One trademark of ADHD is low levels of dopamine, a neurotransmitter released by the brain that makes kids feel good and helps them focus. Increasing dopamine in the brain through medication is an effective treatment for ADHD. However, more than a year into a nationwide stimulant shortage, parents still struggle to fill prescriptions for their kids.

As the shortage stretches on, many caregivers are working to implement ADHD treatment tactics without medication. Here are some gut health strategies to consider.

Don’t Skip Meals

The way your child’s brain works is influenced by what they eat, and good nutrition is essential. Eating unhealthy, non-nutritious foods may contribute to inattention and problematic behaviors, while a diet with a variety of healthy foods nourishes the brain to pay attention and function optimally.

[Free Download: 5 Rules for an ADHD-Friendly Diet]

A study in Cell Metabolism found that dopamine release in the brain can occur at two different times: when food is swallowed and once the food reaches the stomach.¹ Skipping a meal robs the body of two potential releases of dopamine. If your child is not hungry, try to keep them on a regular meal schedule to help regulate opportunities for dopamine release. Healthy snacks help, too. A protein-rich diet, including fish, poultry, eggs, and legumes (e.g., beans, lentils, peas, etc.), can help increase dopamine levels.

Introduce Variety

Many kids with ADHD want to eat the same things every day, but doing so may mean they miss out on producing more of that feel-good hormone. Research has also found a strong connection between gut health and mental health. ² A healthy gut is best described as having a diverse microbiome, consisting of different types of microorganisms (bacteria, fungi, viruses, etc.) that coexist harmoniously in the digestive tract. Increasing the diversity of your child’s gut microbiome with a protein-rich diet, including fish, poultry, eggs, and legumes (e.g., beans, lentils, peas, etc.), ensures that dopamine can be adequately synthesized.

Introduce new foods slowly and in a variety of ways. For example, pick a vegetable your child usually eats and connect it to another vegetable or legume. So if your child eats raw carrots, pair them with a dip made of puréed red peppers or smooth refried beans. If your child prefers crunchy foods, make crunchy cooked veggies in the oven or air fryer. Experiment with spices, too. Offering your child small tastes (repeatedly) will build their acceptance of new foods. Kids are more likely to expand their taste and preference for new foods when given multiple chances to learn about and experience new food.

[Free Download: Meal-Planning Guide for ADHD Families]

Mindful Eating

Young children, especially those with ADHD, may be easily distracted during mealtimes. Make it a point to give your child a heads-up on what’s for dinner and when it will be served. Kids with ADHD do best when they know what to expect and follow a schedule. Then, turn off all electronic devices, including the TV, while eating to limit distractions. If possible, sit and eat together at the table. This lets your child know that during meals, it’s time to pause (even for a minute) and focus on eating. This is also a great time to share a moment with your child.

Gut Health Strategies for Treating ADHD: Next Steps

• Read: The ADHD Diet Plan: Healthy Foods and Supplements for Kids & Adults 
• Read: Food Therapy: The Right Nutrition for ADHD Symptoms
• Download: ADHD Brain Food: What to Eat, What to Avoid
• Watch: “What to Eat, What to Avoid: The ADHD Guide to Food and Nutrition for Children”

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

The opinions expressed in ADDitude Guest Blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of ADDitude. Blogs are not reviewed by an ADDitude physician or any member of the ADDitude editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. ADDitude does not endorse any specific product, service or treatment.

Do not consider ADDitude Blogs as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on ADDitude. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. ADDitude understands that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately.

Sources

¹Thanarajah, S.E., Backes, H., DiFeliceantonio, A.G., Albus, K., Cremer, A.L., Hanssen, R., Lippert, R.N., Cornely, O.A., Small, D.M., Brüning, J.C., Tittgemeyer, M. (2018) Food Intake Recruits Orosensory and Post-ingestive Dopaminergic Circuits to Affect Eating Desire in Humans. Cell Metabolism. https://doi.org/10.1016/j.cmet.2018.12.006

²Chen, Y., Xu, J., Chen, Y. (2021). Regulation of Neurotransmitters by the Gut Microbiota and Effects on Cognition in Neurological Disorders. Nutrients. https://doi.org/10.3390/nu13062099

October 19, 2023

Red Dye 3 is one of four food additives now banned by the landmark California Food Safety Act, the first law of its kind in the United States. The ban, which was signed on October 7 by Governor Gavin Newsom, cites research linking the additives to serious health risks but has drawn ire from some trade associations that accuse it of sidestepping the Food and Drug Administration (FDA).¹ , ² According to Food Safety magazine, the targeted chemicals are already banned in the European Union, in part, because studies have linked them to cancer, reproductive issues, and childhood behavioral and developmental problems.³

Known as the “Skittles ban,” the California law will take effect in 2027 and prohibit the manufacturing, selling, or distributing of food products containing potassium bromate, brominated vegetable oil, propylparaben, and Red Dye No. 3, a synthetic dye made from petroleum that is found in foods, drinks, and medications.⁴

Joel Nigg, Ph.D., director of the ADHD Research Program at Oregon Health and Science University, called food dyes a “public health concern” that affects children with and without ADHD.

“There is enough evidence that food dyes affect behavior in some sensitive children with ADHD (and other children without the condition) to justify warning labels on foods containing synthetic dyes,” Nigg told ADDitude.

