Nutrition Strategies for Children with ADHD – Part 2

Austin CookingThis week I introduced you to my son, Austin, and some nutrition interventions that do and do not work to help children with Attention Deficit Hyperactivity Disorder (ADHD). While it’s true that impulsivity, inattentiveness, and hyperactivity are each hallmarks of ADHD, so are creativity, innovation, imagination, and usually intelligence! Children with ADHD are often the best little chefs if this imagination and creativity are fostered correctly. You see, while most of us can shut out the multiple distractions that come at us each day to focus on the task at hand, individuals with ADHD are not able to shut out that stimuli. Another child tapping a pencil, someone humming a tune, or a butterfly outside the school window are each enough to pull the attention of a child with ADHD in many different directions.

This inability to maintain focus is thought to be related to a disorder of the dopamine receptors in the brain and a decrease in serotonin activity (both of these chemicals are known as neurotransmitters that help control brain activity). Therefore, it’s believed that a child with ADHD has difficulty or the inability to shut down the right brain in favor of the left brain as many of us normally do. So while this can lead the child to be impulsive and inattentive, these children are also usually the builders, creators, engineers, inventors, and chefs.

Austin underwent 6 weeks of psychological testing a few years ago to determine the cause of his nervous tics and impulsive behavior. He was diagnosed as a genius with ADHD. We weren’t surprised – at the age of 2 he was building 500 piece puzzles and massive Lego structures. We originally thought he would be an engineer when he grows up, and we still think that is a possibility. But now we’re thinking he may become a chef – he has decided he loves cooking and baking if he gets to cook from scratch rather than from a box. The science of food intrigues him; he wants to know the role that each individual ingredient plays to make the final product. Even as a Registered Dietitian who studied food science in college he sometimes stumps me with his questions!

Working with my son in the kitchen has taught me several things that are helpful for all children, and not just those with ADHD:

  • Children are known to ask (sometimes repeatedly) “when will dinner be done?” For children with ADHD and other behavioral diseases characterized by impulsivity, it is especially difficult for them to wait for the meal (or really anything else). But when they are helping make the food, they don’t need to ask – they will know. Preparing the ingredients, assembling the meal, and placing it in the oven while setting the timer for cook time will give them something active to do while waiting and give them control and knowledge over the time to completion.
  • All children are more likely to eat new foods if they help prepare them. Developmentally and age appropriate tasks should be assigned to children to help with some aspect of meal preparation, even if it is simply setting the table.
  • Creativity and imagination should be encouraged, even in the cooking process! I let Austin experiment with new or substituted ingredients, just so he can see what will happen. Some of these are tried and true things, like substituting applesauce for the fat source in muffins to reduce the overall calories. While it’s a well-known cooking “trick” for those of us who have been cooking for years, it is still a fun novelty for my son while sneaking some “stealth health” into our food. Other times, I let him try things that will have unexpected results (like using baking soda instead of baking powder to see for himself the difference between the two, or using different spices and seasonings). If the meal doesn’t turn out right, we always have a back-up soup or crock-pot meal that can stand in its place. But the memories created, knowledge gained, and creativity fostered are priceless in comparison.

My husband fears that my cooking career is on hiatus for the next 6 years until Austin leaves for college! In the meantime, I’m loving having a partner in the kitchen to expand my own skills and spend quality time with my son all while harnessing his ADHD in a positive manner. If you have a child with ADHD, I hope you will consider some of these tips and guidelines as a way to utilize their ADHD to their benefit while becoming more engaged in nutrition in the kitchen!

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Wendy Phillips, MS, RD, CNSC, CLE, FAND is the Immediate Past President of VAND and a Division Director of Nutrition for Morrison Healthcare. She is the mom of 2 boys, ages 12 and 15.

