PrintDoes Nutrition Make a Difference?, Part 2
On the other hand, the timing of meals might affect the efficacy of certain medications. Some newer long-acting stimulants, like Adderall XR, Focalin XR, and Ritalin LA, are absorbed more quickly on an empty stomach. If these medications are taken with food—particularly with a high-fat breakfast — they’ll be absorbed more slowly into the bloodstream and may take longer to start working. This is not a problem with Concerta or Daytrana, two long-acting methylphenidate preparations.
More research is needed to determine how big a difference meal-timing makes, and whether there’s any benefit in having a child stick to low-fat breakfasts. If a child’s ADHD medication is currently given with breakfast and does not seem to work quickly enough, perhaps it should be given an hour beforehand. The most important thing is that kids eat a hearty meal in the morning. All children, and not just those with ADHD, learn better when they’ve eaten a good breakfast.
How can parents get their children to eat well while they’re on ADHD medication?
Parents often worry that their children aren’t getting enough to eat, and that their growth will be stunted. The truth is that stimulants generally cause only modest reductions in weight and height, and there are no data to suggest that these are long-term effects.
If parents are really concerned about a child’s appetite or stature, I suppose they might ask the pediatrician about putting the child on an alternative medication. Among the stimulants, methylphenidate generally has less of an effect on weight, and possibly height, than amphetamines.
I’ve heard that low blood sugar can cause inattention. Any truth to this?
Low blood sugar can affect cognitive performance — among kids with diabetes. There’s nothing written specifically about hypoglycemia and ADHD.
There’s a lot of talk these days about fish oil. Does it affect ADHD?
Some anecdotal reports suggest an effect, but there are few hard data. One recent study found that fish-oil supplements improved attention and concentration, but another study failed to find any benefit. Taking fish oil isn’t likely to be harmful, as long as this is done in addition to, and not instead of, a proven treatment like medication.
How can parents avoid “food battles”?
As much as possible, parents should respect their children’s food preferences. If a child hates broccoli, for example, there’s no sense in trying to force him to eat it. Parents needn’t worry if a child occasionally falls short of eating a balanced, varied diet, and there’s nothing wrong with letting a child indulge a sweet tooth every once in a while.
Flexibility is essential. Parents like to set meal times, but this may not work when medications affect a child’s appetite. It’s better to give kids as much as they want to eat when they’re hungry. Lunch is the meal most likely to be affected; many kids taking a stimulant eat very little or skip lunch altogether. If your child comes home from school hungry, give her a hearty snack rather than make her go hungry until dinnertime. If your child gets hungry later in the evening, let him have as much as he wants then.
I’m not saying that ADHD should define the family’s meal schedule. There’s something to be said for sitting down to eat together, and a big after-school snack shouldn’t preclude a child from joining the rest of the family at the dinner table.
This article comes from the February/March 2007 issue of ADDitude.
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