Does Diet for Children with ADHD Matter?

Written by Dr. Steve Chaney on . Posted in ADHD Diet

Could A Healthy Diet Help Your Child?

Author: Dr. Stephen Chaney

 

diet for children with adhdDoes diet for children with ADHD matter?

The prevalence of ADHD appears to be skyrocketing. It increased by 42% in just 8 years between 2003 and 2011. Currently, 4.5 million children in the US are on ADHD medication, at a cost to taxpayers of $45 billion.

Unfortunately, ADHD medications come with serious side effects like loss of appetite and delayed growth, sleep disorders, nausea & stomach pains, headaches, moodiness and irritability. Even more worrisome is that many children say they “just don’t feel right” while they are on the drugs. Finally, there is the unintended message we are sending our children that drugs are the solution to their problems.

It is no wonder that millions of parents are looking for more natural solutions for their child’s ADHD. That is why recent headlines like “The Mediterranean Diet Could Help Children with ADHD” generate such interest.

In this issue of Health Tips From the Professor I have looked at the studies behind the headlines to answer your most pressing questions:

  • Would something as simple as the Mediterranean diet help my child control their ADHD symptoms?
  • Do they have to adhere to the Mediterranean diet, or would other healthy diets work just as well?

Answering these questions will tell us if diet for children with ADHD matters.

adhd dietHow Was The Study Designed?

The study behind the headlines (A Rios-Hernandez et al, Pediatrics DOI: 10.1542/peds.2016-2027) looked at 60 children and adolescents (ages 6-16) from southern Spain who were newly diagnosed with ADHD and compared them with 60 sex- and age-matched controls without ADHD from the same schools.

A food frequency questionnaire was administered by a trained interviewer and a scoring system called KIDMED was used to evaluate adherence to a Mediterranean-type diet. The study excluded children with more severe psychological problems and any children taking ADHD medications or nutritional supplements.

Does Diet for Children with ADHD Matter?

 

  • In a preliminary analysis of the data, the investigators discovered:
    • Breastfeeding was associated with decreased risk of ADHD.
    • Inactivity was associated with increased risk of ADHD.
    • Obesity was associated with increased risk of ADHD.

    child adhd dietOf course, the main point of the study was to investigate whether adherence to a Mediterranean-type diet influenced the risk of developing ADHD. The answer to this question was clear cut.

    • Adherence to a Mediterranean-type diet significantly reduced the risk of ADHD in both children and adolescents.

    So, clearly diet for children with ADHD does matter.

    Next, the investigators used the data obtained from the food frequency questionnaires to ask what components of a Mediterranean diet were most influential in reducing the risk of developing ADHD. These results were also very interesting:

    Dietary components that decreased the risk of ADHD included:

    • Consuming two or more servings of fruit every day (In Spain, the extra servings of fruit were primarily citrus, but presumably other fruits would be just as effective).
    • Consuming fresh or cooked vegetables more than once a day.
    • Consuming fatty fish on a regular basis (2-3 times a week).
    • Consuming grains or rice almost every day.
    • Starting the day with a healthy breakfast.

    Dietary components that increased the risk of ADHD included:

    • Eating at fast food restaurants more than once a week.
    • Skipping breakfast.
    • High consumption of soft drinks.
    • High consumption of candy and sugar.

    What Does This Mean For You?

    foods adhd dietThis study clearly showed that adherence to a Mediterranean diet is associated with a significantly lower incidence of ADHD.

    Of course, this study was conducted in southern Spain where a healthy diet is the Mediterranean diet. The question for people in other parts of the world is whether other healthy diets would work just as well.

    Based on their detailed study of the effect of individual dietary components, it is reasonable to assume that any healthy diet that…

    …emphasized fresh fruits & vegetables, whole grains, omega-3-rich fish, and…

    …started the day with a healthy breakfast, and…

    …minimized (or eliminated) fast foods, sodas, candy & other sweets…

    …would reduce the risk of ADHD.

    Plus, this is an approach that has no side effects. Just side benefits.

