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Attention-Deficit Hyperactivity Disorder: Role of Nutrition

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What is Attention-Deficit Hyperactivity Disorder?

Attention-deficit hyperactivity disorder (ADHD) is a disorder that affects the nervous system. It is commonly noticed in young children and it is characterized by aggressiveness, hyperactivity and loss of attention. A number of factors are responsible for this disorder but the role of diet has been gaining importance over the recent years. Some of the factors such as use of food additives, allergy to certain foods, and deficiency of substances such as fatty acids and magnesium have been associated with the increased occurrence of this disorder. Therefore, as indicated by various researches, the dietary modification may play a vital role in the management of ADHD.

Dietary Modifications can make a Difference!

Some of the important nutrients that have been identified to have a role in the management of ADHD have been discussed below.

Fatty Acids

The importance of essential fatty acids such as omega-3 fatty acids in the growth and maturation of a child is manifold. The maturation of the brain cells is one of the important steps in the maturation process. A deficiency of omega-3 fatty acids has been associated with the disruption in the normal functioning of the nervous system. Coordination between the thought and action of an individual may be affected if the nervous system functions abnormally. Significant improvements in such symptoms in individuals with ADHD were noted when omega-3 fatty acids and vitamin C supplementation was included in their diet. Furthermore, another study reported improvement in the behavior of the children suffering from ADHD following high-dose administration of essential fatty acids.1 More studies are being conducted to formulate an appropriate dose and frequency of administration of omega-3 fatty acid supplements in ADHD.

Magnesium and Vitamin B6

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The transmission of nerve impulses in the brain is a complex event that needs many substances for proper action. Vitamin B6 and magnesium have been shown to have an important contribution wherein their deficiency is associated with abnormal functioning of the nerve cells. This may be one of the causative factors in ADHD. A study by Mousain-Bosc et al. demonstrated improvements in the symptoms of ADHD following the administration of magnesium and vitamin B6 supplements.2 Another study reported that supplementation of polyvitamin complex with Mg (MAGNE-B6) showed improvements in the behavior, anxiety levels, aggressiveness and attention in children with ADHD. Further studies are being conducted to determine the dosage, frequency and combinations of these substances for individuals suffering from ADHD.   

Zinc

It has been suggested that deficiency of zinc may be a causative factor for ADHD. The loss of attention in individuals suffering from ADHD may be owing to decreased levels of zinc. The supplementation of zinc may be helpful in older age group patients, individuals who have a high BMI score, and low levels of zinc and free fatty acids in their body.3 Further studies are required to substantiate the usefulness of zinc supplementation in ADHD.

Additives and Food Allergy

The requirement of certain food additives has always been questioned across numerous studies. A causal relationship was also expressed between the use of additives and the occurrence of ADHD. Several studies have proved the relationship between the use of additives and problems in behavior of children. It was noted in a study that evaluated in 3-year-old children. The study reported that according to their parents, the normal behavior patterns in these children were altered following the use of artificial coloring agents and benzoate preservatives for a certain period of time.4

Use of certain foods may have an impact on the hyperactivity and other behavior patterns of children. Children with ADHD may be sensitive to certain foods that may alter their behavior. Some of the symptoms such as hyperactivity were related to the use of sugar according to certain studies. These children should be assessed for the presence of food allergies and their response to individual food substances in order to formulate a diet that would be beneficial for them.

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Iron

Another substance being studied for its use in ADHD is iron. Children with severe symptoms of ADHD have been reported to have low amount of iron in their body. This may point out the usefulness of iron in ADHD. In a case study the symptoms of ADHD were observed in a child who had low iron content. The improvements were noted following iron supplementation in this child. However, further studies are required to establish the exact relation between iron and ADHD and the significance of iron supplementation in such children or adults.  

Acetyl-L-Carnitine and Phosphatidyl Serine

The proper functioning of nerve cells that send nerve signals is dependent on the concentration of certain hormones in them. An alteration in the levels of these hormones may affect the nerve cells. The supplementation of acetyl-L-carnitine (ACL) in certain studies performed on animals demonstrated the stabilization of the activity of the nerve cells. The problem with the loss of attention and increased aggressiveness in boys with ADHD seemed to decrease following the administration of carnitine supplements.5  

On the other hand, phosphatidyl serine (PS) is known to support the lining of the nerve cells that send nerve signals. A study, which involved the administration of PS supplements in children suffering from ADHD, reported improvement in their behavior. Further studies are being performed to determine the efficacy of these nutrients in treating the symptoms of ADHD.

What are the Overall Benefits of Diet?

The benefits of dietary supplementation and restrictions have been supported and opposed across numerous studies. Although a clear indication does not exist, the benefits cannot be overlooked. A trial by Harding et al. compared the efficacy of supplements with the Ritalin (used commonly in ADHD) and found them to have an equal efficiency in treating the symptoms of ADHD.6 Nevertheless, unsupervised dietary modifications or supplementation may be harmful to individuals.

The decision to make alterations or restrictions in the diet and the use of supplements must be done in accordance with a physician who is well-equipped to treat ADHD.

References

1.Sorgi PJ, Hallowel EM, Hutchins HL, Sears B. Effects of an open-label pilot study with high-dose EPA/DHA concentrates on plasma phospholipids and behavior in children with attention deficit hyperactivity disorder. J Nutr. 2007; 6: 16.

2.Mousain-Bosc M, Roche M, Polge A, Pradal-Prat D, Rapin J, Bali JP. Improvement of neurobehavioral disorders in children supplemented with magnesium-vitamin B6. I. Attention deficit hyperactivity disorders. Magnes Res. 2006; 19(1): 46–52.

3.Bilici M, Yildirim F, Kandil S, et al. Double blind, placebo-controlled study of zinc sulfate in the treatment of attention deficit hyperactivity disorder. Prog Neuropsychopharmacol Bio Psych. 2004; 28(1): 181–190.

4.Bateman B, Warner JO, Hutchinson E. The effects of a double blind, placebo controlled, artificial food colourings and benzoate preservative challenge on hyperactivity in a general population sample of preschool children. Arch Dis Child. 2004; 89(6): 506–511.

5.Van Oudheusden, Scholte HR. Effect of carnitine in the treatment of children with attention-deficit hyperactivity disorder. Prosta Leuko Ess Fatty Acids. 2002; 67(1): 33–38.

6.Harding KL, Judah RD, Gant C. Outcome based comparison of Ritalin versus food-supplement treated children with AD/HD. Alter Med Rev. 2003;8(3): 319–330.