ADHD and Diet in Children – Part 1. My son was diagnosed with ADHD in Kindergarten. I was a Registered Dietitian back then and had been since 2000. However, I admit all I was thinking about back then was keeping his diet balanced. This included ensuring he received enough protein, iron and other essential vitamins and minerals through the foods he ate. I never thought about diet and ADHD in children.
I never seriously thought about food additives to avoid or specifically, “Diet and ADHD in children,” until recently.
Nathan was pickier when he was younger, and he was thin. So, in addition to giving him a multivitamin with iron, I gave him one bottle of Pediasure every day. I also gave him 1000 IU of Vitamin D (and still do) every day. (I take 6,000 IU per day. We use Seeking Health D3 drops).
I started giving Nathan vitamin D after I was diagnosed with vitamin D deficiency. My doctor prescribed a high dose of vitamin D (10,000 IU per day) to counteract the deficiency. The vitamin therapy had amazing effects on my mood–within 3 days I felt better. I was ready to start selling vitamin D, I was so impressed. I've struggled with depression in the past, so this was a HUGE deal!
I also noticed that as I continued to take it, I got sick with the cold much less often. To this day, if I get a cold, it's milder and it doesn't last as long. This is the same with my son.
More people are realizing that vitamin D is essential for much more than strong bones.
It treats and prevents depression, increases your immune system, and is even helpful for diabetes. However, not everyone is on the bandwagon.
The standard 400 IU is not enough to prevent deficiency in most people, but this is the most common amount on multivitamin labels. In fact, this is still another vitamin that many people are deficient in, and most aren't even aware of it. (See my articles on Zinc Deficiency and Magnesium Deficiency for two other examples).
The research is still catching up on how important vitamin D is for good health. However, the vitamin D council has the latest, and the most accurate information regarding vitamin D. (Vitamin D is not actually a vitamin. It's a hormone and is part of the endocrine system). Click here for my article about foods high in Vitamin D.
What about Additives to Avoid?
Okay, so I was satisfied with the fact that Nathan was getting all the most important nutrients through his diet and/or through the supplements I was giving him. One thing I didn't think about back then, however, was whether there were food additives in his diet that could be contributing to his symptoms. I never asked the question, “Do certain foods or ingredients affect kids with ADHD?”
New Discovery of the Importance of Diet and Children with ADHD
I didn't start thinking about food additives until Nathan was seven, because I was overwhelmed with all his other issues. And let's face it. Most doctors don't emphasize food or nutrition as potential therapy for special kids such as ours. My son's doctor certainly didn't.
As a Registered Dietitian Nutritionist, we are required to complete a certain number of continuing education units. So, when it was time to search for that perfect continuing education class, I came across an awesome book titled, “Eating for Autism,” by Elizabeth Strickland. When I read this book, the lights started coming on. And I immediately made changes to further improve Nathan's health.
For example, I immediately put Nathan on a high-quality Omega-3 supplement. (I will talk more later about why quality is so important and how to know you are getting the best quality). I also changed his multivitamin so that it did not contain any artificial flavors or colors. Previously he was taking Flintstones chewable vitamins, which were prescribed by his pediatrician. He wasn't taking omega-3s at all before this.
I want to point out a few things that I believe are important to know about children's multivitamins.
When Nathan's pediatrician first prescribed multivitamins, I had to tell the pharmacist I wanted iron in the vitamin, because the doctor ordered them without iron. The doctor was worried about the supplement causing constipation. However, a multivitamin with iron only contains 100% of the US RDA and shouldn't cause constipation (be sure to check with your doctor before making changes like this). Normally, iron causes constipation when taken as a single mineral supplement because it is a larger amount. NOTE: I do not recommend iron supplements without a doctor's order because of the risk of toxicity.
A separate iron supplement should only be necessary if your child is diagnosed with iron-deficiency anemia (low iron in the blood). This requires a simple blood test. At that point, the risks of constipation outweigh the risks of iron-deficiency anemia.