Concerns about increasing rates of ADHD and other behavioral disorders prompted the California Legislature to ask the Office of Environmental Health Hazard Assessment (OEHHA) to conduct a food dye assessment in 2021. Its report, titled Health Effects Assessment: Potential Neurobehavioral Effects of Synthetic Food Dyes in Children, found links between several dyes and hyperactivity in children. The report argues that current federal levels for safe intake of synthetic food dyes may not sufficiently protect children’s behavioral health.

According to the OEHHA report, the FDA’s Acceptable Daily Intake levels (ADIs) for synthetic food dyes are based on 35- to 70-year-old studies that were not designed to detect the types of behavioral effects observed in children today. Comparisons with newer studies indicate that the current ADIs may not adequately protect children from the behavioral effects of some dyes, and suggest they should be lowered.²

Is Red Dye No. 3 a Health Risk?

Red Dye No. 3 was approved for use in food in 1907 but was banned in cosmetics in 1990 after studies found it caused cancer in lab animals. Food safety advocates, scientists, and doctors have urged the FDA to issue a nationwide ban on synthetic food dyes for years. (Red No. 3 is already banned in The European Union, Canada, Australia, New Zealand, China, and Japan.)

“The FDA considered the issue in 2011 and again briefly in 2019 but opted not to take action,” Nigg said. “Since 2011, several new literature reviews have converged supporting the conclusion that food dyes increase the risk of ADHD symptoms.”

The California law may exert new pressure on the FDA to act.

“The primary purpose of this bill was to protect kids and families and consumers in the state of California,” State Assemblyman Jesse Gabriel told The New York Times. “But a secondary purpose here was to send a message to Washington that the FDA process is broken, and hopefully to spur momentum in Washington D.C., for real, significant change.”

“We’re stuck in this regulatory quandary where you’re not allowed to apply it [Red No. 3] to your skin, but you can ingest it in food — so it’s completely illogical,” Brian Ronholm, director of food policy for Consumer Reports said in the same article.

In October 2022, the Center for Science in the Public Interest (CSPI), a consumer advocacy group, and 23 other organizations, filed a petition formally asking the FDA to ban Red No. 3 in foods.

An FDA spokesperson told NPR the agency is “actively reviewing” the petition and will assess whether there’s “sufficient data” to revoke its use. The FDA spokesperson added that the agency “evaluates and regulates ingredients added to food to ensure that the authorized use of these ingredients is safe. This includes the four ingredients included in the California bill.”

How to Avoid Red Dye No. 3

In the meantime, Nigg advises children with ADHD to avoid foods containing food dyes — an admittedly difficult task. According to the Environmental Working Group’s Eat Well Guide, Red Dye No. 3 is used in nearly 3,000 products, including sodas, juices, yogurts, snacks, candy, frostings, instant rice and potato products, cereals, and boxed cake mixes. It is also used in medications including Vyvanse. ⁵

“Parents are well-advised to remove food dyes from their child’s diet if they can,” Nigg said. “It is on the list of things to try to do — along with other health actions like a healthy diet, exercise, and lower stress. I encourage parents to do what they can knowing it’s hard to do it all. Every bit can help.”

To start, Nigg suggests steering clear of most processed and packaged foods.

“Eat whole foods found on the perimeter of the grocery store — eggs, milk, cottage cheese, meat and poultry, nuts and seeds, fresh fruits, vegetables, and legumes,” he said. “Families should also be cautious when buying seemingly ‘healthy’ foods, some of which contain synthetic dyes: pickles, flavored oatmeal, salad dressing, peanut butter, and microwave popcorn, for example. Synthetic dyes are also in toothpaste, medication, and cosmetics. Parents should read all product labels closely.”

To check for the presence of Red Dye No. 3, look at a product’s ingredient lists for “FD&C Red #3” and look for dyes in the “inactive ingredients” section for medications.

The American Academy of Pediatrics has also advised parents to limit foods that often contain synthetic dyes, such as sugary drinks, juices, and candy, that may affect children’s behavior and attention.

Sources

¹ McCann, D., Barrett, A., Cooper, A., Crumpler, D., Dalen, L., Grimshaw, K., Kitchin, E., Lok, K., Porteous, L., Prince, E., Sonuga-Barke, E., Warner, J.O., Stevenson, J. (2007) Food Additives and Hyperactive Behaviour in 3-Year-Old and 8/9-Year-Old Children in the Community: A Randomised, Double-Blinded, Placebo-Controlled Trial. Lancet. doi: 10.1016/S0140-6736(07)61306-3.

² California Office of Environmental Health Hazard Assessment. (2021) Health Effects Assessment: Potential Neurobehavioral Effects of Synthetic Food Dyes in Children. https://oehha.ca.gov/media/downloads/risk-assessment/report/healthefftsassess041621.pdf

³ Henderson, Bailee. (2023, October 9) California Food Safety Act Signed Into Law, Officially Banning Four Toxic Additives by 2027. Food Safety. https://www.food-safety.com/articles/8939-california-food-safety-act-signed-into-law-officially-banning-four-toxic-additives-by-2027

⁴  Osborne, Margaret. (2023, October 17). What to Know About California’s New Law Banning Food Additives, Including Red Dye No. 3. Smithsonian. https://www.smithsonianmag.com/smart-news/california-bans-food-additives-including-red-dye-no-3-180983082/

⁵ FD&C Red No. 3. drugs.com. https://www.drugs.com/inactive/fd-c-red-no-3-247.html

NUTRITION: What should my child eat (and avoid) to improve their ADHD symptoms?

A: There’s no clear scientific evidence that ADHD is caused by diet or nutritional problems. But certain foods may play at least some role in affecting symptoms… | Keep reading on ADDitude »

SUPPLEMENTS: Which vitamins and supplements can improve my child’s ADHD symptoms?

