ADHD
ADHD is defined as a neurodevelopmental disorder involving inattention, hyperactivity, and impulsiveness; therefore, it stands to reason that eating foods to support and promote brain focus and attention, and foods that have a calming effect may help with hyperactivity and restlessness. Other symptoms of ADHD include struggling to complete a task, staying focused, and difficulty curbing inappropriate behavior. Many of these symptoms affects the ability to do well in school and maintain healthy relationships.
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Autism Spectrum Disorder
Autism is defined as a developmental disorder of variable severity that is characterized by difficulty in social interaction and communication and by restricted or repetitive patterns of thought and behavior. Like with ADHD, diet can support and promote cognitive function and may even help with some common Autistic behaviors.
Antisocial Behavior
Anti-social behaviors are actions that lack consideration for the well-being of others. We will look at what roll nutrition could play in decreasing antisocial behavior as well.
Below we will look at some of the foods that may be helpful according to research.
General Diet
Before we dive in, it should be noted that studies are finding that incorporating an overall balanced diet full of a variety of essential nutrients has the most benefit regarding these conditions. Unfortunately, children with Autism or ADHD may have nutrient deficiencies due to picky eating. Common deficiencies may include vitamin B6, vitamin B12, Folic Acid, and Vitamin D. Therefore, multivitamin supplements are often recommended and have been shown to improve Autism and ADHD symptoms.
The Research On Overall Diet
In an 8-week double-blinded randomized placebo-controlled study, two times as many participants on micronutrient supplements compared to a placebo reported a decrease in hyperactivity, impulsivity and even symptoms remission in participants with ADHD. Interestingly, a year later, those who stopped taking the supplements found that the symptoms returned (14). Those that stayed on the supplements saw even more improvements. These results suggest that adequate nutrient intakes play an important role in ADHD symptoms.
One study looked at 120 children and adolescents and found an increased prevalence of ADHD in children and adolescents who had diets higher in fast food, sugar, sugar-sweetened beverages, and low in Mediterranean-style diet foods. (12).
In one case study, a 21-year old female suffering from ADHD, Bipolar Disorder, anxiety, and panic disorder saw improvements in mood, anxiety, hyperactivity, and impulsivity with micronutrient supplements. In fact, after one year of treatment, the participant went into remission from all mental illnesses (15).
Studies have found that the consumption of a combination of fatty acids, Omega-3s, probiotics, amino acids, vitamins, and minerals (especially magnesium, zinc, and iron) appear to improve metabolic stress markers in individual with ADHD. Moreover, these individuals reported a reduction in emotional problems (81, 82, 84).
Yet another study found a higher rates of ADHD in children who ate a diet high in processed foods, salt, and sugar and low in Omega-3, fiber and folate. Lower rates of ADHD were seen in children who had diets rich in fish, fruits, vegetables, legumes, and whole grains (81)
Preliminary research indicates that probiotics, folate, choline, glutamine, and antioxidants may play a positive role in helping ADHD symptoms.
Antisocial Behavior
Nutrition deficiencies in multiple vitamins and minerals as well as essential fatty acids have been shown to effect behavior. A double-blinded, placebo controlled randomized study showed that when prisoners took vitamin and mineral supplements, they committed 26.3% fewer offenses compared to the placebo group. Based on these results, researchers of this study concluded that anti-social behavior in prison, including violence, may be reduced by preventing vitamin, mineral, and essential fatty acid deficiencies. (63).
Magnesium, Vitamin B6, and Vitamin B12
According to an earlier study, levels of zinc, magnesium, calcium, and phosphorus have been shown in children with ADHD (64). Moreover, low levels of magnesium have been show to increase distractibility and hyperactivity. (64).
Another study saw significant improvements in ADHD symptoms for almost all children with ADHD who received Magnesium and vitamin B6 supplements. The improved symptoms included hyperactivity, aggressiveness, and lack of attention. When the supplements were discontinued the symptoms returned (65).
