What If Paleo Really Is the Answer?

I've used nutritional interventions for hundreds of people with attention deficit hyperactivity disorder (ADHD) during the past 24 years. Dietary changes can result in significant improvements in symptoms of hyperactivity, concentration, impulsivity, and even oppositional behavior.

Many people are eager to try foods and supplements to help manage ADHD symptoms, but often don’t know where to start. Here are dietary changes that, I have found, deliver the most symptom relief.

Foods rich in protein — lean beef, pork, poultry, fish, eggs, beans, nuts, soy, and low-fat dairy products — may have beneficial effects on ADHD symptoms. Protein-rich foods are used by the brain to make neurotransmitters — chemicals that help brain cells talk with each other. Eating protein for breakfast will help a child build brain-awakening neurotransmitters. Protein also prevents surges in blood sugar, which increase hyperactivity.

The single most important thing I recommend is to decrease the amount of sugar in the ADHD diet. Eating simple processed carbohydrates, like white bread, waffles, or white rice, is almost the same as feeding you or your child sugar. They can make you irritable, stressed, and unfocused. Serve breakfasts and lunches high in protein, complex carbs, and fiber instead to increase concentration and better behavior.

[Get This Download: Free Guide to a Delicious (and ADHD-Friendly!) Diet]

Omega-3 fatty acids, found in fish oil, can improve hyperactivity, impulsivity, and concentration. Research¹ suggests that kids with ADHD have lower blood levels of omega-3’s than kids without the condition. One recent study² showed that 25 percent of kids with ADHD had a decrease in symptoms after three months. Fifty percent showed improvement by six months.

The two main omega-3 fatty acids contained in supplements are EPA and DHA. It appears that most benefits are derived from supplements that contain more EPA versus DHA. In general, a total dose of 700 to 1,000 mg seems good for younger children; 1,500 to 2,000 mg for older children. Because the chewable forms of omega-3’s — gummies, say — don’t have that much fish oil in them, it is best to take a capsule or liquid.

Many people are unaware of the important role iron plays in controlling ADHD symptoms. A 2004 study³ found that the average iron level of children with ADHD (measured as ferritin) was 22, compared with 44 in children without ADHD. Another study⁴ showed that increasing iron levels improved symptoms for children with ADHD almost as much as taking a stimulant. Because too much iron is dangerous, have your pediatrician test ferritin levels before giving iron.

These minerals are essential to normal health and may play an important role in controlling ADHD symptoms. Many children, with and without ADHD, don’t get enough of them. Zinc regulates the neurotransmitter dopamine and may help methylphenidate work more effectively⁵. Magnesium is also used to make neurotransmitters and has a calming effect on the brain. Have your doctor test your child’s mineral levels.

[Click to Download: 5 All-Natural ADHD Supplements]

Several studies suggest that artificial additives make kids without ADHD more hyperactive, and make hyperactive children worse⁶. Gatorade, cheese puffs, and candy contain artificial colors and preservatives, but are found in other foods as well. Read food ingredient labels to find additive-free foods. Fresh unprocessed foods are your best bet. Avoid colorful cereals, and substitute 100-percent fruit juice for soft drinks.

Many children with ADHD are sensitive to certain foods in the diet, making their symptoms worse. The most common culprits are dairy, wheat, and soy. If there are two foods that you suspect are exacerbating your child’s ADHD symptoms, eliminate one for two or three weeks. Observe your child’s symptoms during that time to see if they improve. Find a professional to guide you if your child needs to be on a restrictive ADHD diet.

An allergy to gluten — a protein found in wheat, barley and rye — can worsen ADHD symptoms, in addition to causing a whole other set of problems. Many of ADHD patients improve on gluten-free diets. If you suspect you have a gluten allergy, see your doctor and ask about going on an elimination diet. If you are allergic, your doctor will help you switch to a gluten-free ADHD diet.

Most herbs that have been recommended for managing ADHD symptoms have been poorly researched. The ones that have research⁷ behind them and work are a combination of valerian and lemon balm, which seems to relax children with ADHD by reducing anxiety. To improve attention, a product called Nurture & Clarity may help. These is some evidence that pycnogenol, made from pine bark, improves concentration in some children⁸. Look for standardized herbs that are free of contaminants.

[Read This Next: Leveraging Sleep, Exercise, and Diet to Improve ADHD]

Sandy Newmark, M.D., is a member of the ADDitude ADHD Specialist Panel.

¹ Young, Genevieve, and Julie Conquer. “Omega-3 Fatty Acids and Neuropsychiatric Disorders.” Reproduction Nutrition Development, vol. 45, no. 1, 2005, pp. 1–28., doi:10.1051/rnd:2005001.
² Johnson, M., S. Ostlund, G. Fransson, B. Kadesjo, and C. Gillberg. “Omega-3/Omega-6 Fatty Acids for Attention Deficit Hyperactivity Disorder: A Randomized Placebo-Controlled Trial in Children and Adolescents.” Journal of Attention Disorders, vol. 12, no. 5, 2009, pp. 394-401.
³ Konofal, Eric, Michel Lecendreux, Isabelle Arnulf, and Marie-Christine Mouren. “Iron Deficiency in Children With Attention-Deficit/Hyperactivity Disorder.” Archives of Pediatrics & Adolescent Medicine, vol. 158, no. 12, 2004, pp. 1113.
⁴ Konofal, E., M. Lecendreux, J. Deron, M. Marchand, S. Cortese, M. Zaïm, MC Mouren, and I. Arnulf. “Effects of Iron Supplementation on Attention Deficit Hyperactivity Disorder in Children.” Journal of Pediatric Neurology, vol. 38, no. 1, 2008, pp. 20-26.
⁵ Akhondzadeh, Shahin, Mohammad-Reza Mohammadi, and Mojgan Khademi. “Zinc Sulfate as an Adjunct to Methylphenidate for the Treatment of Attention Deficit Hyperactivity Disorder in Children: A Double Blind and Randomized Trial [ISRCTN64132371].” BMC Psychiatry, vol. 4, 2004, pp. 9
⁶ Mccann, Donna, et al. “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.” The Lancet, vol. 370, no. 9598, 2007, pp. 1560–1567., doi:10.1016/s0140-6736(07)61306-3.
⁷ Müller, S.F., and S. Klement. “A Combination of Valerian and Lemon Balm Is Effective in the Treatment of Restlessness and Dyssomnia in Children.” Phytomedicine, vol. 13, no. 6, 2006, pp. 383-87.
⁸ Kaplan, Bonnie J., Jane Mcnicol, Richard A. Conte, and H. K. Moghadam. “Overall Nutrient Intake of Preschool Hyperactive and Normal Boys.” Pediatrics, vol. 17, no. 2, 1989, pp. 127-32.