A: Several studies have shown a drop in hyperactivity and impulsivity with zinc supplements. The same research, though, reports no change in inattentiveness… | Keep reading on ADDitude »

ADDITIVES: Should my child with ADHD avoid food dyes?

A: A study of nearly 300 children by the United Kingdom’s Food Standards Agency in 2007 showed that the consumption of foods containing dyes could increase hyperactive behavior… | Keep reading on ADDitude »

FISH OIL: Should my child with ADHD take a daily fish oil supplement?

A: Our brains use omega-3s in the hippocampus, the memory center of the brain. If you are low in omega-3 fatty acids, it may be… | Keep reading on ADDitude »

OMEGA-3s: Should my child with ADHD eat foods rich in omega-3 fatty acids?

A: A deficiency of omega-3s is bad news for a child’s or adult’s brain. Our hunter-gatherer ancestors ate a diet with a ratio of about 2 to 1 omega-6s to omega-3s. Today, we eat a diet with the ratio… | Keep reading on ADDitude »

CLEAN EATING: Should I remove all sugar and inorganic foods from my child’s diet?

A: Although not every child with ADHD reacts to sugar in an adverse way, it is best for all parents to limit sugar as much as possible. Soda, if offered at all, should be an occasional treat. Fruit juice should be limited to… | Keep reading on ADDitude »

FIRST-PERSON: “I’ve Become a Food Cop for My Son”

“Our insufferable food rules: no dairy, no gluten, no food dye. None. No trace amounts. No cheating. No “just-one-bite.” We tell the disbelievers that if they’d like to feed it to our kids, they will be parenting the kids for the next two days.” | Keep reading on ADDitude »

RELATED RESOURCES

FREE DOWNLOAD: Alternative ADHD Treatment Guide

Lean about the benefits and risks of alternative treatment options like neurofeedback, nutrition, supplements, and more. | Download now on ADDitude »

FREE DOWNLOAD: ADHD Vitamins and Supplements

This guide outlines ADHD-friendly vitamins and supplements — like iron, zinc, and magnesium — that may help common ADHD symptoms. | Download now on ADDitude »

8-Part Guide to ADHD Treatment in Children:

Q 1: How should I approach my child’s ADHD treatment plan?
Q 2: Is ADHD medication right for my child?
Q 3: How can I address side effects associated with my child’s ADHD medication?
> Q 4:  How can I integrate nutrition & supplements into my child’s ADHD treatment?
Q 5: How can I integrate exercise & mindfulness into my child’s ADHD treatment?
Q 6: What therapies should I integrate into my child’s ADHD treatment plan?
Q 7: How should I adjust and optimize my child’s ADHD treatment plan over time?
Q 8: How can my child’s treatment plan safely address comorbid conditions?

Dietary Disguises

“My 6-year-old is a super smeller and taster with texture issues. I put 1/2 teaspoon of orange sherbet-flavored fish oil in orange juice. I mix a capsule of supplements in a peanut butter and honey sandwich. I sprinkle a probiotic in a sports drink.”

“Eating a popsicle before taking any medicine or supplement freezes the taste buds so the taste isn’t as strong.”

“Thick chocolate milkshakes work for us. In a blender, pour in milk, the powder or liquid supplement, and chocolate ice cream. Blend until no longer chunky.”

“Homemade waffle and pancake mix can hide protein powder and flax seeds.”

[Download: Free Guide to ADHD Brain Food]

“There are vegan alternatives to fish oil that provide omega-3 nutrients, like chia seeds and hemp. I use these in smoothies, yogurt, and oatmeal.”

“I drip the liquid from a fish oil capsule into a shot of fruit juice, then have my kids eat dinner to overshadow any lingering tastes.”

“My son loves the protein café latte shakes and they’re loaded with vitamins and minerals. They also have caffeine, which I think helps him.”

“Protein powders, spinach, and hemp, flax, and chia seeds go in smoothies with frozen fruit and non-dairy almond or coconut milk.”

[Read: ADHD and Fish Oil Supplements — What’s a Safe Dosage?]

“My child is autistic and has gut issues. He needs to take a laxative daily. I mix the powder in flavored water to make it taste better.”

“I put fish oil in smoothies and make popsicles out of the smoothies.”

“I always put powdered supplements in applesauce. For the ones that taste bad, I give a juice chaser afterward.”

“I have my own challenges with supplements and find that using yogurt with a drizzle of honey helps.”

“I sprinkle my son’s capsules into a small spoonful of pre-made cake frosting. A spoonful of sugar makes the medicine go down!”

“I put powder or liquid supplements in banana smoothies, chocolate milk, and pudding.”

“I give my kids gummies.”

“I mix liquid fish oil into tea with lemon and sugar.”

Picky Eaters with ADHD: Next Steps

• Download: Everyday Foods Filled with Omega-3s
• Read: The Parent’s Guide to Mealtime with Picky Eaters
• Read: ARFID, SPD, & Other Conditions Linked to Feeding Difficulties in Kids

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

NATURAL TREATMENT: What natural treatments are proven to benefit ADHD symptoms?

A: Some natural remedies may ease some symptoms. Others have little effect. Among the proven therapies are… | Keep reading on ADDitude »

NUTRITION: What dietary changes could improve my ADHD symptoms?

A: There’s no clear scientific evidence that ADHD is caused by diet or nutritional problems. But certain foods may play at least some role in affecting symptoms… | Keep reading on ADDitude »

SUPPLEMENTS: What vitamins or supplements could improve my ADHD symptoms?

