The Big 3: How Nutrition, Exercise & Sleep Curb ADHD in Children
Regardless of whether medication is part of your child’s treatment, maximizing these three basic needs – nutrition, exercise, and sleep – can effectively harness their power as natural remedies for ADHD.
No treatment plan for attention deficit hyperactivity disorder (ADHD or ADD) is complete if it doesn’t harness the power of nutrition, exercise, and sleep to improve wellbeing. What we eat, our physical activity levels, and our sleep habits have tremendous effects on us – a fact that’s amplified for ADHD brains and bodies.
Regardless of whether medication is part of your child’s treatment, maximizing these three basic needs can effectively transform them into natural remedies for ADHD, and arguably build the foundation for other interventions to take hold.
ADHD Natural Remedy: Nutrition
Mounting research confirms that eating well contributes positively to the performance and abilities of any child with ADHD.
Watch Out for Blood Sugar Levels
One of the most important things to keep in mind when it comes to a child’s wellbeing is glycemic index (GI), or how fast the body converts carbohydrates into sugar.
All carbohydrates turn into sugar, but some are converted faster (high glycemic index) and some slower (low GI). These rates of conversion affect a child’s energy levels over the day; anything that causes blood sugar levels to quickly spike (like sugary, processed foods) means that the body will work hard to quickly drop that sugar, actually bringing it below normal levels. The result is often an irritable, fidgety, or nervous child who can’t focus as well.
To maintain steady, normal blood sugar levels, ensure that the child’s meals, especially at the start of the day, are balanced:
- Avoid processed carbs and sugars. That means no frozen waffles, pancakes, Pop Tarts, jelly, and other products that readily turn to sugar in the body. Go for low glycemic index foods, like steel cut oats, or true whole grain bread, to boost focus and performance. One study shows that kids who ate low GI breakfasts had better executive functioning, working memory, and attention compared to kids who ate processed foods.1
- Opt for protein. Protein is filling and provides consistent energy through the day. Eggs and lean meats are great sources.
- Some fat is OK. Fats are important – they work to decrease the absorption and processing of carbohydrates into sugar.
A significant percentage of kids with ADHD are sensitive to some kind of food. In one study that placed children with ADHD on a restricted elimination meal plan, more than half of subjects saw a 40 percent improvement on ADHD rating scale performance.2 The same results appeared in an older study, where hyperactive children saw improvement in behavior after being placed on a few foods plan.3
In my practice, I estimate that about 30 to 50 percent of children I see do have some food sensitivity.
Not sure what food sensitives your child may have? Try this technique I use with my patients: eliminate a whole set of foods – dairy, wheat, corn, soy, eggs (common culprits) – for three weeks.
- If improvement is detected, start adding the foods back one by one for a couple of days (I usually recommend starting with gluten first). Give it three to four days to see if there are any developing behaviors associated with each food. The process should take six weeks in all.
- If no improvement detected, food sensitivities are likely not an issue for your child.
Eliminating foods, in my experience, tend to work on children who primarily present symptoms of hyperactivity rather than inattentiveness. This method also works on children who already have a history of allergies, eczema, gastrointestinal issues, and other allergic-type manifestations.
Several studies show that artificial colors, flavors, and preservatives tend to increase hyperactivity in a sizable portion of children, ADHD or not.4 Even then, children with ADHD are more likely than the general population to be sensitive to food dyes, and may see symptoms worsen. Opt for whole foods to avoid synthetic dyes, and, as with food sensitivities, try to detect through a process of elimination if your child is sensitive to a particular dye.
Supplements for ADHD
Fish Oil and Omega-3: This is the most common supplement used by patients with ADHD. Why? Studies show that omega-3 fatty acids (with high doses of EPA) are modestly effective in treating ADHD in children.5 Fish oil helps to increase levels of omega-3s that are often naturally lacking in children with ADHD, which in turns helps with brain functioning. I recommend the 1000mg bottles (combined EPA+DHA) for kids younger than 8, and 2000mg for older kids.
Iron: Many kids with ADHD are relatively iron (serum ferretin) deficient6, which may explain irregular dopamine regulation in the brain7. One study showed that children with ADHD who took iron supplements saw an improvement in ADHD symptoms compared to children who took a placebo.8 Have your child’s doctor measure their serum ferritin levels to see if an iron supplement is necessary.
ADHD Natural Remedy: Exercise
Regular exercise should be a part of life for every child, but especially for children with ADHD. Exercise benefits the body and mind in many ways. For one, it increases dopamine levels, which increases focus and attention – a major plus for children with ADHD.
Another feature of exercise is that it actually triggers epigenetic changes (i.e. DNA changes) that make the brain grow.9 Exercise also increases the production of Brain Derived Neurotropic Factor (BDNF)10, which is essential to normal brain functioning.
One hour of exercise a day is optimal, but this should be increased as much as possible.
As far as exercise options, sports are one route, but keep in mind that children with ADHD may prefer individual sports as opposed to team sports. Physical education classes in school, if well done, can count, as does playing outside with friends when possible.
Exercise can be so therapeutic for ADHD symptoms that I actually recommend against sacrificing exercise time for tutoring or because of poor grades. In fact, research seems to indicate that exercise improves academic scores11 perhaps better than spending the equivalent amount in class or study time.
