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Role of Nutrition in
ADHD
Kate Hilliard, MS, RD, LD, CDE
About Me
Breastfeeding: First Line of Defense?
• Children with ADHD are less likely to have been breastfed and/or breastfed
as long as non-ADHD children
• Dr. Mimouni-Bloch Study:
Groups 3 months 6 months
ADHD 43% 29%
Siblings of ADHD group
(w/o dx):
69% 50%
Non- related kids (w/o dx): 73% 57%
Source: Duration of breastfeeding and ADHD. Mimouni-Bloch, et. Journal Breastfeeding Medicine. Retrieved 2017 www.everydayheatlth.com
Breastfeeding
Preschoolers Breastfed
ADHD 54%
Non-ADHD 78%
Groups Nurse <1 mo. 1-5 mos. 6+ mos.
ADHD 57% 20% 22%
Non-ADHD 26% 28% 46%
Dr. Adesman Study's:
Source: Adesman, A., et. Pediatric Academic Societies. 2013. Data drawn from 2007 National Health Survey Retrieved 1/2017 www.everydayheatlth.com
Essential Fatty Acids - DHA
• Docosahexanoic Acid: cannot make internally
• Matures and stabilizes cortical circuits, synaptogenesis, myelin development
• Preterm delivery assoc. deficits in myelin integrity sugg. > risk for ADHD
Source: Role of perinatal long-chain omega-3 fatty acids in cortical circuit maturation: Mechanisms and implications for psychopathy McNamara, Vannest, Valentine. World J Psychiatry. 2015 Mar 22; 5(1): 15-34
Malnutrition: Gluten Allergy
• Damaged villi cannot properly process
• Vitamin B6, B12
• Folate
• Iron
• Vitamin D & K
• Calcium & Magnesium
• Tryptophan and other monoamine precursors needed for the production of
key neurotransmitters in the brain (serotonin, dopamine and norepinephrine)
Exercise
• Regular physical activity programs at school showed important enhancement
of cognitive performance and brain function
• Exercise programs for kids remain underfunded and under prioritized in
many school curriculum
• Exercise releases dopamine and serotonin
• Does intensity or duration matter?
Your Brain on Exercise
Electrophysiological plots representing brain processing
• 12-week program improved kids math and reading test
scores in all kids, but especially in those with signs of
ADHD
• Just 26 minutes of daily physical activity for 8-weeks
significantly relieved ADHD symptoms in grade-
school kids
Source: Pilot Physical Activity Intervention Reduces Severity of ADHD Symptoms in Young
Children. Alan L. Smith, Betsy Hoza, Kate Linnea, et. First Published August 25, 2011
Food Dyes
Food colors used:
• 2 REDS – red 3, red 40
• 2 BLUES – blue 1, blue 2
• 2 YELLOWS – yellow 5, yellow 6
• GREEN – green 3
ADHD and Red #40
• For these children consuming this food coloring can increase behavioral issues
and lead to:
hyperactivity
attention problems
irritability
learning problems
aggressiveness
restlessness.
• Elimination diets can help up to 60% of children experiencing these symptoms
Foods Containing Red #40
Sprinkles
Fruit Snacks, Gummy Bears,
Swedish Fish
Hard Candies, Jolly Ranchers,
Skittles, Starbursts
Cheetos
Gatorade
Fruit Punch, Hi-C, Hawaiian
Punch
Mountain Dew Code Red,
Sunkist Orange,
Cherry and Berry Yogurts
Breakfast Cereals: Lucky
Charms, Fruity Pebble, Fruit
Loops, Trix
Gelatin
Strawberry Ice Cream Bars
(Good Humor Strawberry
Shortcake)
Salad Dressings (Kraft Catalina)
Hamburger Helper Lasagna
Cake Mixes, Pre-made cakes and
cookies
Are Food Dyes Necessary?
How Much is Too Much?
Feingold Diet
• He was aware of the historic change in prevalence of disease and behavioral
problems in children during the early 1960s
• Eliminate synthetic colors, synthetic flavors and the preservatives BHA,
BHT – and also a group of foods containing a natural salicylate radical.
• High salicylate foods: tomatoes, cucumbers, peppers, oranges, apples, berries,
grapes, almonds, certain spices.
