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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Latest Article

Can Plant-based Diets Be Unhealthy?

Posted September 10, 2019 by Dr. Steve Chaney

Do Plant-Based Diets Reduce Heart Disease Deaths?

Author: Dr. Stephen Chaney

 

plant-based diets vegetablesPlant-based diets have become the “Golden Boys” of the diet world. They are the diets most often recommended by knowledgeable health and nutrition professionals. I’m not talking about all the “Dr. Strangeloves” who pitch weird diets in books and the internet. I am talking legitimate experts who have spent their life studying the impact of nutrition on our health.

Certainly, there is an overwhelming body of evidence supporting the claim that plant-based diets are healthy. Going on a plant-based diet can help you lower blood pressure, inflammation, cholesterol and triglycerides. People who consume a plant-based diet for a lifetime weigh less and have decreased risk of heart disease, diabetes, and cancer.

But, can a plant-based diet be unhealthy? Some people consider a plant-based diet to simply be the absence of meat and other animal foods. Is just replacing animal foods with plant-based foods enough to make a diet healthy?

Maybe not. After all, sugar and white flour are plant-based food ingredients. Fake meats of all kinds abound in our grocery stores. Some are very wholesome, but others are little more than vegetarian junk food. If you replace animal foods with plant-based sweets, desserts, and junk food, is your diet really healthier?

While the answer to that question seems obvious, very few studies have asked that question. Most studies on the benefits of plant-based diets have compared population groups that eat a strictly plant-based diet (Seventh-Day Adventists, vegans, or vegetarians) with the general public. They have not looked at variations in plant food consumption within the general public. Nor have they compared people who consume healthy and unhealthy plant foods.

This study (H Kim et al, Journal of the American Heart Association, 8:e012865, 2019) was designed to fill that void.

 

How Was The Study Done?

plant-based diets studyThis study used data collected from 12,168 middle aged adults in the ARIC (Atherosclerosis Risk in Communities) study between 1987 and 2016.

The participant’s usual intake of foods and beverages was assessed by trained interviewers using a food frequency questionnaire at the time of entry into the study and again 6 years later.

Participants were asked to indicate the frequency with which they consumed 66 foods and beverages of a defined serving size in the previous year. Visual guides were provided to help participants estimate portion sizes.

The participant’s adherence to a plant-based diet was assessed using four different well-established plant-based diet scores. For the sake of simplicity, I will include 3 of them in this review.

  • The PDI (Plant-Based Diet Index) categorizes foods as either plant foods or animal foods. A high PDI score means that the participant’s diet contains more plant foods than animal foods. A low PDI score means the participant’s diet contains more animal foods than plant foods.
  • The hPDI (healthy plant-based diet index) is based on the PDI but emphasizes “healthy” plant foods. A high hPDI score means that the participant’s diet is high in healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) and low in animal foods.
  • The uPDI (unhealthy plant-based diet index) is based on the PDI but emphasizes “unhealthy” plant foods. A high uPDI score means that the participant’s diet is high in unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) and low in animal foods.

For statistical analysis the scores from the various plant-based diet indices were divided into 5 equal groups. In each case, the group with the highest score consumed the most plant foods and least animal foods. The group with the lowest score consumed the least plant foods and the most animal foods.

The health outcomes measured in this study were heart disease events, heart disease deaths, and all-cause deaths. Again, for the sake of simplicity, I will only include 2 of these outcomes (heart disease deaths and all-cause deaths) in this review. The data on deaths were obtained from state death records and the National Death Index. (Yes, your personal information is available on the web even after you die.)

 

Do Plant-Based Diets Reduce Heart Disease Deaths?

plant-based diets reduce heart deathsThe participants in this study were followed for an average of 25 years.

The investigators looked at heart disease deaths over the 25 years and compared people with the highest intake of plant foods to people with the highest intake of red meat and other animal foods. The results were:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

What Else Did The Study Show?

The investigators made a couple of other interesting observations:

  • The association of the overall diet with heart disease and all-cause deaths was stronger than the association of individual food components. This underscores the importance of looking at the effect of the whole diet on health outcomes rather than the “magic” foods you hear about on Dr. Strangelove’s Health Blog.
  • Diets with the highest amount of healthy plant foods were associated with higher intake of carbohydrates, plant protein, fiber, and micronutrients, including potassium, magnesium, iron, vitamin A, vitamin C, folate, and lower intake of saturated fat and cholesterol.
  • Diets with the highest amount of unhealthy plant foods were associated with higher intake of calories and carbohydrates and lower intake of fiber and micronutrients.

The last two observations may help explain some of the health benefits of plant-based diets.

 

Can Plant-Based Diets Be Unhealthy?

plant-based diets unhealthy cookiesNow, let’s return to the question I asked at the beginning of this article: “Can plant-based diets be unhealthy?” Although some previous studies have suggested that unhealthy plant-based diets might increase the risk of heart disease, this study did not show that.

What this study did show was that an unhealthy plant-based diet was no better for you than a diet containing lots of red meat and other animal foods.

If this were the only conclusion from this study, it might be considered a neutral result. However, this result clearly contrasts with the data from this study and many others showing that both plant-based diets in general and healthy plant-based diets reduce the risk of heart disease deaths and all-cause deaths compared to animal-based diets.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

There is one other subtle message from this study. This study did not compare vegans with the general public. Everyone in the study was the general public. Nobody in the study was consuming a 100% plant-based diet.

For example:

  • The group with the highest intake of plant foods consumed 9 servings per day of plant foods and 3.6 servings per day of animal foods.
  • The group with the lowest intake of plant foods consumed 5.4 servings per day of plant foods and 5.6 servings per day of animal foods.

In other words, you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet.

 

The Bottom Line

A recent study analyzed the effect of consuming plant foods on heart disease deaths and all-cause deaths over a 25-year period.

When the investigators looked at heart disease deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

A more subtle message from the study is that you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet. The people in this study were not following some special diet. The only difference was that some of the people in this study ate more plant foods and others more animal foods.

For more details on the study, 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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