Cow's Milk and Iron Deficiency
I previously worked for the Women, Infant, and Children program as a Public Health Nutritionist. While there, I discovered that iron deficiency is common. I also completed my master's degree project on Iron Deficiency Anemia and its connection to excessive cow's milk intake. So, this issue is close to heart.
For those interested, the results of the study showed that children who stay on the bottle longer than 12 months are at increased risk of iron deficiency anemia.
This is because:
Cow's milk has no iron, and in fact too much cow's milk can interfere with iron absorption (affect the ability of your child to use the iron from other foods)
Drinking from a bottle usually means drinking substantial amounts of milk. Whole milk is high in calories*, and so will fill the child up and make him less interested in other foods (such as iron rich foods).
So, prevention of iron deficiency was important to me before Nathan was even born.
This is because Iron deficiency is serious and should not be taken lightly.
Iron deficiency anemia results in developmental delays, (and can even cause permanent mental retardation, if it's severe enough, and doesn't get treated). Iron deficiency also results in increased risk of infection, fatigue, and a whole slew of other issues. Prevention is the best treatment. The good news is that most doctors test for iron deficiency early on. If your child has not been tested. I strongly encourage you to get him or her tested.
It is important to note that if there is no deficiency of iron, and your doctor has not ordered an iron supplement to treat the deficiency, a simple multivitamin with iron should prevent iron deficiency anemia, even if the diet is inadequate in iron.
I gave Nathan the Flintstones vitamins with iron for several years. They were free through his insurance. Once I started learning more about the risks of artificial colors and their effects on kids with ADHD and autism, I started giving him vitamins that don't contain artificial additives. I paid for these myself, which was worth it to me. Although to be fair to the doctor, she might have been willing to prescribe the healthier ones, I just never asked.
It's important to know that gummy vitamins do not contain iron.
It can be hard to get your kid to chew healthier multivitamins. This is something I started having problems with. Nathan got to a point where he wouldn't take the chewable vitamins. Of course, he liked the gummy vitamins. However, I knew he needed iron to prevent anemia, because he wasn't eating much meat at all (or meat alternatives, such as eggs, beans, peas, nuts, seeds). So, I searched high and low for gummy vitamins that contained iron. I could not find one with iron!
So, if you want your child to get iron in his multivitamin, you'll need to find another type than gummies.
(If you know of a gummy vitamin with iron, please let me know)!
So, back to the first step to healing. I didn't necessarily do the steps in order (nor did I even do all the steps. For example, I see no evidence that Nathan is gluten or casein intolerant). However, I'm going to try to talk about them in order–sort of.
Anyone who knows me knows that I tend to jump around from topic to topic when I'm talking. Since I am writing to you, that shouldn't be too much of a problem!
First, like I discussed above, make sure your child is getting his or her basic nutritional needs met. You can do this by:
Completing a 3-day diary of everything your child eats. (Click here for a basic 3-day food record–it's free–that I whipped up). Make it as detailed as possible, including serving sizes, brand names, time of day eaten, how much actually eaten, how much your child likes the food. Remember it's only 3 days! 🙂
Try not to make any changes or improvements during this 3-day period. Don't judge yourself or your child. No one has to see this except you.
Use MyFitnessPal.com or some other calorie/nutrient calculator to help. MyFitnessPal.com will make it much easier to see any major deficiencies (or excesses) in intake off the top.
For example, proteins, carbohydrates (simple, complex, fiber), fats (saturated, mono and poly, trans), cholesterol
Vitamins A, C, sodium, potassium
This is a good starting point.
After you've done a 3-day diary for your children (and yourself, if you're feeling brave :D), The next is to recognize, and then to avoid (or minimize) synthetic (artificial) food additives that are detrimental to his or her (and your) health.
So, in summary, record and review your children's and your (whole family's?) diets. Look for glaring deficiencies. Think about adding a multivitamin with iron (if not already taken) to your child's diet. Talk to your doctor about having your child tested for iron and/or vitamin D deficiency if you feel it's a problem.