A: Besides being good for heart health, omega-3 fatty acids improve symptoms of ADHD, including behavior, cognitive skills, and focus… | Keep reading on ADDitude »

CAFFEINE: Can caffeine improve my ADHD symptoms?

A: A few studies have looked at how caffeine can affect ADHD, but the results have been mixed. Caffeine is a stimulant, but… | Keep reading on ADDitude »

DIETARY BALANCE: How can I better understand the way nutrition affects ADHD brain functioning?

A: Research indicates that healthy eating supports a healthy ADHD brain. At the same time, science tells us that ADHD symptoms significantly impede and impair individuals’ ability to make positive choices around food… | Keep reading on ADDitude »

BRAIN FOODS: What foods should I eat (and avoid) to improve my ADHD symptoms?

A: Carbs affect brain function and mood. The rate at which sugar from a particular food enters brain (and other body) cells is called the “glycemic index.” Foods with the best brain sugars include… | Keep reading on ADDitude »

FIRST-PERSON: “I Keep My ADHD Symptoms Under Control By…”

“Watching what I eat helps. I function better when I eat healthy foods like lean protein, veggies, and fruits instead of processed foods.” | Keep reading on ADDitude »

RELATED RESOURCES

FREE DOWNLOAD: ADHD Brain Food: What to Eat, What to Avoid

Research shows that protein promotes alertness in the brain. Carbohydrates do the opposite. And artificial colors and flavors are even worse. | Download now on ADDitude »

FREE DOWNLOAD: ADHD Vitamins and Supplements

This guide outlines ADHD-friendly vitamins and supplements — like iron, zinc, and magnesium — that may help common ADHD symptoms. | Download now on ADDitude »

8-Part Guide to ADHD Treatment in Adults:

Q 1: How should I approach my ADHD treatment plan?
Q 2: Should I treat my ADHD symptoms with medication?
Q 3: How can I address the side effects associated with ADHD medication use?
> Q 4: How should I integrate nutrition into my ADHD treatment plan?
Q 5: How should I integrate exercise & mindfulness into my ADHD treatment plan?
Q 6: What therapies should I integrate into my ADHD treatment plan?
Q 7: How and when should I adjust my ADHD treatment plan for optimal benefit?
Q 8: How should I adjust my ADHD treatment plan if I have comorbid conditions?

The Clinicians’ Guide to Treating Complex ADHD is a clinical compendium from Medscape, MDEdge, and ADDitude designed to guide health care providers through the difficult, important decisions they face when treating pediatric and adult patients for ADHD and its comorbid conditions. This guided email course will cover the following topics:

• DECISION 1: What should I consider when developing a comprehensive treatment plan for ADHD?
• DECISION 2: What medications and other approaches should I turn to as first-line treatments for ADHD?
• DECISION 3: How can I decide which ADHD medication to prescribe first?
• DECISION 4: What challenges and side effects should I anticipate from ADHD medications, and how should I address them?
• DECISION 5: How can I improve treatment outcomes for patients with ADHD and comorbid diagnoses?
• DECISION 6: What dietary, behavioral, or other complementary interventions should I recommend to patients with ADHD?
• DECISION 7: How should I follow up with patients with ADHD, and what should we discuss during these checkups?

NOTE: This resource is for personal use only.

BEYOND MEDICATION: Which nonpharmacologic treatments are proven to benefit pediatric patients with ADHD?

A: Effective behavioral treatments for ADHD do not change ADHD symptoms, but they do help children learn how to manage them… | Keep reading on ADDitude »

LIFESTYLE INTERVENTIONS: How can patients optimize nutrition, sleep, exercise, and other lifestyle factors to improve ADHD symptoms?

A: Regardless of whether a child’s treatment includes medication, maximizing exercise, sleep, and nutrition can effectively transform them into natural remedies for ADHD, and arguably establish the foundation… | Keep reading on ADDitude »

EXERCISE: How much and what type of physical activity will benefit a patient with ADHD, according to research?

A: With regular physical activity, we can raise the baseline levels of dopamine and norepinephrine by spurring the growth of new receptors in certain brain areas… | Keep reading on ADDitude »

SUPPLEMENTS: What supplements and/or vitamins can aid with ADHD symptom control?

A: Usually given in the form of fish oil, omega-3s are probably the best-researched supplement for ADHD. Numerous studies… | Keep reading on ADDitude »

PARENT TRAINING: How can Collaborative & Proactive Solutions parent training benefit an ADHD treatment plan, according to research?

A: CPS has been shown in randomized trials with both parent groups and in home counseling to be as effective as Parent Training in reducing oppositional behavior and reducing… | Keep reading on ADDitude »

NEUROFEEDBACK: Is neurofeedback an effective ADHD treatment, according to research?

A: A body of research suggests that neurofeedback is a promising therapy for ADHD, but it should be considered a complement to medication and/or behavior therapy rather than… | Keep reading on ADDitude »

ENVIRONMENTAL CHANGES: Which accommodations and environmental changes have the greatest positive effect on children with ADHD?

