that clinical trials on this subject have not been consistent. "The evidence is mixed" on whether omega-3s can help kids with ADHD, he says. But given the heart benefits for all of us (not just those with ADHD), Prince says, it can't hurt.