ADHD Natural Remedy: Sleep
Adequate sleep is crucial for children with ADHD, who are already at a higher risk for experiencing sleep problems compared to children without ADHD. How much sleep we get affects our behavior, attention, and mood. Learning is also dependent on sleep; studies show that we consolidate what we learn as we sleep.12
- Preschool: 10-13 hours
- School-age: 9 to 11 hours
- Teen: 8 to 10 hours
Barriers to adequate sleep, however, are practically everywhere. In children, these barriers tend to be school schedules, sports and extracurricular commitments, and screen time/electronic devices. In children with ADHD, abnormal or inadequate circadian rhythms can also contribute to sleep problems.
Improving sleep comes with practicing good sleep hygiene, like turning off all electronics (or removing them from the room) one hour before bedtime as a calming signal to the mind. Screen activities can be replaced with relaxing, sleep-friendly alternatives like reading or taking a warm bath.
If sleep problems persist:
- Consult with your child’s medical providers. Behavioral professional psychologists and counselors can also help with implementing healthy sleep routines.
- Consider melatonin. Melatonin is a hormone that regulates sleep and can be helpful when administered as a supplement (especially if ADHD medications are causing sleep-related side effects). Start with half a milligram (liquid doses are easier to control), building up to 5 milligrams until results are achieved.
Natural Remedies for ADHD: Next Steps
- Download: What to Eat (and Avoid) for Improved ADHD Symptoms
- Read: The ADHD Nutrition Plan – Healthy Foods and Supplements for Kids & Adults
- Learn: 12 Brain-Building Food Rules
The content for this article was derived from the ADDitude Expert Webinar “How Nutrition, Sleep, Exercise & Behavioral Interventions Can Reduce ADHD Symptoms” by Sandy Newmark, M.D. (available as ADDitude ADHD Experts Podcast episode #217), which was broadcast live on April 24, 2018.
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1 Cooper, S., Bandelow, S., Nute, M., Morris, J., & Nevill, M. (2012). Breakfast glycaemic index and cognitive function in adolescent school children. British Journal of Nutrition, 107(12), 1823-1832. doi:10.1017/S0007114511005022
2 Pelsser, Lidy M et al. (2011). Effects of a restricted elimination food plan on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial. The Lancet, Volume 377, Issue 9764, 494 – 503. https://doi.org/10.1016/S0140-6736(10)62227-1
5 Block, M., Qawasmi, A. (2011). Omega-3 Fatty Acid Supplementation for the Treatment of Children With Attention-Deficit/Hyperactivity Disorder Symptomatology: Systematic Review and Meta-Analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 50(10), 991-1000. https://doi.org/10.1016/j.jaac.2011.06.008
6 Konofal, E., Lecendreux, M., Arnulf, I., & Mouren, M. C. (2004). Iron deficiency in children with attention-deficit/hyperactivity disorder. Archives of pediatrics & adolescent medicine, 158(12), 1113–1115. https://doi.org/10.1001/archpedi.158.12.1113
7 Wang, Y., Huang, L., Zhang, L., Qu, Y., & Mu, D. (2017). Iron Status in Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-Analysis. PloS one, 12(1), e0169145. https://doi.org/10.1371/journal.pone.0169145
8 Konofal, E., Lecendreux, M., et.al. (2008). Effects of iron supplementation on attention deficit hyperactivity disorder in children. Pediatric Neurology, 38(1), 20-26. https://doi.org/10.1016/j.pediatrneurol.2007.08.014
9 Barrón-Cabrera, E., Ramos-Lopez, O., González-Becerra, K., Riezu-Boj, J. I., Milagro, F. I., Martínez-López, E., & Martínez, J. A. (2019). Epigenetic Modifications as Outcomes of Exercise Interventions Related to Specific Metabolic Alterations: A Systematic Review. Lifestyle genomics, 12(1-6), 25–44. https://doi.org/10.1159/000503289
10 Sleiman, S. F., Henry, J., Al-Haddad, R., El Hayek, L., Abou Haidar, E., Stringer, T., Ulja, D., Karuppagounder, S. S., Holson, E. B., Ratan, R. R., Ninan, I., & Chao, M. V. (2016). Exercise promotes the expression of brain derived neurotrophic factor (BDNF) through the action of the ketone body β-hydroxybutyrate. eLife, 5, e15092. https://doi.org/10.7554/eLife.15092
11 McPherson, A., Mackay, L., Kunkel, J., & Duncan, S. (2018). Physical activity, cognition and academic performance: an analysis of mediating and confounding relationships in primary school children. BMC public health, 18(1), 936. https://doi.org/10.1186/s12889-018-5863-1
12 Diaz, A., Berger, R., Valiente, C., Eisenberg, N., VanSchyndel, S., Tao, C., Spinrad, T. L., Doane, L. D., Thompson, M. S., Silva, K. M., & Southworth, J. (2017). Children’s Sleep and Academic Achievement: The Moderating Role of Effortful Control. International journal of behavioral development, 41(2), 275–284. https://doi.org/10.1177/0165025416635284