A: Encourage parents and teachers to use clear and concise instructions with supplementary visual tools. When providing instructions in classrooms, teachers should look directly at the student… | Keep reading on ADDitude »

RELATED RESOURCES

The Exercise Rx for ADHD: How Movement Improves Attention, Working Memory, and Executive Functions

Expert Webinar with John Ratey, M.D. | Listen now on ADDitude »

The Whole-Person Treatment Approach to ADHD

Expert Webinar with Lidia Zylowska, M.D. | Listen now on ADDitude »

How CBT and ADHD Coaching Help Adults Manage Their Symptoms Naturally

Expert Webinar with J. Russell Ramsay, Ph.D., and David Giwerc | Listen now on ADDitude »

New Supplement Strategies: Using Trace Minerals and Plant Extracts to Treat ADHD in Children and Adults

Expert Webinar with James M. Greenblatt, M.D. | Listen now on ADDitude »

7-Week Guide to Treating ADHD:

Q 1: What should I consider to develop a comprehensive ADHD treatment plan?
Q 2: What medications and other approaches should I turn to as first-line treatments for ADHD?
Q 3: How can I decide which ADHD medication to prescribe first?
Q 4: What challenges and side effects should I anticipate from ADHD medications, and how should I address them?
Q 5: How can I improve treatment outcomes for patients with ADHD and comorbid diagnoses?
> Q 6: What dietary, behavioral, or other complementary interventions should I recommend to patients with ADHD?
Q 7: How should I follow up with patients with ADHD, and what should we discuss during these checkups?

Growing in lockstep with our scientific understanding of ADHD is our knowledge about epigenetics — the study of how lifestyle factors like nutrition, exercise, and sleep exert real, physical changes on a person’s DNA. ADHD is a genetic disorder, yes. But epigenetic changes to DNA do influence how strongly or weakly those ADHD genes get expressed in day-to-day life. In other words, you can positively impact ADHD symptoms by modifying your environment through sleep, exercise, and food changes.

In most cases, sleep, food, and exercise will not replace medication or therapy in a treatment plan, nor should they — they’re most effective as complementary treatments. It’s best to balance professional care with deliberate healthy lifestyle choices in an integrated approach to treatment. Here’s how to get started:

In this download, you will learn the following:

• What lifestyle changes can improve ADHD symptoms
• How to improve your sleep hygiene
• What to include in a bedtime routine
• How to start an exercise routine
• And more!

NOTE: This resource is for personal use only.

During a recent ADDitude webinar titled “Lifestyle Changes with the Biggest Impact on Kids with ADHD,” we received hundreds of questions from parents interested in leveraging sleep, nutrition, exercise, and mindfulness to manage their kids’ ADHD. Here, ADDitude editors answer some of your most common questions and provide links to relative resources.

Q1: How can I help my child concentrate long enough to embrace mindfulness techniques?

Getting children with ADHD to slow down and sit quietly in the lotus position is neither easy nor necessary for an effective mindfulness practice. A calm and steady meditation routine need not happen in silence or while standing still. Consider the mindful “SEAT,” which includes a quick reflection on immediate sensations, emotions, actions, and thoughts. The “silent sigh” is a slow exhale that can be used at the verge of a meltdown and as an alternative to more demanding deep-breathing exercises. Once you’ve found an activity that appeals to your child’s ADHD brain, the next step is to encourage consistent practice.

Next Steps:

• Download: Mindfulness for ADHD Kids: 10 Easy Meditation Exercises
• Forget the Lotus Position: How to Meditate — ADHD Style
• Watch: A Parent’s Guide to Mindfulness and Self-Regulation Strategies for Children with ADHD

Q2: Do you have any suggestions for a child with ADHD who has trouble getting to sleep?

Losing just one hour of sleep a night can affect a child’s academic performance, according to the American Academy of Sleep Medicine. To trick the ADHD brain into sleep mode, try to maintain the same bedtime for your child each night. Give them at least one hour to get ready for bed without access to electronics. Increased exercise during the day can help tire out both the mind and body, though it’s best to finish physical activity at least three hours before the lights go out. Some parents have found success with weighted blankets, white noise machines, and essential oils.

Next Steps:

• Download: Sound Sleep Solutions for Kids with ADHD
• Read: Say Good Night to Your Child’s ADHD Sleep Challenges
• Watch: My Son’s Anxiety Keeps Him Awake at Night
• Read: Why Children with ADHD Hate Bedtime

Q3: Is long-term melatonin use safe? My 11-year-old cannot “turn off his brain” without it.

Melatonin is considered healthy, safe, and effective for most children and adults in small doses and with short-term use. Studies have not shown a link to dependency, but data is lacking on the safety of taking melatonin long-term. Talk to your doctor or pediatrician about potential side effects and to determine the best dosage for your child.

Q4: My 13-year-old son is obsessed with sugar. Is this normal with ADHD, and are we helping him if we limit his sugar intake?

ADHD brains are typically lacking in dopamine. It comes as no surprise, then, that children with ADHD crave the dopamine surge that sugar provides. Though research is ongoing, some studies suggest that more sugar can lead to increased hyperactivity and impulsivity. To test the effect of sugar on your child’s behavior, try the sugar test. Cut back their intake as much as possible for 10 days. On day 11, introduce a sugary snack or drink and see if this impacts their energy and focus.

Next Steps:

• Download: What to Eat (and Avoid) for Improved ADHD Symptoms
• Read: Got a Picky Eater on Your Hands? Here’s How to Cope
• Why Sugar is Kryptonite: ADHD Nutrition Truths

Q5: How do I implement the Nurtured Heart Approach when my 2e child finds it patronizing? I praise him for small things that he regularly fails to do.

