Episode 127 – Nutrition For ADHD Part 1

Key Topics Covered

This has been one of the most requested topics so far.
It’s important to note that nutrition won’t “cure” ADHD, but symptom management could be improved.
There is a lot of information to cover, so this will be split into two parts.
Part 1 will cover:
- Nutrients of interest.
- Logistical challenges.
- Elimination diets.
Part 2 will cover:
- Food colours.
- Sugar.

Nutrients of Interest

There are a lot of nutrients that are commonly deficient in those with ADHD. But this creates a ‘chicken or the egg’ scenario about which causes which.
Our focus is on nutrients that have been linked with improved symptoms when addressed.

Iron

Addressing an iron deficiency can help.
But this is far more relevant when you factor in that iron deficiency is significantly more prevalent in those with ADHD.
For example, one small study found that 84% of children with ADHD were low in ferretin vs 18% in the control group.

Omega-3s

A systematic review found that 13/16 studies on omega-3 and omega-6 supplementation found improvements in symptoms.
If dietary omega-3 intake is not already high, it makes sense to address this, whether through food or supplements.
The proposed mechanism is that it helps the transmission of chemical messages in the brain and also reduces oxidative stress.

Zinc

Supplementing zinc, if addressing a deficiency, can help.
In fact, every study that has been done on zinc supplementation and ADHD has found benefits in symptoms.

Vitamin D

Supplementation if addressing a deficiency likely helps, although the research is weaker in this area.

Magnesium

Some research has found that people with ADHD tend to have lower levels of magnesium in the body compared to those who don’t have ADHD.
Therefore, magnesium supplementation may help improve symptoms of inattention, hyperactivity, and impulsivity in those with magnesium deficiency.

B Vitamins

One 2016 study found that adults with ADHD tended to have lower levels of certain B vitamins, including B2, B6, and B9.
Lower levels of both B2 and B6 were also associated with an increased severity of ADHD symptoms.
Research on addressing these issues has not been as promising as other areas though.

Multivitamin

As a clear sign that micronutrients matter, two studies have been done on multivitamins and both have found benefits.

Logistical Challenges

Not all of these will be relevant to everyone. Challenges will depend on how ADHD presents in the person, however these are some common ones seen in practice:

Poor appetite.
Loss of appetite from stimulant medication.
Forgetting to eat during the day (hyperfocus).
Overeating at night.
Binge Eating Disorder.
Food sensitivities.
Digestive problems.
Impulsive decision-making.
Emotional eating.
Poor planning and preparation.
Commonly restoring to takeaway/dining out.
Eating for stimulation & dopamine seeking.

Solutions

Again, not all of these may be relevant. However if implementing any of these can help, that is a win.

Prepping & Reminders

Planning and prepping everything in advance if possible.
Make a grocery list or order groceries online.
Find what works for you, whether it is calendars, checklists, reminders and alarms. This may help as a reminder to eat.
Meal prep in advance.
Utilizing time-saving items: Slow cookers, air fryers, pre-cut vegetables, frozen fruit and vegetables, microwave rice, or even pre-made meals.
Use visual reminders: Place foods you want to eat more of in your line of eyesight.

Meal Strategies

Prioritizing breakfast is probably a good thing for helping with a lot of aspects.
If you take medication that suppresses appetite, it could be worth having breakfast prior to this.
Have set small frequent meals and snacks.
Taking nutrient supplements if relevant. If it is unrealistic to get through food, using a supplement can help.
Reducing distractions during meals: Eating in a comfortable environment with minimal distractions (like TV, phone, or noise) can help you focus on your food and eat more mindfully.
Getting enough sleep, staying well hydrated, and reducing stress can all help too.

Elimination Diets

Elimination diets have been consistently effective in research
10 out of 12 studies on the topic found consistent improvements while participants were on an elimination diet.
For context, in those 10 studies, 50-80% of participants experienced noticeable improvements in symptoms. In another 11th study, 24% of participants had noticeable improvements.

Oligoantigenic Diet

The most effective approach so far has been an “oligoantigenic diet” which basically means a diet that avoids common food allergens.
For example, they would avoid foods such as cow’s milk, cheese, eggs, chocolate and nuts. But there are varying levels of strictness.

Few Foods Diet

The most commonly used approach is called The Few Foods Diet – which as the name implies, is highly restrictive.
It involves an elimination phase, a reintroduction phase, and a personalization phase. This total process can take as long as 18 months.

Should You Do It?

Whether it is worth pursuing an elimination diet is an individual decision.
A few things worth factoring in:
- The research looks way more promising than it actually is. When proper blinding is used, the effect size drops to about ⅓ of what the average has been so far.
- That therefore means there is still real benefit there. It is just smaller than the unblinded research has found.
- The research has also only really looked at the elimination phase. We suspect that after going through the whole personalization process, symptoms would remain similar – but it also may look slightly less effective after that process.
- It is incredibly restrictive and a tough process to go through.
- If binge eating was a factor, adding this restriction would be risky. Plus even without binge eating, nutrition for ADHD is tough enough as it is.
- The best-case scenario found in research involves that 50-80% success rate. So even if that was a fair assessment, it means 20-50% of people didn’t get a noticeable benefit.
- This is where I think it makes sense to pay attention to your personal situation. For some people, going down this route makes sense. For others, it doesn’t.

Relevant Blogs / Resources

Blog Posts

Nutrition for ADHD

Studies Mentioned