Other studies have looked at Magnesium and vitamin B6 as it relates to Autistic Spectrum Disorder. Some of these studies show improvements in behavior, speech, eye contact, IQ, social skills, and social interactions (127).
Vitamin B12 deficiency is a concern for children and adults with Autism. Research showed improvements in children with Autism after taking Vitamin B12 (135, 136).
Zinc
Low levels of zinc have been linked to inattentiveness, hyperactivity, and impulsivity. In a double-blinded, placebo-controlled study, participates with ADHD who took zinc sulfate supplements significantly improved hyperactivity, impulsivity, and social scores compared to the placebo (66, 67, 86).
Iron
Iron supplements may have benefits in regards to reducing ADHD symptoms on individuals who are deficient in Iron (67, 87).
Vitamin D
Deficiencies in Vitamin D has also been linked to ADHD and Autism. In fact, evidence points to the possibility that gestational and early childhood vitamin D deficiency may increase the risk developing of autism (126).
Omega-3
Children with ADHD generally have low omega-3 levels. While evidence is conflicting, most studies show either a significant or modest improvement in ADHD symptoms after taking Omega-3 supplements. These studies, including double-blinded, randomized placebo-controlled studies, have shown a significant improvement in ADHD symptoms in children taking Omega-3 supplements compared to a placebo. Some of the improved symptoms include restlessness, aggressiveness, completing work, emotional lability, oppositional behavior, conduct problems, and academic performance. (13, 67,68, 69, 70, 71, 72).
Omega-3 may also be beneficial for children with Autism. According to research, children with Autism and Asperger’s who take Omega-3 have less anxiety and aggression and decreased hyperactivity and impulsivity. They also show better attention spans and improved language development, as well as reading and spelling skills (123, 124, 125).
Antioxidants and Inflammation
According to emerging research, chronic inflammation, especially inflammation of the brain, and oxidative stress may contribute to ADHD and/or lead to ADHD symptoms. So it is reasonable to assume that a diet rich in antioxidants and other anti-inflammatory foods may be beneficial. Furthermore, high levels of inflammatory markers in the body have been associated with increased intensity of hyperactivity and inattention symptoms (89). It is also noted that people with inflammatory conditions such as allergic and atopic eczema and asthma are at a higher risk for ADHD (90).
Autism has been linked to higher levels of oxidative stress, and antioxidant supplements have been associated with improvements in autism symptoms severity (131).
One study found oxidative stress in 88.64% of the children with Autism who participated in the study (134). Some evidence indicates that antioxidants may improve social communication, unusual behavior, and self-regulation in individuals with Autism. In one study, those with Autism who ate 70% cacao dark chocolate, which is rich in antioxidants, for 4 weeks, showed significant improvements on the Autism Spectrum Rating Scale (130).
Sulforphane
Sulforaphane is an antioxidant found in broccoli sprouts and cauliflower. Preliminary research showed that sulforaphane improves social interaction and behavior deficits in individuals with Autism (90). In mice, sulforaphane improved autism and protected against memory impairment (89, 90,
N-acetyl Cysteine
NAC, which is found in many plants, especially onions, has been shown to have promising results as a possible therapy for Alzheimer’s, Schizophrenia, Autism, depression, addiction, substance abuse, OCD, and mood disorders. N-acetyl Cysteine inhibited levels of proinflammatory cytokines in animal studies and also had anti-depressant effects. One study found NAC decreased ADHD symptoms in patients with lupus and inhibited autoimmune inflammation (90).
Gut Health
Although the research is preliminary and somewhat lacking in regards to Autism, Schizophrenia and ADHD, gut dysbiosis has been associated with other neuropsychiatric disorders like depression, Parkinson’s disease, bipolar disorders, and anxiety; therefore, some have speculated that improving ones gut health could have similar benefits for those with Autism and ADHD (83, 91).
Moreover, even though the research is lacking, some research does exist. This preliminary research suggests that gut health may impact symptoms of Autism, Schizophrenia, and ADHD.
