Friday, January 28, 2011

My child was just diagnosed with ADD/ADHD… What should I do?

 There are a variety of treatment options for ADD/ADHD, including behavioral, educational and pharmaceutical. I’m going to limit my thoughts here to nutritional recommendations, as they are immediately under the control of most consumers. The other approaches have their place, and it’s important to have a team of professionals on board when dealing with this condition – don’t forget that it takes a village to raise a child.

The basis for health starts in the kitchen for many conditions, and ADD/ADHD is no exception. The most important changes to make for a child with ADD/ADHD are: less sugar, more protein, healthier fats, fewer additives, and more antioxidants. These are healthy recommendations for anyone, but have specific reasoning in this condition.

Less sugar and more protein are flip sides of the same coin. Unbalanced blood sugar is often a major contributor to a child’s inability to maintain focus in school. When blood sugar is very high, due to high sugar intake, energy levels are high, and the child may not be able to focus that energy productively. When blood sugar plummets as a reaction to high blood sugar levels, attention drops off. By keeping your child’s consumption of refined sugar to a minimum, you can prevent this spike and valley effect; this is especially important at breakfast, which sets the tone for the rest of the day. Protein is converted into sugars more slowly, thus maintaining a steadier blood sugar level throughout the day, and so it prevents the rise and fall. Most people think that protein comes in the form of meat only, but I often urge parents to consider eggs, nuts and seeds as good protein sources that can be consumed regularly.

A healthier fat profile is also important to successful management of ADD/ADHD. Unsaturated fats, such as those found in fish oil, have long been recommended to children with learning or behavioral challenges on the basis that they promote healthy growth of neural tissue. While I believe there may be some benefit to neural function, it’s not clearly been demonstrated. What is more likely, is that it may be due to the anti-inflammatory effect of unsaturated fats. The exact pathophysiology of ADD/ADHD is not yet understood, but little disease takes place in the body without inflammation, and so it is possible that this is the mode of action.

There has long been speculation that food additives may contribute to ADD/ADHD symptoms, but recent studies have begun to establish a stronger connection. The association is strongest with hyperactivity, and the link is becoming increasingly strong. Many of the studies indicate that increased consumption of food additives predisposes children to hyperactivity, but there are some studies showing that food additives may aggravate hyperactive behaviors in children already diagnosed with ADHD.

Finally, there has also been research indicating that antioxidants may be helpful in ADD/ADHD. Again, a clear mechanism has not been established, but it may be that the benefit provided by antioxidants is due to their anti-inflammatory effect.

If you were to take these recommendations and apply them to a diet, here’s what it would look like: minimal amounts of processed foods; little to no refined sugar; moderate amounts of fruit, grain and meat; copious amounts of vegetables; regular servings of nuts and seeds; regular servings of fish. This diet is fairly similar to what is now called the Mediterranean Diet, and while it requires a little work, it is one that provides benefit to the whole family, beyond the recently diagnosed child.

One lifestyle change that goes along with a diet like this is the need to cook regularly. While cooking does add a task to the day, it has two potential positive effects on a child with ADD/ADHD. One, it provides a potential outlet for the child; while not universally true, many children enjoy helping out with cooking, as it provides a lot of varied stimulus that will keep the child focused when they might normally be watching TV or tearing the house apart. Two, it has the potential of slowing down the pace of the household, generating a calmer atmosphere, which may rub off on your ADD/ADHD child.

ADD/ADHD is a tough diagnosis for a lot of families, because it’s a behavioral issue as well as a learning issue. It’s important to have a team of professionals with whom your can consult, from teachers, to learning aides, to coaches, to doctors, to counselors, etc. Finding the match that works best for you is key; follow your instincts, and make sure you feel that the people you work with are listening to you and are honestly engaged in helping your child achieve his or her potential. These dietary suggestions won’t fix everything (though you’d be surprised how far they can go!), but they will certainly give your child a solid base from which to work.