Unable to focus on something that’s happening at class? Cannot resist the urge to keep moving around even when it’s not feasible? Do you keep disturbing others often? A yes to these might not only ruin your quality of life but also destroy your peace as all of them are signs of attention-deficit/hyperactivity disorder (ADHD). ADHD is a behavioural problem whose common symptoms include inattentiveness, hyperactivity and impulsiveness. Though this is not confined to children symptoms of ADHD are noticed at an early age and diagnosed accurately when the kid is between 6 and 12 years of age. In general, kids are restless and their attention span is short. Every kid might go through phases in life where they are restless and inattentive and this doesn’t confirm the presence of ADHD. If you notice things are radically different it is better to speak with the physician.
The prevalence rates of the disease have increased in the last two decades due to various factors including changes in environmental and epigenetic factors apart from increased awareness, improved screening methods and pharmaceutical marketing. Most of the symptoms linked with ADHD are due to reduced dopamine activity in the brain and course of treatment includes methylphenidate or amphetamine-containing medications that help in increasing dopamine availability in the brain. Pharmacotherapy is sometimes combined with psychotherapy but medications don’t relieve the symptoms completely and moreover, their side effects such as sleeping-related issues, reduced taste perception and appetite lead to lower adherence rates among children. Hence, physicians focus more on alternative therapies that include lifestyle changes and altered diet intake that can reduce the symptoms. Though parents have the common perception that ADHD children are mostly underweight due to heightened activity levels there are many of them who are obese/overweight as these kids often engage in binge-eating behaviour and the dysregulation of neurotransmitters can affect appetite and satiety levels too. We have conflicting results on the proposed dietary restrictions that could reduce ADHD symptoms in kids including avoidance of sugary foods, food additives and colour preservatives. There have been trials on what’s called the ‘Few Foods Diet’, a diet that’s based on lamb, rice, lettuce, pears and water that has decreased inattention and impulsivity among kids but most of the research in ADHD focus only on a group of foods rather than looking at the overall dietary pattern.
The Dietary Pattern & Not Certain Ingredients Impact ADHD
To study better about ADHD and learn how nutrition has an impact on it, we need more information about dietary pattern that’s more revealing as nutrients interact with each other affecting the health of children in comparison to their effect when taken as a single nutrient. We have evidence that a dietary pattern characterized by more intake of saturated and trans-fat and lesser intake of omega-3 fatty acids, fibre, fruits and vegetables was linked to increased ADHD risk in kids aged 14 years in an Australian cohort study. Another case-controlled study found that adhering to a diet that’s rich in fish, white meat and other mineral-rich foods was associated with fewer ADHD symptoms in children. The study below looks at the impact of ADHD on nutrient intake over time in a population-based sample of school-aged kids.
Generation R Study
The study here used data from the Generation R Study which had information on 7893 live-born children. All kids who completed the Child Behaviour Checklist (CBC) at ages 6 and 10 years and a semiquantitative FFQ at age 8 years were included in the present analysis which left the research team with 3680 children. Symptoms for ADHD were measured at ages 6 and 9.7 years using a child behaviour checklist (CBCL) that could be filled by parents or caretakers. The subscale contained six ADHD problems involving “can’t concentrate” “can’t sit still,” “can’t stand waiting,” “demands must be met,” “gets into everything” and “quickly shifts.” The parents rated these pointers in a 3-point scale resulting in a score ranging from 0 to 12. In kids aged around 10 years the CBCL scale was used for 7 items that included “fails to finish things,” “can't concentrate and can't pay attention for long,” “can't sit still,” “impulsive or acts without thinking,” “inattentive or easily distracted,” “talks too much,” and “unusually loud.” The kids’ dietary intake was analysed using an FFQ which was filled by parents or caregivers. The diet quality score was set based on adherence to a Dutch dietary recommendation for children and the ingredients used for scoring included fruit (≥150 g/d), vegetables (≥150 g/d), whole grains (≥90 g/d), fish (≥60 g/wk), legumes (≥84 g/wk), nuts (≥15 g/d), dairy (≥300 g/d), oils and unsaturated fats (≥30 g/d), sugar-containing beverages (SCBs; ≤150 g/d), and high-fat and processed meat (≤250 g/wk) (42). The kids were given a score between 0 and 1 depending on the quantity of the food consumed. For example, a score of 0 for fruits meant that the child did not consume any fruits, a score of 0.5 indicated that he/she consumed 75 grams of the recommended 150 grams/day and a score of 1 meant that the kid consumed ≥150 g/day. Reverse scoring was used to mark sugar containing beverages (SCB), high-fat and processed meat with higher scores indicating lower consumption. Total score was the sum of the 10 component scores that ranged between 0 and 10 with higher scores indicating a healthier overall diet.
Of the 3680 kids, 70.4% were of Dutch origin and 14.5% were overweight/obese. 50% kids spent more than 2 hours a day watching TV or using smartphones and participated in sports between 2 and 4 hours every week. Around 6 years of age, 0.6% of kids used medication for ADHD which increased to 3.3% at age 10 y. The researchers tried to understand whether ADHD symptoms at age 6 were associated with dietary patterns after 2 years. The researchers found an inverse association between ADHD symptoms at age 6 and diet quality at age 8 years and the association remained significant when adjusted for social and lifestyle factors. In another set of linear aggression, a higher diet quality score at age 8y was linked to a lower ADHD symptom score at age 10y implying that a 1-point higher diet quality was linked to a 0.02 lower ADHD symptom. The researchers found a significant inverse association between ADHD symptoms at age 6y and dietary pattern at age 8y and no association between dietary pattern at age 8y and ADHD symptoms at age 10y.
It was also found that association of diet quality with ADHD symptoms was not significantly different for boys and girls or even between children who were obese/overweight compared with those who were not. Even after the exclusion of specific diet groups one by one, there was a similar association found for ADHD with diet quality. The study clearly proved that ADHD symptoms in childhood are associated with a poorer diet quality but it’s not true the other way around.
Children’s Attention-deficit/Hyperactivity Disorder Symptoms Predicts Lower Diet Quality but Not Vice Versa: Results from Bidirectional Analysis in a Population-based Cohort: https://academic.oup.com/jn/article/149/4/642/5420415
Nutrition Management of Children with Attention Deficit Hyperactivity Disorder: https://journals.sagepub.com/doi/full/10.1177/1941406414551202
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Dr. Nafeesa Imteyaz of First Eat Right clinic, is the Best Dietitian Nutritionist in Bangalore. Best Dietitian Nutritionist in Pune. Best Dietitian Nutritionist in Hyderabad. Best Dietitian Nutritionist in Chennai. Best Dietitian Nutritionist in Mumbai. Best Dietitian Nutritionist in Delhi. Best Dietitian Nutritionist in Kolkata.