One study looked at gut health as a part of early prevention. In a randomized trial, 75 infants were given lactobacillus rhamosus or a placebo for 6 months. The diagnosis of ADHD or Asperger’s Syndrome developed in 17.1% of the placebo group by age 13 whereas none of the probiotic group developed either condition (79).
Another study wanted to see if consuming probiotics would improve the symptoms of ADHD in children who already had ADHD. In this study, those that received the probiotic reported better health-related quality of life compared to the placebo (80).
Other research shows that those with Autism tend to have abnormal microbiomes shows that improved gut health and probiotics may improve behavioral symptoms of Autism (132, 133). Probiotics do appear to help improve GI symptoms in individuals with Autism as well (133).
Foods to Consider Limiting
Sugar and Sugar Soft Drinks
Sugar intakes including sugary soft drinks appears to increase symptoms of ADHD. Moreover, high consumption of sugar soft drinks were associated with mental health issues including hyperactivity, conduct problems, and mental disorder (74 ).
Artificial Colors, Flavors, and Dyes and Food Additives
Here we have an example of quantity vs quality of studies. The effects of artificial colors on behavior in children with or without ADHD has been extensively studied for the past 35 years; however, some of the studies were weak in design. Even so, these studies suggest artificial colors may have a small negative impact on children’s behaviors, hyperactivity, breathing disorders, and GI symptoms even on children without ADHD (120, 121). For example, in one randomized, double-blinded, placebo-controlled study, artificial colors and/or sodium benzoate resulted in increased hyperactivity. (72).
In another randomized placebo-controlled study, 297 children from the general population (i.e. children without ADHD) aged 3-9 years were found to have an increase in hyperactive behavior after they ate a mixture of food dyes and sodium benzoate preservative. In contrast to many previous studies, the children were from the general population and did not have attention-deficit/hyperactivity disorder (122).
Because of these findings, FDA requires certain artificial food colors to be listed and the European Union takes it a step further by requiring a warning label listing adverse effects to children’s attention and behavior.
According to an article in “Today’s Dietitian,” highly refined foods often contain artificial dyes and preservatives that are associated with aggravator behavior symptoms in people with autism (120, 121).
Salicylate
Some have suggested that Salicylate may have a negative impact on children with ADHD symptoms; however, according to The Medical Journal of Australia, no peer-reviewed evidence supports this theory as of yet. Moreover, the authors express concern that salicylate restrictions could increase the risk of nutrient deficiencies, including deficiencies in nutrients that have been shown to have a positive impact on ADHD symptoms (73).
The Take Home Message
Highly refined products are going to have more artificial colors and preservatives, MSG, high-fructose corn syrup, sugar, and artificial sweeteners and may have the biggest negative impact on symptoms of ADHD and Autism. Therefore, eating whole foods with simple ingredients most of the time is encouraged.
Food Intolerances and Sensitivities
Studies show that when individuals with ADHD and Autism eliminated their particular food intolerances and sensitivities, their symptoms improved by anywhere between 24-80% (75, 76, 77, 78).
In one study, 50 children began a restricted elimination diet for 5 weeks. Researchers found that 78% of the participants saw significant improvements in ADHD (85).
As for Autism, researcher have found that eliminating gluten and casein from the diet, appears to improve behavior problems and cognitive and social functions for 25% of those with autism (128, 129).
Other common allergy/sensitive/intolerant foods are eggs, fish, seafood, tree nuts, peanuts and soy. If an individual with Autism is intolerant to any of these foods, eliminating these foods from the diet may be beneficial.
A Note on Food Sensitivities and Intolerances
Food sensitivities and intolerances can contribute to poor gut health. Inversely, poor gut health can increase food sensitivities. Changing your diet can greatly improve your gut health and many symptoms and conditions, but if you are still having problems even after incorporating a healthier diet and following your doctor’s medical treatment; then, you may want to try an elimination diet to determine if you have any food sensitivities or food intolerances.