If your child is rejecting attempts at the Nurtured Heart Approach to positive parenting, don’t get discouraged just yet. Continue to ignore negative behavior and energetically reward progress, and your efforts should eventually pay off. However, there is no one-size-fits-all strategy when it comes to improving behavior. Dr. Robert Brooks suggests using “islands of competence” and contributory activities that incorporate a child’s strengths and interests. You might also consider Parent-Child Interaction Therapy, Daily Special Time, or this list of suggestions from readers.

Next Steps:

• Download: Your Free Guide to Ending Confrontations and Defiance
• A Radically Positive Parenting Technique: The Nurtured Heart Approach
• Read: “My Child Resists Everything! Will He Ever Open Up to New Experiences?”

The content for this article was based on questions submitted by live attendees during the ADDitude ADHD Experts webinar titled “Lifestyle Changes with the Biggest Impact on Kids with ADHD” [Video Replay & Podcast #414] with Sandy Newmark, M.D., which was broadcast live on August 4, 2022.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Up to two-thirds of children with attention deficit hyperactivity disorder (ADHD) have used complementary and alternative medicine (CAM) to address their symptoms, according to a new study published in the Journal of Attention Disorders.

Nutrition modifications; natural products, such as herbs, vitamins, and minerals; and mind-body practices like mindful meditation were the most-reported CAMs. The use of alternative therapies was higher in families where the caregiver preferred natural therapies for ADHD and believed CAMs could synergistically boost conventional medicine.¹

In addition, researchers found two predictive factors for alternative therapy use: parents’ education level (the more educated the parents, the more likely alternative therapies were used) and female gender.

“It seems that parents with higher education are open-minded,” the researchers wrote. “Additionally, they usually try Internet sources, books, and even magazines and other information sources to treat their children.”

The study found that more females opted for complementary and alternative medicine than males. “One of the most important reasons for the higher CAM use in patients of the female gender is the fact that they usually employ more health services than males,” researchers said.²

For the study, researchers reviewed The Web of Science Core Collection, PubMed, and Scopus databases from inception to February 10, 2022, for reports of complementary and alternative medicine usage by patients with ADHD. Data came from 12 original papers, which included a total of 4,447 patients, all younger than 18 years old.

To the researchers’ knowledge, this is the first systematic review to examine the prevalence, possible determinants, and type of alternative therapies used by patients with ADHD.

They recommended training healthcare providers on the most common CAM therapies and possible adverse effects or interactions with conventional medications. “They [healthcare providers] should have a deeper and more informed dialog about this matter with ADHD patients, which encourages them to disclose their CAM use,” researchers said.

This study had several limitations, such as only including articles published in English, and that most studies were from the U.S. and Australia.

Sources

¹Wu, J., Li, P., Luo, H., & Lu, Y. (2022). Complementary and Alternative Medicine Use by ADHD Patients: A Systematic Review. Journal of Attention Disorders. doi.org/10.1177/1087054722111155

²Lorber, J., Moore, L. J. (2002). Gender and the Social Construction of Illness. Rowman Altamira.

Lifestyle changes — improving nutrition and exercise, taking select supplements, and reliably using prescribed medication — may help to effectively manage ADHD symptoms in children, according to research. The impact of these changes is often underestimated and undervalued, but evidence shows that they can have a positive effect on a child’s academic performance, behavior, and sleep. In this webinar, caregivers will learn about the outcomes they might expect when they build the following lifestyle changes into a child’s day:

• Time in nature
• Unstructured play
• Healthy exercise and nutrition
• Stress management
• Behavioral management
• Adequate Sleep
• Screen time management

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Sanford Newmark, M.D., is the director of clinical programs at Osher Center for Integrative Health at the University of California, San Francisco. Prior to joining the Osher Center, Dr. Newmark founded the Center for Pediatric Integrative Medicine, an integrative medicine consulting practice treating a wide array of pediatric problems. He specializes in the integrative and holistic treatment of children with autism and ADHD, combining conventional medicine with nutrition, behavior management, and various complementary modalities.

Dr. Newmark lectures widely on autism and ADHD and has authored three chapters in integrative medicine textbooks. He is the author of the book ADHD Without Drugs, a Guide to the Natural Care of Children with ADHD. (#CommissionsEarned)

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Unhealthy eating habits are more prevalent among children with inattentive symptoms of attention deficit hyperactivity disorder (ADHD) than they are among those without the condition. This finding came from a new study published in Nutrients that compared the food consumption and dietary habits of children with and without ADHD in relation to their age and ADHD presentation. ¹

The study sample included 734 children in Spain, including 259 preschoolers aged 3 to 6 years (57 with ADHD and 202 controls) and 475 elementary-school-age children aged 10 to 12 years (213 with ADHD and 262 controls).

Researchers measured three types of eating patterns:

• Western-like (including eggs, processed meat, potatoes, legumes, sodas, and cooked vegetables)
• sweet (dairy desserts, sweet cereals, preserved fruit, and sweets)
• healthy (nuts, fish, raw vegetables, and fresh fruit)

Findings revealed only 12% of children with inattentive ADHD adhered to a healthy pattern compared to 40% of children in the control group. Children with inattentive ADHD were most likely to follow the Western-like pattern.

Both groups demonstrated unhealthy eating habits, specifically consuming more than the recommended amount of sweets (fruit juice, dairy desserts, red meat, sweet cereals, and sweet sodas). Almost all preschool children (95% of the children with ADHD and 96% of children in the control group) practiced poor eating habits. In the elementary-school-age group, researchers found that 92% of children across both groups should improve the quality of their diets. ¹

“The study population generally has a poor-quality diet that it needs to improve to prevent future health issues,” the authors said. “This indicates the need to improve children’s diets in general. These results paint a picture of a current problem in many developed countries: nutritional deficiencies and excesses that can lead to childhood obesity.”

