When it comes to breakfast, 8-year-old Madeline, diagnosed with ADHD last year, knows what she likes - carbohydrates. Her meal of choice is toast with jelly or waffles topped with fruit or, as her mother puts it, "anything made with white flour."
While there's nothing wrong with eating carbohydrates in the morning, an all-carb breakfast is a recipe for inattention. It won't steady a child's blood sugar throughout the morning, help her stay alert, or prevent energy dips that cause a child to lose focus in the classroom. A balanced breakfast - high in protein and carbohydrates from whole grains, fruits, and/or vegetables - ensures a varied supply of nutrients along with enough calories to sustain mental and physical energy until the next meal.
"If you don't eat properly, you can become distracted, impulsive, and restless," says Ned Hallowell, M.D., founder of the Hallowell Center for Cognitive and Emotional Health in Andover, Massachusetts, and author of Delivered from Distraction. "Skipping breakfast or self-medicating with food can sabotage the best of ADHD treatment plans. In treating the condition, you must consider a balanced diet an essential component of a proper regimen."
Protein is an important ingredient in that treatment. "Protein helps keep your ADHD child's blood sugar levels steady and prevents the mental and physical declines that inevitably come from eating an unbalanced breakfast containing too many carbs," says Hallowell.
Like most children with ADHD, Madeline has very specific preferences and she will reject any food she's not fond of. Her mother knows what foods to keep on hand and which to serve first thing in the morning to ensure that breakfast goes smoothly. She tries to balance these foods in ways that give her daughter as many calories and as much high-quality protein as possible, especially on school days.
"When you're thinking about your child's eating habits, or any other behavior, you have to recognize his unique temperament and behavioral traits, and work around them," says Dr. Stanley Greenspan, M.D., author of The Challenging Child.
What works best for Madeline, her mother says, is to eat a small breakfast at home and to have a second breakfast on the way to school. Madeline takes her medication with her first meal, so by the time she's heading out the door, it's beginning to take effect and she's better able to focus on eating. To fill in the protein gaps, her mom may send along some scrambled eggs with cheese in a tightly wrapped tortilla, a high-protein cereal bar, or a bottled yogurt smoothie.
Children need more calories and protein per pound of body weight than adults do, to ensure normal growth and development and to maintain good health. The average daily amounts of calories and protein recommended by government health experts for normal-weight children and adolescents are as follows:
- Ages 1-3: 1300 calories, 16 grams protein
- Ages 4-6: 1800 calories, 24 grams protein
- Ages 7-14: 2000 calories, 28 - 45 grams protein