Among people with food sensitivities, some have always had them, while others can become sensitive to a food by eating one food too often.
Gluten is an example of a food Americans could be eating too often, which may be one reason some are becoming sensitive to gluten. In the American diet, we are not getting much variety when it comes to grains. We eat pasta, sandwiches, wraps, pizza, and buns several times a day, EVERYDAY…all are usually made from wheat!
Usually you can eliminate the foods you are sensitive to while simultaneously eating foods that improve your gut health. Once you have healed your gut, many people can add those foods back into their diet. Remember though, variety is key. Others will find that they will have to continue eliminating a food to continue reaping the health benefits and control their symptoms.
Common food intolerances and sensitivities include wheat, gluten, and milk. Certain children appear to have intolerances to artificial colors, artificial dyes, artificial flavors, artificial sweeteners, or artificial preservative such as BHA, BHT, TBHQ. It is also noted that 15% of children with ADHD have Celiac disease.
Eating less processed foods and more whole foods will also cutdown on the amount of food colors and additives in ones diet.
The Feingold Diet
The Feingold diet is an elimination diet that involves eliminating artificial colors, artificial preservative, and artificial sweeteners from the diet to improve ADHD symptoms. The diet is meant to determine if an individual has any food intolerances or sensitivities.
In Phase 1 of the diet, the individual would avoid foods on a specific list. Some have reported a notable positive difference within days of implementing phase 1.
For phase 2, the individual will begin adding foods back into their diet one at a time so that they can note any changes to their symptoms. Phase 2 is the time when the individual will discover which particular foods they might be sensitive or intolerant.
The goal is not to be on the Feingold diet forever, but to figure out your particular food intolerances or sensitivities. Then, the individuals can avoid unnecessarily omitting foods in which they tolerate. In the end, we want to eliminate as little as possible.
Studies have found that the Feingold diet only works for children who are intolerant or sensitive to foods.
Mindfulness
Several studies including a recent meta-analysis, a systemic review, and a controlled trial conclude that mindfulness may reduce ADHD symptoms and be an effect form of ADHD treatment (114, 115, 116).
You can learn more about how to incorporate mindfulness, including mindful eating, into your life, in the book, The Nourishing Meal Builder. You can also get The Nourishing Meal Builder: The Gluten-Free, Dairy-Free Edition.
Nutrition for ADHD, Autism, Antisocial Behavior, and General Childhood Behavior: A Quick Guide
- Eat an antioxidant-rich, Mediterranean-style diet full of wholefoods like fruits, vegetables, fish, nuts, seeds, and dark chocolate.
- Due to picky eating and the fact that vitamin and mineral deficiencies appear to worsen symptoms, consider taking a multivitamin.
- If getting Omega-3 in the diet proves difficult due to picky eating, consider an Omega-3 supplement or eating foods fortified with Omega-3.
- Eat mostly whole foods and limit sugar, refined carbohydrates, and ultra-processed foods which contain artificial colors, flavors, and additives.
- Limit foods in which you or your child are sensitive or intolerant. Consider temporarily following the Feingold diet to determine food sensitivities and intolerances.
- Consider adding probiotic-rich foods to your diet.
- Incorporate mindfulness practices. Mindfulness and mindful eating techniques can be found in The Nourishing Meal Builder and The Nourishing Meal Builder: The Gluten-Free, Dairy-Free Edition.
Lacy Ngo, MS, RDN is a registered dietitian and owner of Mindfulness in Faith and Food, LLC. Mindfulness in Faith and Food, LLC focuses on how to live your healthiest, happiest, most meaningful life through faith-based mindfulness and evidence-based nutrition. Ngo is one of the top experts in faith-based mindfulness and nutrition and the author of several books including, Mindfulness in Faith and Freezer Meals, The Nourishing Meal Builder, and Faith, Mindfulness, & Nutrition. You can also find evidence-based nutrition articles, recipes, convenient healthy snack lists, and faith-based mindfulness techniques on her blog, Mindfulness in Faith and Food.
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