Foundational Nutrition When Living With ADHD
October is National ADHD Awareness Month. With increased diagnosis rates in recent years, more people are seeking support in navigating how this relates to their nutrition and overall health. For some individuals, this influences their daily habits and behaviors. Dietitians play a valuable role in supporting patients in navigating these unique challenges while assisting them in creating strategies that fit their needs and lifestyles. Let’s look at some of the foundational considerations for nutrition while living with ADHD.
Aiming for balance
Since ADHD is a neurological condition, it’s beneficial to prioritize nutrients and nutritional practices that support the brain. The best place to start? Fueling the brain regularly throughout the day, so it has the energy needed to do its job well. This begins with eating something to start the day, ideally within an hour of waking. Glucose is the brain’s primary and preferred fuel source, so ensuring there are carbohydrates at each meal, especially this first meal, will provide the necessary energy to start the day fueled and focused.
When it comes to eating for brain fuel, the quality of carbohydrates matters. Carbohydrates are found in whole foods, such as starchy vegetables, grains, beans, and fruits; they’re also found in refined products, such as processed grains, snack foods, and high-sugar drinks and snacks. Limiting consumption of highly processed carbohydrate sources is beneficial, as these carbohydrates break down more quickly in the body and can cause a drop in blood sugar that negatively affects attention, memory, and behaviors. Less processed and whole-food carbohydrate sources break down more slowly, minimizing the risk of a drop in blood sugar, supporting the ability to focus, and providing stable energy.
Along with prioritizing high-quality, less refined carbohydrates, pairing them with other whole, fresh foods promotes balanced meals and snacks. The Plate Method framework is a great tool for meal planning as it outlines this concept with 1/4 plate of starches/carbohydrates, 1/4 of protein, and 1/2 plate of non-starchy vegetables. Pairing protein and fiber sources with starches supports satiety at and between meals, which enhances the ability to focus, stabilizes mood, and prevents big shifts in energy levels throughout the day.
Appetite and meal timing
Individuals with ADHD may struggle with appetite changes related to unpredictable eating schedules, periods of food fixation, food boredom, or medications. Medications used for ADHD management are often dosed in the morning, having their peak stimulating effect by midday, around lunchtime/early afternoon. This is beneficial for optimizing attention and focus during the work and school day; however, some individuals report that the use of stimulant medications for ADHD management leads to a reduction in appetite and hunger cues. At times like this, relying on the body’s natural signals may not be the best approach to adequate nourishment. To prevent imbalanced eating throughout the day, dietitians encourage patients who struggle with reduced hunger cues to eat on a schedule instead of solely letting hunger guide their decision of when or whether to eat. Individuals who aren’t proactive when navigating this may struggle with overeating later in the day when the medication wears off, or simply falling short of their daily nutrient needs. Striving to eat a meal or snack every 3-5 hours, depending on individual needs, is a good frame of reference.
Next-level considerations: inflammation, sensitivities, and gut health
Regarding specific nutrients of importance for brain health and function, B vitamins, magnesium, iron, and zinc stand out. There have been some associations between deficiencies in these nutrients and the prevalence of ADHD. Eating a balanced diet minimizes gaps in nutrients – both our macronutrients (protein, fats, and carbohydrates) that provide energy and micronutrients (vitamins and minerals) that help the body put that energy to use in cells and tissues. One nutrition approach showing benefits for ADHD is the Mediterranean-style diet, which focuses on whole grains, fruits, starchy and non-starchy veggies, an abundance of beans, nuts, seeds, and legumes, with a shift in protein focus towards more fish and seafood, and lower amounts of dairy and poultry. Since some approaches to ADHD management touch on the elimination of possible allergens and sensitivities, it’s best to work with a dietitian to navigate these changes to ensure a balanced and varied diet.
To expand on the importance of diet, nutrients, and brain health, some studies have shown that a gluten-free diet may help with ADHD symptoms, especially for those with celiac disease. There are a few mechanisms likely at play here and possibly others that have yet to be explored. To start, in the case of celiac disease, gluten triggers the immune system to attack the lining of the small intestine, an area responsible for nutrient absorption. Decreased nutrient absorption means a less nourished body overall. Impaired and inflamed intestinal lining leads to reduced function in other areas, too. We see a connection between serotonin, a neurotransmitter produced in the intestines (also sometimes referred to as the ‘gut’) that is linked to mood and memory, being lower in individuals with ADHD. The vagus nerve is a connector between the gut, needed for optimal brain function. This means an anti-inflammatory approach to nutrition (such as the Mediterranean-style Diet) may improve both gut and brain health.
There is even more intriguing data related to digestive health and ADHD. The gut is filled with microbes – bacteria, fungi, and yeast – that communicate with the brain. It is believed that an imbalance between types of microbes may play a role in ADHD. A systematic review of the benefits of a particular strain of bacteria (Lactobacillus rhamnosus GG or LGG, found in the product Culturelle Digestive Daily capsules) used as a probiotic supplementation in children with ADHD showed better emotional, physical, social, and school functioning, and a higher health-related quality of life compared to the placebo group. There was also mention of the potential anti-inflammatory effects of probiotics in general, which could provide additional benefits. Despite some research showing promise, other trials show less conclusive data. Overall, there is evidence in support of probiotics, but more research is needed.
In summary, we can create a foundation of brain and body support for managing ADHD with intentional daily food and nutrition habits.
- Build meals and snacks focusing on complex carbohydrates, protein, healthy fats, and fiber.
- Ensure consistency with eating throughout the day, striving to eat a meal or snack every 3-5 hours.
- Incorporate a variety of whole, nutrient-dense foods to support adequate intake of key nutrients for brain health, such as B vitamins, magnesium, iron, and zinc.
- Consider digestive health and microbial balance as areas to explore further when developing a customized approach to managing ADHD in everyday life.
At Summerfield, our dietitians help support you on your health journey by completing a comprehensive health and nutrition intake assessment, discussing your individual challenges and health goals, providing education on areas of interest and relevance, partnering with you to create an action plan, and monitoring progress while providing ongoing support. Making changes to health behaviors isn’t easy, but having someone alongside you to encourage your efforts and celebrate your success is highly beneficial!
Resources
https://www.todaysdietitian.com/newarchives/0323p44.shtml
https://www.healthstandnutrition.com/adhd-diet-food-supplements/