Click here for a free handout of food combinations that increase absorption of Iron. Hint: Combining iron rich foods and vitamin C rich foods is the key. Click here for recipes and articles on iron rich foods.
In case you don't already know this. Adobe Reader is free and allows you to type into the document. When you click “Fill and Sign,” it allows you to type on the lines. This is something I just recently discovered.
It is much less common for kids living in developed countries such as the United States, Canada, Australia, and Europe to be deficient in protein. But it is a risk that should be taken seriously, especially if you have a picky eater in your house. Knowing why protein is important is the first step to understanding the potential severity of protein deficiency, especially to growing children, and pregnant and breastfeeding women. Educating yourself on which foods are high in protein as well as how much protein is needed during different life stages will help you prevent protein deficiency from being an issue in your family's home.
There are many reasons why protein is important to a person's diet.
The body uses protein to make antibodies, which are important for a strong immune system.
Protein is necessary to produce enzymes. Enzymes are the chemicals that break down foods and enable cells to complete chemical reactions in a timely manner.
DNA/RNA synthesis is not possible without certain amino acids that make up proteins.
It is important for the repair of skin, organ and other tissues and cells, including hair. It is also important for maintaining fluid balance in the blood, and for properly functioning enzymes and hormones. In fact, enzymes and hormones ARE proteins.
Higher amounts of protein are required when a person is sick or recovering from an illness. Also, when a woman is pregnant or breastfeeding, protein requirements are increased. There is also an increased need for high quality protein when there is damage to the body cells, such as post-op recovery and healing after bones are broken.
Protein makes up 20-30% of muscle, 50% of bones, 20-30% of the liver, 30% of blood, and a substantial percentage of skin and hair.
A good example of the importance of protein AND iron is Hemoglobin.
Hemoglobin is the protein in blood responsible for carrying oxygen throughout your body.
Note also that a hemoglobin molecule also contains an iron atom.
So, if there is not enough iron or protein in the diet, there will be insufficient hemoglobin. This means the ability of the blood to circulate oxygen throughout the body will be depleted. Thus, both Iron and protein are important for healthy blood and a healthy person.
Proteins are made up of amino acids which are the building blocks of life.
Amino acids are necessary to build healthy muscles, and for proper nerve function.
If there is a protein deficiency in the diet, there could be:
Stunted growth
Poor muscle mass
Edema (water retention in cells)
Thin and fragile hair
Extreme cases of Protein Malnutrition are called “Kwashiorkor”
Difference Between Essential and Non-Essential Amino Acids.
Essential amino acids must be eaten through foods in your diet, and non-essential amino acids do not.
The following are the eight essential amino acids that must be taken in through the diet.
Tryptophan is a precursor to the important neurotransmitter serotonin. It has been shown to help some migraine sufferers who get what are known as “serotonin headaches,” though evidence is conflicting. Food sources include beef, turkey, chicken, flax seeds, almonds, eggs, and English walnuts.
Tyrosine is important for making sure the brain is producing adequate amounts of the feel-good neurotransmitters L-dopa, dopamine, norepinephrine, and epinephrine (adrenalin). It is also important for proper thyroid function and healthy skin. Foods rich in tyrosine include whole grains, oats, pork, milk, cheese, and other dairy products, soy foods, including tofu, avocadoes, and bananas.
Valine is essential for proper organ function, especially the liver and gall bladder. This amino acid is also important for balancing nitrogen levels in the body. Valine deficiency could lead to myelin sheath damage (the myelin sheath protects nerve cells), which in turn could lead to nerve damage. Foods rich in valine include tuna, snapper, cheese, soy protein, chicken, and nuts.
Isoleucine is necessary for the synthesis of hemoglobin, a major constituent of red blood cells. It is also important for stabilizing blood sugar and energy levels. Isoleucine is found alongside valine in many foods, including soy protein, chicken, lentils, chickpeas (garbanzo beans), and liver.