Researchers did not find any remarkable differences between age groups either in food intake (by grams or servings) or between children with ADHD and their control peers. Both groups ate adequate amounts of protein products, dairy products, and oily fish. They ate inadequate amounts of starches, vegetables, fruits, legumes, nuts, white meat, white fish, and eggs.

This study supports previous reports that “inattentive symptoms of ADHD were directly related to bingeing or disinhibited eating behavior and indirectly to internal appetite signals by pathways of association via negative mood.” ²,³

“This emotional dysregulation may lead to emotional eating, which in turn may significantly influence the individual’s food choices (usually for unhealthy and comfort food),” the authors said.

Sources

¹Rojo-Marticella, M., Arija, V., Alda, J. Á., Morales-Hidalgo, P., Esteban-Figuerola, P., & Canals, J. (2022). Do children with attention-deficit/hyperactivity disorder follow a different dietary pattern than that of their control peers? Nutrients. 14(6), 1131. //doi.org/10.3390/nu14061131

²O’Neill S., Rudenstine S.(2019).Inattention, emotion dysregulation and impairment among urban, diverse adults seeking psychological treatment. Psychiatry Research. 282,112631.//doi.org/10.1016/j.psychres.2019.112631

³Kaisari P., Dourish C.T., Rotshtein P., Higgs S. (2018). Associations between core symptoms of attention deficit hyperactivity disorder and both binge and restrictive eating. Frontiers in Psychiatry. 9,103. //doi.org/10.3389/fpsyt.2018.00103

Research on turmeric and curcumin’s effect on symptoms of attention deficit hyperactivity disorder (ADHD or ADD) is scarce. But a growing number of studies reveal other possible health benefits, ranging from improved cognitive functioning to therapeutic effects on chronic conditions ranging from heart disease and cancer to Alzheimer’s disease. ^{1 2}

Turmeric and Curcumin: Health Benefits

Despite increased interest in the health benefits of turmeric and curcumin, the ginger plant from which they are derived has been used in Indian and Eastern Asian medical systems for thousands of years. Findings from clinical studies substantiate these traditional uses, showing that curcumin possesses anti-inflammatory, hypoglycemic, antioxidant, wound-healing, antimicrobial, and possible neuroprotective properties. ^{4 1}

Curcumin for Mood and Mind

Preliminary research shows that curcumin may improve cognitive functioning. In one small study that examined the effects of a curcumin formulation (400 mg once daily) on healthy adults aged 60 to 85, participants showed improved performance on sustained attention and working memory tasks one hour after administration (compared to placebo).⁵ Working memory and mood also fared significantly better in participants following four weeks of steady administration.

Another small study found that a daily oral curcumin supplement (Theracurmin, 90 mg dose delivered twice daily) improves memory, attention, and mood.¹ The 40 participants in the 18-month study were between the ages of 51 to 84, and randomized to receive curcumin or placebo. Compared to the placebo, the curcumin group improved in several measures of memory, including long-term retrieval and visual memory. The curcumin group also showed significant improvement in depression screener scores compared to the placebo group.

[Get This Free Download: Vitamins and Supplements for Managing ADHD Symptoms]

Other studies suggest that curcumin may have anti-anxiety and anti-depressant effects.^{6 7} According to one review, available research suggests a small, non-significant benefit of curcumin for major depression, but more research is needed to better understand this benefit.⁸

Curcumin for Body

As a natural anti-inflammatory agent, curcumin may have therapeutic effects on a variety of chronic conditions,⁹ including the following:

• arthritis¹⁰
• Alzheimer’s disease¹¹
• inflammatory bowel disease¹²
• metabolic syndrome¹³
• cancer^{14 15}
• cardiovascular diseases¹⁶

Though literature on curcumin is growing, no clear conclusions were reached about turmeric and curcumin’s role in decisively treating or preventing health conditions.¹⁷ Curcumin is also challenging to study, given its low bioavailability, among other reasons.¹⁵

[Read: 10 Foods (and Supplements and Vitamins!) to Boost Your ADHD Brain]

Turmeric and Curcumin: Forms, Dosage, and Consumption Tips

Turmeric supplements are available in a variety of dosages, and most are advertised as containing 95% curcuminoids. Many turmeric and curcumin supplements also contain piperine, a compound found in black pepper, which is known to increase bioavailability (bloodstream absorption) of the substance.³

Taking turmeric in supplement form may be the best way to reach the elevated curcumin levels that are associated with health benefits. In spice form, black pepper may enhance its benefits.

Curcumin is generally recognized as a safe substance, and there is no recommended turmeric or curcumin dosage established for adults and children. Across supplements, 500 mg, twice a day, is a commonly recommended dosage. One review found that curcumin was safe at 6 g/daily, orally, for 4 to 7 weeks, but stomach upset may occur.¹⁸ Curcumin dosages have also varied considerably in studies, but have shown to be safe and tolerable even at doses between 4,000 mg and 8,000 mg/daily.³

In the aforementioned studies on cognition, benefits were associated with 90 mg of curcumin taken twice daily,¹ and 400 mg taken daily.⁵

As with all supplements, the source and quality are important. Choose supplements that are USP certified, indicated by a silver stamp on the label. And be sure to tell your doctor if you’re taking turmeric supplements. Some studies suggest that turmeric ingested in large amounts may interfere with iron absorption.¹⁹

Turmeric and Curcumin: Conclusions

Turmeric and its active ingredient curcumin have a variety of properties that may benefit both mind and body. Further studies and clinical trials, however, are needed to validate these substances as effective therapeutic agents for a variety of conditions, including ADHD.