    Finally, if you read the study carefully, it is clear a holistic approach is always best. For example:

    • Individual dietary components had small effects on ADHD symptoms.
    • When those individual components were combined into a healthy diet, a major reduction in ADHD symptoms was observed.
    • The study suggested that reduction in ADHD symptoms would be even greater with a healthy lifestyle that included regular exercise and weight control.
    • The authors stated that supplementation could also play a role in reducing ADHD symptoms. They felt the best evidence was for supplementation with omega-3 fatty acids and a multivitamin multimineral supplement.

We can certainly conclude that diet for children with ADHD matters.

 

The Bottom Line

 

A recent study in southern Spain has looked at the relationship between adherence to a healthy Mediterranean diet and the risk of developing ADHD symptoms in children and adolescents.

  • In a preliminary analysis of the data, the investigators discovered:
    • Breastfeeding was associated with decreased risk of ADHD.
    • Inactivity was associated with increased risk of ADHD.
    • Obesity was associated with increased risk of ADHD.
  • These factors were independent of adherence to a Mediterranean diet.
  • Adherence to a Mediterranean-type diet significantly reduced the risk of ADHD in both children and adolescents. This was the major finding of the study.
  • The dietary components in the study that decreased the risk of ADHD were:
    • Consuming two or more servings of fruit every day (In Spain, the extra servings of fruit were primarily citrus, but presumably other fruits would be just as effective).
    • Consuming fresh or cooked vegetables more than once a day.
    • Consuming fatty fish on a regular basis (2-3 times a week).
    • Consuming grains or rice almost every day.
    • Starting the day with a healthy breakfast.
  • The dietary components that increased the risk of ADHD were:
    • Eating at fast food restaurants more than once a week.
    • Skipping breakfast.
    • High consumption of soft drinks.
    • High consumption of candy and sugar.
  • Based on their detailed study of the effect of individual dietary components, it is reasonable to assume that any healthy diet that…
    • …emphasized fresh fruits & vegetables, whole grains, omega-3-rich fish, and…
    • …started the day with a healthy breakfast, and…
    • …minimized (or eliminated) fast foods, sodas, candy & other sweets……would reduce the risk of ADHD.
  • Plus, this is an approach that has no side effects. Just side benefits.
  • Finally, if you read the study carefully, it is clear a holistic approach is always best. That would include:
    • A healthy diet
    • regular exercise and weight control.
    • Supplementation with omega-3 fatty acids and a multivitamin multimineral supplement.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Is Our Microbiome Affected By Exercise?

Posted November 6, 2018 by Dr. Steve Chaney

Microbiome Mysteries

Author: Dr. Stephen Chaney

is our microbiome affected by exerciseIn a recent post,  What is Your Microbiome and Why is it Important,  of “Health Tips From The Professor” I outlined how our microbiome, especially the bacteria that reside in our intestine, influences our health. That influence can be either good or bad depending on which species of bacteria populate our gut. I also discussed how the species of bacteria that populate our gut are influenced by what we eat and, in turn, influence how the foods we eat are metabolized.

I shared that there is an association between obesity and the species of bacteria that inhabit our gut. At present, this is a “chicken and egg” conundrum. We don’t know whether obesity influences the species of bacteria that inhabit our gut, or whether certain species of gut bacteria cause us to become obese.

Previous studies have shown that there is also an association between exercise and the species of bacteria that inhabit our gut. In particular, exercise is associated with an increase in bacteria that metabolize fiber in our diets to short chain fatty acids such as butyrate. That is potentially important because butyrate is a primary food source for intestinal mucosal cells (the cells that line the intestine). Butyrate helps those cells maintain the integrity of the gut barrier (which helps prevent things like leaky gut syndrome). It also has an anti-inflammatory effect on the immune cells that reside in the gut.

However, associations don’t prove cause and effect. We don’t know whether the differences in gut bacteria were caused by differences in diet or leanness in populations who exercised regularly and those who did not. This is what the present study (JM Allen et al, Medicine & Science In Sports & Exercise, 50: 747-757, 2018 ) was designed to clarify.  Is our microbiome affected by exercise?