4 More Reasons Why Protein is Important
Leucine is important for growth and repair of muscle and bone tissue, and for wound healing. Leucine is also important in helping to stabilize blood sugar levels and for Growth hormone production. The best food sources of leucine are animal protein. The best non-animal protein sources are nuts and seeds.
Lysine is necessary for preventing glycation, which is the sticking together of sugar molecules with protein molecules without proper enzyme regulation. The result is what are known as “glycation end products (AGEs).” It is also important for proper growth, and for keeping cholesterol levels down. Lysine is found in foods such as soy products, chicken and milk.
Methionine is a supplier of sulfur, which is necessary for collagen production. Collagen is one of the most abundant proteins in the body, and is important for healthy bones, skin, hair, and nails. Methionine also has a fat dissolving effect and helps to prevent fatty liver. This amino acid is a building block in the synthesis of other proteins such as carnitine, melatonin, and glutathione. Food sources of methionine include nuts, eggs, beef, sesame seeds, Brazil nuts, and fish. Unfortunately, extraordinarily little methionine is found in fruits and vegetables.
Phenylalanine: There are two forms of Phenylalanine, L-Phenylalanine and D-Phenylalanine. It is the L form that is an essential amino acid and that must be taken in through the diet. L-Phenylalanine is important to produce Tyrosine, another essential amino acid, as well as serotonin, norepinephrine and epinephrine, the feel-good neurotransmitters. Food sources include pork, chicken and turkey, yogurt, cheese, and milk.
Phenylketonuria
There is a medical condition known as “Phenylketonuria” or “PKU.” This is a genetic disorder that results in a person not being able to breakdown phenylalanine. This has hampered studies done on the effectiveness of phenylalanine for treatment of certain other disorders including depression.
There is a third category of “Conditionally essential” amino acids that applies to exceptional circumstances. For example, babies born prematurely sometimes cannot synthesize them. The conditionally essential amino acids are Arginine, Cysteine, Glutamine, Glycine, Proline, and Tyrosine. I will talk about this in another post.
Click Here for a free printable handout that shows the recommended minimum protein intake for kids as well as a brief list of the best sources of high-quality protein.
There are three (3) types of fats and oils. But what is the difference, and are some all “bad” and some all “good?”
Not really. It's all about balance.
The word “fat” is a general term, the scientific term being “lipid.” Lipids include natural oils, waxes, and steroids. All oils are fats, but not all fats are oils.
Let me explain.
Oils are fats that are liquid at room temperature, because of a higher percentage of monounsaturated and/or polyunsaturated fats. The “unsaturated” part is what makes them liquid. Fats are solid at room temperature because of having a higher percentage of saturated fats.
There is no oil or fat that is strictly saturated or unsaturated. All oils and fats are a combination of saturated and unsaturated parts.
The more saturated a particular fat is, the higher the melting point. “Melting point” refers to the temperature at which a substance will melt. For example, butter has a melting point of about 90 degrees F. This is why butter is solid at room temperature. On the other hand, olive oil, which becomes partially solid in the refrigerator (40 degrees F), will melt once you put it at room temperature, around 70 degrees F.
Are some fats healthier than others?
The unsaturated fats are more “heart healthy.” However, our bodies need some saturated fat to be healthy. Thus, limiting your saturated fat to 10% of total calories from fat is considered optimal.
Another crucial point is that certain types of polyunsaturated fats are anti-inflammatory. For example, the omega-3s are anti-inflammatory. In contrast, the omega-6s are proinflammatory, if there are too many of them in the diet. The ratio is important for good health. An ideal ratio of omega 6 to omega 3 is about 4:1. Thus, omega-6 fats are essential, but balance is important.