Turmeric and Curcumin: Next Steps

• Free Download: 5 Vitamins and Supplements for ADHD
• Read: What Is Integrative Medicine for ADHD? A Holistic Health & Wellness Guide
• Read: The Big 3 — How Nutrition, Exercise & Sleep Curb ADHD in Children

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Sources

¹Small, G. W., Siddarth, P., et.al. (2018). Memory and brain amyloid and tau effects of a bioavailable form of curcumin in non-demented adults: A double-blind, placebo-controlled 18-month trial. The American Journal of Geriatric Psychiatry, 26(3), 266–277. https://doi.org/10.1016/j.jagp.2017.10.010

² Gupta, S. C., Patchva, S., & Aggarwal, B. B. (2013). Therapeutic roles of curcumin: lessons learned from clinical trials. The AAPS Journal, 15(1), 195–218. https://doi.org/10.1208/s12248-012-9432-8

³Hewlings, S. J., & Kalman, D. S. (2017). Curcumin: A review of its effects on human health. Foods (Basel, Switzerland), 6(10), 92. https://doi.org/10.3390/foods6100092

⁴ Gupta, S. C., Patchva, S., & Aggarwal, B. B. (2013). Therapeutic roles of curcumin: lessons learned from clinical trials. The AAPS journal, 15(1), 195–218. https://doi.org/10.1208/s12248-012-9432-8

⁵Cox, K. H., Pipingas, A., & Scholey, A. B. (2015). Investigation of the effects of solid lipid curcumin on cognition and mood in a healthy older population. Journal of Psychopharmacology, 29(5), 642–651. https://doi.org/10.1177/0269881114552744

⁶Lopresti, A. L., Maes, M., Maker, G. L., Hood, S. D., & Drummond, P. D. (2014). Curcumin for the treatment of major depression: a randomised, double-blind, placebo-controlled study. Journal of Affective Disorders, 167, 368–375. https://doi.org/10.1016/j.jad.2014.06.001

⁷Ng, Q. X., Koh, S., Chan, H. W., & Ho, C. (2017). Clinical use of curcumin in depression: A meta-analysis. Journal of the American Medical Directors Association, 18(6), 503–508. https://doi.org/10.1016/j.jamda.2016.12.071

⁸Seo, H.J, Wang, S.M, et. al. (2015). Curcumin as a putative antidepressant. Expert Review of Neurotherapeutics, 15(3,) 269-280, DOI: 10.1586/14737175.2015.1008457

⁹Fadus, M., Lau, C. et.al. (2017) Curcumin: An age-old anti-inflammatory and anti-neoplastic agent. Journal of Traditional and Complementary Medicine, 7(3), 339-346. https://doi.org/10.1016/j.jtcme.2016.08.002

¹⁰Shep, D., Khanwelkar, C., Gade, P. et.al. (2019). Safety and efficacy of curcumin versus diclofenac in knee osteoarthritis: a randomized open-label parallel-arm study. Trials, 20, 214. https://doi.org/10.1186/s13063-019-3327-2

¹¹Chen, M., Du, Z. Y., Zheng, X., Li, D. L., Zhou, R. P., & Zhang, K. (2018). Use of curcumin in diagnosis, prevention, and treatment of Alzheimer’s disease. Neural regeneration research, 13(4), 742–752. https://doi.org/10.4103/1673-5374.230303

¹²Burge, K., Gunasekaran, A., Eckert, J., & Chaaban, H. (2019). Curcumin and intestinal inflammatory diseases: Molecular mechanisms of protection. International Journal of Molecular Sciences, 20(8), 1912. https://doi.org/10.3390/ijms20081912

¹³Azhdari, M., Karandish, M., & Mansoori, A. (2019). Metabolic benefits of curcumin supplementation in patients with metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials. Phytotherapy research : PTR, 33(5), 1289–1301. https://doi.org/10.1002/ptr.6323

¹⁴Giordano, A., & Tommonaro, G. (2019). Curcumin and cancer. Nutrients, 11(10), 2376. https://doi.org/10.3390/nu11102376

¹⁵Tomeh, M. A., Hadianamrei, R., & Zhao, X. (2019). A review of curcumin and its derivatives as anticancer agents. International Journal of Molecular Sciences, 20(5), 1033. https://doi.org/10.3390/ijms20051033

¹⁶Li, H., Sureda, A., Devkota, H. P., Pittalà, V., Barreca, D., Silva, A. S., Tewari, D., Xu, S., & Nabavi, S. M. (2020). Curcumin, the golden spice in treating cardiovascular diseases. Biotechnology advances, 38, 107343. https://doi.org/10.1016/j.biotechadv.2019.01.010

¹⁷National Center for Complementary and Integrative Health. (Last updated 2020). Turmeric. U.S. Department of Health and Human Services. https://www.nccih.nih.gov/health/turmeric

¹⁸Soleimani, V., Sahebkar, A., & Hosseinzadeh, H. (2018). Turmeric (Curcuma longa) and its major constituent (curcumin) as nontoxic and safe substances: Review. Phytotherapy research : PTR, 32(6), 985–995. https://doi.org/10.1002/ptr.6054

¹⁹Smith, T. J., & Ashar, B. H. (2019). Iron Deficiency Anemia Due to High-dose Turmeric. Cureus, 11(1), e3858. https://doi.org/10.7759/cureus.3858