We all know that the quality of a child’s food affects their growth and development including how their body and brain work. But did you know that this is especially true for children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD)? There is strong evidence to show that a varied diet focused on whole foods can have a significant effect on the severity of a child’s ADHD symptoms by improving their thinking, learning, mood and behaviour.

 

What is ADHD?

ADHD is one of the most common childhood disorders, affecting around 1 in 20 children. It is associated with inattention, impulsivity and overactivity which impairs a child’s ability to function and can lead to a detrimental effect on development. ADHD is more common in boys than girls, and 60% of children diagnosed will experience symptoms into adulthood. Children with ADHD experience many challenges related to their eating which may include eating a limited diet, unhealthy snacking, poor appetite, weight concerns (both over and underweight), constipation, nutritional deficiencies, poor concentration whilst eating, constipation and more. Therefore, it is not surprising that getting some expert support from a Dietitian is an essential part of successful management for ADHD.

 

What affects the nutrition of children with ADHD?

Children with ADHD can either under eat or over eat which can result in becoming underweight or overweight when compared with their neurotypical counterparts. Being underweight can be caused by high energy and activity levels such as fidgeting and restlessness, rapid growth in childhood and adolescence leading to higher energy requirements, as well as poor appetite related to their medication or constipation Higher body fat stores in children with ADHD can be due to sporadic eating patterns and poor dietary choices, fussy eating, gastrointestinal upset being mistaken for hunger.  In both situations, vitamin or mineral deficiencies can be present and iron deficiency can also contribute to a poor appetite and difficulty getting them to eat the foods you want them to eat.

Other challenges for children with ADHD meeting their nutritional requirements include medication side effects, difficulties with focus and attention at mealtimes and constipation.

 

Maximising nutrition for children with ADHD

1. Whole foods first

As a family, enjoy a whole foods diet that includes healthy fats, vegetables, fruit, whole grains, and protein foods. By eating less processed foods, the diet will naturally eliminate unnecessary food additives and preservatives that can contribute to ADHD symptoms. Evidence suggests that approximately 25% of children who follow an elimination diet under the guidance of a dietitian to lower the chemical load of their diet have at least some symptomatic improvement and about 10% experience complete remission of symptoms.

2. Make every mouthful count

As children with ADHD often have issues with appetite regulation, it is important to include high protein and high energy foods such as full-fat dairy products, nut pastes, eggs and lentils. A dietitian may recommend oral nutritional supplements for children who are significantly underweight.

3. Listen to internal cues

Teaching your child to understand their hunger cues can help to maximise how much they eat when they feel the hungriest. Using a hunger and fullness chart can help support your child to express how hungry or full they feel.

4. Offer more when they are most hungry

Most children taking ADHD medication have no appetite during the day while their medication is working. Offer more nutritious food when they feel the hungriest, this is often in the morning before their medication has started working or in the evening once it has worn off.

5. Reduce the stress at mealtimes

A parent’s concern over how much their child is eating can cause great stress and generate a feeling of being disempowered for both the parent and the child. This can develop into a negative relationship with food and cause a caloric deficit due to food refusal or refusing to participate in mealtimes. Creating a positive mealtime environment with the family eating together and that allows a child to focus on hunger opportunities can increase the amount a child consumes and also provides important social interactions and demonstration of appropriate mealtime behaviour.

6. Mealtime routines

Children with ADHD feel safest and most focused when they have structure and know what is happening next. By creating a mealtime routine, you can help your child to feel calm and organised, therefore maximising their focus and satisfaction at mealtimes. Reducing distractions can also support positive mealtime routines by removing devices and unnecessary objects around the family dinner table.

7. Movement breaks in mealtimes

Often children with ADHD lose focus during mealtimes before they have consumed their meal. To help improve their attention, try adding a movement break at regular time points in line with how long your child can focus. The use of a timer can also help your child learn how long mealtimes are and work towards sitting at the table for longer periods of time.

 

How can a dietitian help?

Dietitians can assist you and your child to meet their nutritional requirements while developing strategies for tackling fussy eating or helping them learn to eat a wider range of foods, constipation or gut health management, difficult mealtimes and reduced focus when eating. They can also provide guidance in determining food chemicals that may exacerbate symptoms or impact your child’s growth and development

 

By Kylie Spicer - Provisional APD