 

How Was The Study Designed?

is our microbiome affected by exercise studyThis study was performed at the University of Illinois. Thirty-two previously sedentary subjects (average age = 28) were recruited for the study. Twenty of them were women and 12 were men. Prior to starting the study, the participants filled out a 7-day dietary record. They were asked to follow the same diet throughout the 12-week study. In addition, a dietitian designed a 3-day food menu based on their 7-day recall for the participants to follow prior to each fecal collection to determine species of gut bacteria.

The study included a two-week baseline when their baseline gut bacteria population was measured, and participants were tested for fitness. This was followed by a 6-week exercise intervention consisting of three supervised 30 to 60-minute moderate to vigorous exercise sessions per week. The exercise was adapted to the participant’s initial fitness level, and both the intensity and duration of exercise increased over the 6-week exercise intervention. Following the exercise intervention, all participants were instructed to maintain their diet and refrain from exercise for another 6 weeks. This was referred to as the “washout period.”

VO2max (a measure of fitness) was determined at baseline and at the end of the exercise intervention. Stool samples for determination of gut bacteria and concentrations of short-chain fatty acids were taken at baseline, at the end of the exercise intervention, and again after the washout period.

In short, this study divided participants into lean and obese categories and held diet constant. The only variable was the exercise component.

 

Is Our Microbiome Affected By Exercise?

is our microbiome affected by exercise fitnessThe results of the study were as follows:

  • Fitness, as assessed by VO2max, increased for all the participants, and the increase in fitness was comparable for both lean and obese subjects.
  • Exercise induced a change in the population of gut bacteria, and the change was comparable in lean and obese subjects.
  • Exercise increased fecal concentrations of butyrate and other short-chain fatty acids in the lean subjects, but not in obese subjects.
  • The exercise-induced changes in gut bacteria and short-chain fatty acid production were largely reversed once exercise training ceased.

The authors concluded: “These findings suggest that exercise training induces compositional and functional changes in the human gut microbiota that are dependent on obesity status, independent of diet, and contingent on the sustainment of exercise.” [Note: To be clear, the exercise-induced changes in both gut bacteria and short-chain fatty acid production were independent of diet and contingent on the sustainment of exercise. However, only the production of short-chain fatty acids was dependent on obesity status.]

 

What Does This Study Mean For You?

is our microbiome affected by exercise gut bacteriaThere are two important take home lessons from this study.

  • With respect to our gut bacteria, I have consistently told you that microbiome research is an emerging science. This is a small study, so you should regard it as the beginning of our understanding of the effect of exercise on our microbiome rather than conclusive by itself. It is consistent with previous studies showing an association between exercise and a potentially beneficial shift in the population of gut bacteria.

The strength of the study is that it shows that exercise-induced changes in beneficial gut bacteria are probably independent of diet. However, it is the first study to look at the interaction between obesity, exercise and gut bacteria, so I would interpret those results with caution until they have been replicated in subsequent studies.

  • With respect to exercise, this may be yet another reason to add regular physical activity to your healthy lifestyle program. We already know that exercise is important for cardiovascular health. We also know that exercise increases lean muscle mass which increases metabolic rate and helps prevent obesity. There is also excellent evidence that exercise improves mood and helps prevent cognitive decline as we age.

Exercise is also associated with decreased risk of colon cancer and irritable bowel disease. This effect of exercise has not received much attention because the mechanism of this effect is unclear. This study shows that exercise increases the fecal concentrations of butyrate and other short-chain fatty acids. Perhaps, this provides the mechanism for the interaction between exercise and intestinal health.

 

The Bottom Line

A recent study has reported that:

  • Exercise induces a change in the population of gut bacteria, and the change was comparable in lean and obese subjects.
  • Exercise causes an increase in the number of gut bacteria that produce butyrate and other short-chain fatty acids that are beneficial for gut health.
  • These effects are independent of diet, but do not appear to be independent of obesity because they were seen in lean subjects but not in obese subjects.
  • The exercise-induced changes in gut bacteria and short-chain fatty acid production are largely reversed once exercise training ceases.

The authors concluded: “These findings suggest that exercise training induces compositional and functional changes in the human gut microbiota that are dependent on obesity status, independent on diet, and contingent on the sustainment of exercise.”

For more details and my interpretation of the data, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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