Nutrition


Exercise Helps Children With ADHD in Study

Researchers Hope Physical Activity Can Stem Growing Use of Medications

by Sumathi Reddy

Researchers seeking alternatives to the use of drugs to treat ADHD in children are taking a closer look at exercise as a prescription.

A recent study found regular, half-hour sessions of aerobic activity before school helped young children with symptoms of attention deficit hyperactivity disorder become more attentive and less moody. Other research found a single bout of exercise improved students’ attention and academic skills.

It isn’t clear whether physical exercise offers particular benefits to children with symptoms of ADHD, since students with typical development also showed improvements after the sessions. Children with the condition have greater-than-normal difficulty paying attention and may exhibit impulsive behavior, among other symptoms.

Some doctors who specialize in treating children diagnosed with ADHD say they often incorporate exercise in the therapy. And some teachers have begun getting students up from their desks for short bursts of physical activity, finding it helps them pay attention to their studies.

“It benefits all the kids, but I definitely see where it helps the kids with ADHD a lot,” said Jill Fritz, a fourth-grade teacher at Rutledge Pearson Elementary school in Jacksonville, Fla. “It really helps them get back on track and get focused.”

Growing numbers of children in the U.S. have been diagnosed with ADHD. The Centers for Disease Control and Prevention calculated 11% of children had an ADHD diagnosis in 2011, the latest data available. That was up from 7.8% in 2003. Among all children in the U.S., 6.1% in 2011 were taking an ADHD medication, such as Adderall and Ritalin, up from 4.8% in 2007.

In a study published online Tuesday in the Journal of Abnormal Child Psychology, students in kindergarten through second grade did 31 minutes of aerobic physical activity before the start of school for 12 weeks. Another group of students engaged in a sedentary, classroom-based activity. The study, conducted at schools in Vermont and Indiana, involved 202 students.

The participants included children with typical development and others who were classified as at-risk for developing ADHD because of elevated symptoms of the disorder based on parent and teacher assessments.

The study found children in the exercise groups showed greater improvements in areas such as attention and mood than did those in the sedentary groups. The benefits of the exercise applied similarly to typically developing children as well as children with ADHD symptoms.

“This is the first large-scale demonstration of improvements in ADHD symptoms from aerobic physical activity using a randomized controlled trial methodology,” said Betsy Hoza, lead author of the study and a professor of psychological science at the University of Vermont. “This shows promise as a new avenue of treatment for ADHD but more work needs to be done before we know for sure if it really is,” she said.

Dr. Hoza described the benefits as “moderate” but said the results were comparable with what would be expected from an ADHD behavioral intervention with a trained professional.

Many schools have cut back on the amount of time devoted to recess and physical education because of increasing curriculum demands. Instead, some schools have implemented programs to encourage exercise among students either before or after school, or in shorts periods of activity throughout the day.

Ms. Fritz, the fourth-grade teacher, uses an online program called GoNoodle that leads students in what it calls “brain breaks.” She said she puts it on three or four times a day between study periods. A two-minute program might lead the children in forming letters with their bodies, and a 10-minute session might run through a Zumba dance routine.

GoNoodle, a Nashville, Tenn., startup, launched the program last year. It says the product, offered in both free and premium versions, is currently being used by 130,000 elementary schoolteachers.

Another classroom program, ABC for Fitness, helps teachers use short bursts of activity of three to 10 minutes to accumulate 30 minutes a day. Activities include jumping in place and doing squats. The program was developed by David Katz, co-founder of the Yale University Prevention Research Center, and is offered free to school districts through Dr. Katz’s nonprofit, the Turn the Tide Foundation.

ABC for Fitness was evaluated in a 2010 report published in the journal Preventing Chronic Disease. The study, which took place in Missouri, compared three elementary schools using the program with two other schools not using it. Among the findings: Schools that adopted the exercise program for most of the academic year had a 33% decline in ADHD medications used by its students. That compared with a smaller, 7% decline in medication use in the schools not using the program.

A similar study done with a larger sample size is currently under review, said Dr. Katz, who headed up the research teams on both studies.

Researchers at the University of Illinois at Urbana-Champaign examined the effects on attention and cognition from a single bout of activity. Forty children, age 8 to 10 years, spent 20 minutes either reading or exercising on a treadmill. After the tasks, the researchers measured the children’s attention and reading and math skills using computerized tests. They also measured electrical activity in the children’s brains.

After the tasks, test scores improved more for children who exercised than for those who were reading. Within the exercise group, children with ADHD symptoms scored better than the other children on one particular test that measured self-correction.

“Just 20 minutes of exercise of moderate intensity improved these core abilities to allocate attention and improved scholastic performance,” said Matthew Pontifex, lead author of the study and now an assistant professor of kinesiology at Michigan State University. The study was published in 2013 in the Journal of Pediatrics.

John Ratey, a clinical associate professor of psychiatry at Harvard Medical School and author of several books on ADHD, says he generally includes exercise in treatment plans. He recommends morning exercise for children, even something as little as running around or jumping rope. He said exercise can help reduce the medication dosage a patient is taking, or perhaps replace it altogether.

Dr. Ratey is a consultant to Reebok’s BOKS program, which leads 45-minute vigorous-exercise sessions three to five times a week at about 1,000 elementary schools across the country. “It’s for kids in general but it has a big effect for kids with ADHD,” he said.