The Real World
Nutrition Recommendations
• Fruits and Vegetables
• Whole grains (unless Celiac’s or gluten intolerant)
• Healthful unsaturated fats (emphasize omega 3) – olive oils, nuts, fish
• Good sources of protein – eggs, chicken, turkey, beans
• go easy on unhealthy saturated and trans fats, rapidly digested carbohydrates,
and fast food
• Plenty of physical activity
“Real World” Recommendations
• Individualize!!!
• Parents may be desperate, open to more “extreme” diet
• Encourage healthy eating throughout lifecycle
• Rule out Celiac’s and gluten intolerance first
• Eliminate artificial food dyes (esp. Red 40)
• Get TONS of exercise – recess, sports, afterschool

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Role of Nutrition in ADHD

  • 1. Role of Nutrition in ADHD Kate Hilliard, MS, RD, LD, CDE
  • 3.
  • 4. Breastfeeding: First Line of Defense? • Children with ADHD are less likely to have been breastfed and/or breastfed as long as non-ADHD children • Dr. Mimouni-Bloch Study: Groups 3 months 6 months ADHD 43% 29% Siblings of ADHD group (w/o dx): 69% 50% Non- related kids (w/o dx): 73% 57% Source: Duration of breastfeeding and ADHD. Mimouni-Bloch, et. Journal Breastfeeding Medicine. Retrieved 2017 www.everydayheatlth.com
  • 5. Breastfeeding Preschoolers Breastfed ADHD 54% Non-ADHD 78% Groups Nurse <1 mo. 1-5 mos. 6+ mos. ADHD 57% 20% 22% Non-ADHD 26% 28% 46% Dr. Adesman Study's: Source: Adesman, A., et. Pediatric Academic Societies. 2013. Data drawn from 2007 National Health Survey Retrieved 1/2017 www.everydayheatlth.com
  • 6. Essential Fatty Acids - DHA • Docosahexanoic Acid: cannot make internally • Matures and stabilizes cortical circuits, synaptogenesis, myelin development • Preterm delivery assoc. deficits in myelin integrity sugg. > risk for ADHD Source: Role of perinatal long-chain omega-3 fatty acids in cortical circuit maturation: Mechanisms and implications for psychopathy McNamara, Vannest, Valentine. World J Psychiatry. 2015 Mar 22; 5(1): 15-34
  • 7. Malnutrition: Gluten Allergy • Damaged villi cannot properly process • Vitamin B6, B12 • Folate • Iron • Vitamin D & K • Calcium & Magnesium • Tryptophan and other monoamine precursors needed for the production of key neurotransmitters in the brain (serotonin, dopamine and norepinephrine)
  • 8. Exercise • Regular physical activity programs at school showed important enhancement of cognitive performance and brain function • Exercise programs for kids remain underfunded and under prioritized in many school curriculum • Exercise releases dopamine and serotonin • Does intensity or duration matter?
  • 9. Your Brain on Exercise Electrophysiological plots representing brain processing • 12-week program improved kids math and reading test scores in all kids, but especially in those with signs of ADHD • Just 26 minutes of daily physical activity for 8-weeks significantly relieved ADHD symptoms in grade- school kids Source: Pilot Physical Activity Intervention Reduces Severity of ADHD Symptoms in Young Children. Alan L. Smith, Betsy Hoza, Kate Linnea, et. First Published August 25, 2011
  • 10. Food Dyes Food colors used: • 2 REDS – red 3, red 40 • 2 BLUES – blue 1, blue 2 • 2 YELLOWS – yellow 5, yellow 6 • GREEN – green 3
  • 11. ADHD and Red #40 • For these children consuming this food coloring can increase behavioral issues and lead to: hyperactivity attention problems irritability learning problems aggressiveness restlessness. • Elimination diets can help up to 60% of children experiencing these symptoms
  • 12. Foods Containing Red #40 Sprinkles Fruit Snacks, Gummy Bears, Swedish Fish Hard Candies, Jolly Ranchers, Skittles, Starbursts Cheetos Gatorade Fruit Punch, Hi-C, Hawaiian Punch Mountain Dew Code Red, Sunkist Orange, Cherry and Berry Yogurts Breakfast Cereals: Lucky Charms, Fruity Pebble, Fruit Loops, Trix Gelatin Strawberry Ice Cream Bars (Good Humor Strawberry Shortcake) Salad Dressings (Kraft Catalina) Hamburger Helper Lasagna Cake Mixes, Pre-made cakes and cookies
  • 13. Are Food Dyes Necessary?