Nutritional Strategies for Children With ADHD – Part 1

IMG_0532“All we ever do as a family anymore is talk about my ADHD,” my son Austin complained, as he pushed aside the books I bought to help us learn about this new diagnosis he had been given. I sighed, because I knew he was right, but I didn’t know what else to do. Due to concerns shared by his teachers, we went through several weeks of testing for my youngest son for what we thought at the time was anxiety. Instead, he was diagnosed with Attention Deficit Hyperactive Disorder (ADHD), which in many ways is better than anxiety! Needless to say, we quickly gave ourselves and Austin an extensive education on the disorder, its treatment options and what we could do to help our son. For the first time ever, I began browsing through parenting blogs and nutrition blogs to see what others were doing to help their children cope with ADHD.

I was dismayed by the sensational information that is “published” on some of these blogs, with a complete lack of scientific evidence for what is being recommended. Many of the writers were very persuasive, and other parents seemed to be trying very hard to follow their advice even at a high monetary and peace-of-mind cost to themselves and their families. It was an overwhelming transition to begin with: finding out my child has ADHD, working towards a medication regime that was effective without horrible side effects, working with teachers for a school special education plan, changing routines at home and educating siblings, friends and ourselves. Not to mention helping your child understand his diagnosis and cope with the fact that he will be taking medication for the rest of his life, only to have him tell you he feels like “all we ever do as a family anymore is talk about his disease.” You get the point! I didn’t want to wade through pages upon pages of opinions; I wanted nutrition interventions that had at least been proven to effectively help with ADHD.

So what are those interventions that work? Here’s a quick summary of what I found!

  • Sugar and artificial sweeteners do not increase the impulsivity, inattentiveness, or hyperactivity of children with ADHD (or any other children). However, these substances do have other adverse effects and all children should be encouraged to reduce intake of simple carbohydrates and sugars, and be provided with education to work towards increasing whole grains and complex carbohydrates.
  • The research is conflicting on whether or not artificial food colorings and preservatives increase the symptoms of ADHD. It’s hard enough to help a child learn to control ADHD behaviors. Avoiding all foods with artificial colors and preservatives at home, and expecting him to do so at school and social situations is almost impossible. RDs should have conversations with parents about the pros and cons of this diet to complement other lifestyle and behavioral management components of ADHD and help the family reach their goals for their child.
  • Vitamin D supplementation may be beneficial for children with ADHD. Low blood levels of Vitamin D are common in people with ADHD and other disorders associated with impulsive behavior. Supplementation has been shown to improve inattention, hyperactivity, and impulsivity; individuals with confirmed deficiency may benefit from supplementing with 4,000 IU of Vitamin D per day, but specific dosage advice should be obtained from the child’s pediatrician.
  • Omega-3 fatty acids may help with reducing inattentiveness associated with ADHD. If a deficiency is confirmed or nutrition history suggests very limited dietary intake of Omega-3s, it may be beneficial to choose a supplement that contains both EPA and DHAs (specific types of Omega-3 fatty acids). Specific dosage advice should be obtained from the child’s pediatrician.

As for my son, he is 12 now, and we have been through a lot with medications that didn’t work, some that made him much worse than before, and have finally settled on a medication plan that we are happy with. He started middle school last year, and with many prayers and worried nights, he hit the ground running and had an amazing year – so much better than elementary school, which is surprising for a child with ADHD. He talks about his diagnosis with other children because he too wants to educate others. And, he tells other kids “eating sugar isn’t an excuse for being hyper, so calm down. I know this because my mom is a Registered Dietitian!”

While it’s true that impulsivity, inattentiveness, and hyperactivity are hallmarks of the disease, so are creativity, innovation, imagination, and usually intelligence. In a future blog post I’ll share ideas on how to harness these traits to benefit you and your child in the kitchen!

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Wendy Phillips, MS, RD, CNSC, CLE, FAND is the Immediate Past President of VAND and the Professional Education Chairperson. She is a Division Director of Nutrition for Morrison Healthcare, and the mom of 2 boys, ages 12 and 15.