Below is a list of fats/oils that are categorized by the type of fat they are primarily composed of. Fats are not composed of all one or the other. For example, olive oil has 10 grams of monounsaturated, 1 gram of polyunsaturated, and 2 grams of saturated fat. Olive oil starts to get solid in the refrigerator. Canola oil, on the other hand, has 9 grams of monosaturated, 4 grams of polyunsaturated, and 1 gram of saturated fat. Thus, canola oil stays liquid in the refrigerator.
Sources of Mainly Saturated
Butter
Coconut Oil
Lard
Beef Fat or Tallow
Shortening (Artificially Saturated using a scientific process known as “partial hydrogenation”)
Best Sources Monounsaturated
Olive oil
Canola Oil
Avocado Oil
Nut Oils (Almond, Cashew, Macadamia, Pecans)
Peanut Oil (peanuts are classified as legumes/beans)
In a future article, I will go more in-depth about each individual type of fat. All fats are essential to good health.
I will also discuss in future articles the differences between Omega-6 and Omega-3 oils. They are both important, but ratio DOES matter.
The anti-inflammatory properties of Omega-3s can be therapeutic in treating children with autism and ADHD, especially if they are deficient in the diet. Stay tuned for more…
Other Posts of Interest by Homeschooling Dietitian Mom
Of all of the superfoods, blueberries are one of my favorites. And living in Oregon, we sure do get plenty of them. But what exactly makes blueberries superfoods? And what are some of the ways you can eat them?
Here are at least 5 reasons blueberries are superfoods.
Interesting facts about blueberries:
More species of blueberries exist in North America than in any other continent in the world.
Blueberries have the highest antioxidant capacity of any of the popular fruits and vegetables.
Specifically, blueberries are rich in the phytonutrients known as anthocyanins.
Antioxidants are just what they say they are: “anti”, meaning they work against, “oxidation.”
Oxidation is a process that results in the breakdown of cells. For example, the reason bananas, apples, and potatoes become brown when open to the air is because of oxidation.
Thus, antioxidants prevent cell damage in the body, an example of which is cancer.
Blueberries are an excellent way to reduce your risk of cancer and other age-related diseases.
Blueberries are low in calories. One cup only contains about 80 calories.
These tasty fruits are a good source of fiber, providing 4 grams per serving.
They are also high in vitamin C and a good source of potassium.
As with all fruit, blueberries are high in water (85%). Thus, blueberries hydrate your body naturally.
Blueberries taste delicious and make many other foods more tasty. For example, add some blueberries to your pancake or waffle batter the next time you're fixing breakfast. Or just add the blueberries on top.
Add blueberries to your favorite smoothie in the morning. You can freeze blueberries to increase their shelf life. This is great in the summer because the coldness of frozen berries makes the smoothie more refreshing on a hot summer day.
Add them to your favorite cereal or to plain yogurt to spruce them up AND make them more nutritious.
This is at least 5 Reasons why blueberries are superfoods. Can you think of any more reasons?
There are so many awesome reasons for eating more vegetables, I hardly know where to start! And there are a great many healthy vegetables to choose from. Everyone should be able to find some they like. Below are 6 reasons you need more vegetables in your diet.
I do know that I like to be reminded of the nutritional benefits of consuming more vegetables, because I find that when I am reminded, I'm inclined to eat more of them! So, for starters we're going to look at 6 reasons you need more vegetables in your diet.
One of the reasons why variety in your diet is so important is because every unique food has something special to add. This is especially true of vegetables. In fact, I believe that's one of the main reasons God created so many different kinds of vegetables.
6 reasons you need more vegetables
Low in calories – eating more vegetables will fill you up without the overload of calories and will help with weight control
Small amounts of good carbohydrates and high in Fiber
The exception to “low carbs” being starchy vegetables (potatoes, corn, winter squash)
However, all carbohydrates in vegetables are GOOD carbohydrates, so potatoes are not a BAD vegetable. And potatoes and other starchy vegetables are excellent sources of fiber when you eat the skin.
Vegetables are low in fat.