  • 14. How Much is Too Much?
  • 15. Feingold Diet • He was aware of the historic change in prevalence of disease and behavioral problems in children during the early 1960s • Eliminate synthetic colors, synthetic flavors and the preservatives BHA, BHT – and also a group of foods containing a natural salicylate radical. • High salicylate foods: tomatoes, cucumbers, peppers, oranges, apples, berries, grapes, almonds, certain spices.
  • 17. Nutrition Recommendations • Fruits and Vegetables • Whole grains (unless Celiac’s or gluten intolerant) • Healthful unsaturated fats (emphasize omega 3) – olive oils, nuts, fish • Good sources of protein – eggs, chicken, turkey, beans • go easy on unhealthy saturated and trans fats, rapidly digested carbohydrates, and fast food • Plenty of physical activity
  • 18. “Real World” Recommendations • Individualize!!! • Parents may be desperate, open to more “extreme” diet • Encourage healthy eating throughout lifecycle • Rule out Celiac’s and gluten intolerance first • Eliminate artificial food dyes (esp. Red 40) • Get TONS of exercise – recess, sports, afterschool

Editor's Notes

  1. • This biochemical imbalance in the brain is associated with emotional problems The body becomes unable to produce enough tryptophan and other monoamine precursors needed for the production of key neurotransmitters in the brain such as serotonin, dopamine and norepinephrine ssentialNon-EssentialHistidine (H)Alanine (A)Isoleucine (I)Arginine* (R)Leucine (L)Aspartic acid (D)Lysine (K)Cysteine* (C)Methionine (M)Glutamic acid (E)Phenylalanine (F)Glutamine* (Q)Threonine (T)Glycine* (G)Tryptophan (W)Proline* (P)Valine (V)Serine* (S)Tyrosine* (Y)Asparagine* (N)Selenocysteine (U)Pyrrolysine** (O
  2. By itself Aluminum Hydroxide is a safe food ingredient and it's often sold as an antacid. Yellow 5 has been demonstrated to provoke an allergic reaction in some people and there are FDA regulations that require all prescription medications to post a notice if they are formulated with Yellow 5 Food coloring indicated in health problems are the following: 1) FD & C Yellow No. 5 contains tartrazine. People who have aspirin sensitivity may not tolerate it and it may be especially a bad choice for people who have frequent asthma. Tartrazine is derived from coal tar, which has led to concerns for all people who consume it. 2) FD & C Red No. 3 contains erythrosine, another coal tar based compound. There is suspicion that this colorant may be carcinogenic. Rat studies showed development of thyroid tumors when high doses of erythrosine were administered. In general, other FD & C colors have been thought to possibly have adverse effects on some people. Though these are unsubstantiated, claims that artificial food colors can cause depression, anxiety, and attention deficit disorder (ADD) persist. There has been much anecdotal evidence that reducing artificial food coloring in children’s diets may reduce or eliminate ADD. As noted above, to address this issue, certain European countries have made the use of FD & C colors illegal.
  3. We always liked to pick out the red ones right? Red is a very appealing color, and makes it more appetizing....companies know this and like to use it.
  4. Many of the more earlier studies done on food dyes, particulairly RED 40 were done in very low concentrations…practically pink in color. NOT tested the higher concentrations, which is what is typically consumed~ Just think…all these bright colors…who are they target to?? Kids! So were introducing this chemcially-made product to children who are still developing and growing, and along with that stress we’re causing their bodies to figure out what to do with these additives.
  5. Pediatrician in 1920s started out 1960s (when food dyes, flavorings, and preservatives proliferated on the supermarket shelves).
  6. What a concept, eating fruits and vegetables…we know they don’t have dyes and food products are able to use them to naturally dye their foods. Whole foods: goes along with the first one….when you eat more natural, your body responds better because you aren’t putting your body through the stress of trying to process the things we call food. Ingredient labels tell you all… If you suspect your child, or even yourself has any type of mood disorder, try eliminating the articficial dyes to see if it helps.