7 Natural Brain Foods for Focus and Concentration

If you have ever had problems concentrating, you know how extremely frustrating it is to get anything done. As we age, it seems to be more and more difficult to keep our thoughts collected or even remember where we put our keys. This may be a part of the aging process to some degree, but diet and lifestyle certainly has a lot to do with it as well. Luckily, there are several brain foods that you can include in your daily diet to boost cognitive function, boost concentration, and slow down brain decline.

Here are 7 foods to eat for better cognition, concentration, and for overall brain preservation.

1. Brain Foods – Walnuts

Interestingly enough, walnuts actually resemble small brains. Perhaps this is a clue that we should eat them. A study conducted in the 2007 found that a diet including more than 2% walnuts was able to reverse brain aging, including age related motor and cognitive defects. Walnuts are rich in antioxidants which fight against free radical damage to the brain cells’ DNA.

2. and 3. Coffee and Dark Chocolate

While your average coffee from the local coffee shop might contain all sorts of sugars and additions not worth the health risks, a free-trade organic coffee can do great things for your focus and brain power. A cup or two of coffee first thing in the morning will wake up your brain and allow you to focus and concentrate. The caffeine found in chocolate does the same thing, in addition to harnessing rich, brain-protecting antioxidants. It is wise, however, not to over indulge.

4. Berries

Berries are undoubtedly one of the best anti aging foods around. These little fruit gems protect the brain from oxidative stress while decreasing the effects of age related conditions such as dementia and Alzheimer’s. In addition to delaying memory decline by up to 2.5 years in one study, blueberries have been found to improve learning capacity and motor skills.

5. Spinach

Popeye knew what he was doing when he ate his spinach. Spinach is a dark green leafy vegetable that is loaded with vitamin E, which has been shown to improve cognitive function. Vitamin E helps increases brain tissue and released dopamine which controls information flow in the brain. Further spinach contains lutein, an antioxidant that could protect against cognitive decline.

6. Carrots

While it’s known carrots are great for vision, did you also know that they are also great for the brain? Helping to reduce inflammation and restore memory, the compound found in carrots, known as luteolin, appears to reduce age-related memory loss and boost overall brain health. Other foods that are also high in luteolin include olive oil, celery, rosemary, and peppers.

7. Fish

The omega 3 fatty acids found in fish give our brain a huge boost. Consuming fish weekly can reduce the risk of stroke and dementia while slowing down mental decline. Research also indicates that vital fatty acids help to keep memory sharp as we age.

A Hearty Breakfast

It’s important to know that eating breakfast may help with brain preservation. Researchers warn that skipping breakfast can cause a tremendous strain on the brain. Children who eat a well-rounded breakfast have scored better on tests than those that skip this incredibly important meal. Try having some fresh fruit or high-fiber whole grains like oatmeal and bran. High calorie breakfasts laden with sugar and fat tend to detract from concentration.

Eating Light

Combining these healthy foods into a varied diet will help your brain from becoming sluggish. Eating healthful whole foods (preferably organic), getting enough sleep, exercising daily and managing stress all help with concentration and cognitive function.


Food Additives and ADHD: What’s the Connection?

The role of food additives in causing or worsening ADHD is a controversial topic. Can removing certain foods from your child’s diet really help?

By Amy Paturel, MS, MPH and Medically reviewed by Kevin O. Hwang, MD, MPH

KraftDinnerDo food additives have a role in the rising rates of attention deficit hyperactivity disorder (ADHD)?  This is a controversial subject among experts, but in fact, any child may be a little hyper after eating foods pumped with dyes, high-fructose corn syrup, and other artificial ingredients – whether or not he has ADHD. Unfortunately, such foods are more commonplace than you may think. Take any popular children’s cereal, for example, and you’ll probably see ingredients ranging from refined sugar, corn flour, and gluten to red dye #40, yellow #6, and blue #2.

But sugar and additives aren’t the only culprits. Several studies indicate that some children’s behavior significantly worsens after eating “healthful” foods like milk, eggs and wheat. Some potential problems in the diet include:

Food Colorings / Flavorings

In the mid-1970s, Benjamin Feingold, MD, suggested that enhancements added to processed food — including colorings, flavorings, and related substances — could trigger ADHD. And while a scientific review by the National Institutes of Health concluded that food additives affect only a small proportion of children with behavioral problems, recent research tells a different story. In a study of 300 children from the UK, researchers found that certain mixtures of artificial colors alongside sodium benzoate (a common preservative found in soda and ice cream) may increase hyperactivity.

Sugar 

Since most sugary products also contain dyes, caffeine, and artificial flavors, determining the role sugar plays in ADHD is a challenge. Even if a high-sugar breakfast triggers hyperactive behavior, there’s no way to identify it as the culprit in the midst of so many other potential offenders. “If you give a child jelly beans for breakfast, the crash and burn from the ‘normal’ physiology of blood sugar rising and falling is going to make him feel cranky and irritable,” says Roberta Anding, M.S., R.D., clinical dietitian at Texas Children’s Hospital. “It’s poor nutrition, not true ADHD.”

Milk and Wheat

For some children with ADHD, a diet that eliminates gluten and milk products may produce improvements in behavior. “Milk products and glutens such as wheat are the foods most commonly linked to behavior changes,” says Dana Laake, R.D.H., M.S., co-author of The Kid-Friendly ADHD & