Andrew Adesman, M.D.
You’ve heard that sugar causes attention deficit hyperactivity disorder (ADD ADHD) haven’t you? That food additives can do the same? And didn’t you read somewhere that vitamins may work just as well as medication for ADHD treatment?
These days, there's a tremendous amount of information — and misinformation — about links between ADHD and nutrition, especially for children with attention deficit disorder (ADD ADHD). To separate fallacy from fact, ADDitude’s Carl Sherman, Ph.D., spoke about ADHD treatment with one of the nation’s top experts on ADHD, Andrew Adesman, M.D., chief of developmental and behavioral pediatrics at Schneider Children’s Hospital in New Hyde Park, New York, and a member of the CHADD professional advisory board.
Is there a link between sugar and ADHD?
People blame sugar for all sorts of things. But there’s no reason to think that it causes ADHD or makes symptoms worse. Controlled studies — the ones that compare kids who are on and off sugar — haven’t found any link to attention or behavior in school-age children. In preschool children, there may be a weak association between sugar and ADHD-like symptoms. If parents feel that diet affects their preschooler’s behavior, it might make sense to try restricting sugar to see what happens.
Although I advise parents to consider limiting sweets for other reasons, including good nutrition and dental hygiene, I do not see this as an effective treatment for ADHD.
How about dyes and other food additives, or food allergies?
ADHD isn’t caused by an allergic reaction to food, or anything in food, including additives. The evidence to support elimination diets or tests for food sensitivities simply doesn’t exist. Although it would be nice if foods had fewer chemical additives and less artificial coloring, parents of children with ADHD should not let a general bias against “unnatural” food ingredients guide their approach to treating ADHD. Dietary interventions are difficult to impose and unlikely to bring any benefit.
On the positive side, can vitamins help control symptoms of ADHD?
Some preliminary studies suggest that deficiencies of certain nutrients, including iron, zinc, magnesium, and vitamin B6, are associated with ADHD-like symptoms — and that, in these instances, correcting the deficiency might help curb symptoms. Even if these early findings are accurate, however, the number of children who might benefit from nutritional supplements is likely be small. In any case, children are not routinely screened for nutritional deficiencies. In the next few years, I believe that we will have a better understanding of how prevalent these deficiencies are, when we should test for these deficiencies, and whether supplements can help some children with ADHD.
Should parents have their kids screened for nutritional deficiencies?
Given how unlikely it would be for nutritional deficiency tests to turn up a problem, I don’t recommend that.
But if parents worry about nutritional deficiencies, and are interested in pursuing even unlikely causes of ADHD, I suppose they might ask the doctor for blood tests that could identify them or might suggest alternative treatments.
In either case, it is probably wise for children to take a daily multivitamin to ensure that they’re getting all the nutrients they need.
It’s been suggested that certain foods render ADHD medication less effective. Is that so?
To my knowledge, the only food that might affect the action of stimulant medication is grapefruit juice. It alters the way the body absorbs and breaks down amphetamines, like Adderall, and it probably should be avoided by kids or adults who take this drug. Otherwise, I don’t know of any foods that interfere with the effectiveness of ADHD medication.
This article comes from the February/March 2007 issue of ADDitude.
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