Avocados are an exception; however, avocados are excellent sources of monounsaturated fats which are good fats.
Naturally low in sodium when fresh (or canned with no salt added)
Rich in vitamins and minerals, especially vitamin A, vitamin C, vitamin K, folate, B6, potassium, manganese
Now that we've discussed 6 reasons you need more vegetables in your diet, lets discuss 6 different vegetables and how their individuality can enhance your health when you eat more of them.
The wonderful thing about tomatoes is that they are available year-round, plus they are so versatile, you can sneak these vegetables into almost any diet, no matter how “vegetable hating” the individual is.
Tomatoes have a low glycemic index, are low in sodium (fresh, no salt added canned), are low in calories, and low in fat. Tomatoes are also high in fiber.
For example, 1 cup cherry tomatoes, which is about 8-10 tomatoes, only has about 27 calories, less than half a gram of fat, only 7.5 mg sodium, 5.8 grams carbs, with 1.9 of the carbohydrates being fiber.
High in Vitamins
The same serving size of tomatoes is packed with vitamins and minerals, as the list below shows.
Vitamin A (1241 IU – 25% US RDA)
Folate (6% US RDA)
B6 – (6% US RDA)
Vitamin C (18.9 mg 32% US RDA)
Vitamin K (11.8 mcg 15% US RDA)
High in Minerals
Potassium (353 mg 10% of US RDA)
Manganese (8% of RDA)
Choline (No established RDA, but significant to persons with Diabetes)
See Below for delicious recipe that contains tomatoes.
Bell Pepper
Low in Calories, (15 calories in one small pepper), fat, sodium (similar to tomatoes), and carbs, 6.9 carbs, 2.5 fiber
One of the best sources of Vitamin C of any vegetable. One small bell pepper will provide you with 100% of your needs for the day.
Also, a significant source of vitamin B6. This is important because vitamin B6 is low in many diets. This is because of high intake of enriched breads and cereals, which have been stripped of the outer bran and endosperm.
Bell peppers are not as good a source of potassium as other vegetables, but they do have potassium. And, it all adds up, right?
Broccoli
Low in calories, sodium, fat, and carbohydrates. For example:
“Beets are highly nutritious and “cardiovascular health” friendly root vegetables. Certain unique pigment antioxidants in this root and its top greens have been found to offer protection against coronary artery disease and stroke. These antioxidants also lower cholesterol levels within the body and have anti-aging effects.”
Carrots
Like most other vegetables, carrots are low in calories, fat, carbohydrates, and excellent sources of fiber.
One thing about carrots stands out, however:
Carrots are a supersonic source of vitamin A. For example, 1 cup chopped carrots contains 12,383 IU of vitamin A (a whopping 428% of US RDA)!
In addition, 1 cup chopped carrots provides 13% of your daily needs of vitamin C, 21% of vitamin K, and 6% of folate and vitamin B6.
And carrots contain more than 400 mg of potassium per 1 cup serving.
Mushrooms
Of course, mushrooms are low in calories, fat, carbohydrates, and sodium like other vegetables. However, mushrooms are totally unique on this list.
First, mushrooms are not actually vegetables. They are technically fungus. Second, mushrooms are “the only vegetarian food” that are known to have their own vitamin D.
I always suspected this is because they naturally grow in the sun. And that's what science says.
When mushrooms are exposed to UV (sun) rays, they make their own vitamin D. This increases the vitamin D content of them for eating. I don't know about you, but that is so cool!
According to www.Berkeleywellness.com:
“Mushrooms contain a “pro-vitamin,” or precursor, called ergosterol that is converted into vitamin D when exposed to the sun’s ultraviolet (UV) radiation. This is like how your skin synthesizes vitamin D in response to sun exposure. However, commercially cultivated mushrooms are almost always grown indoors in the dark. As a result, they usually have negligible amounts of vitamin D. In contrast, wild mushrooms—notably chanterelles, maitake, and morels—are usually rich in D because they get sun exposure.”
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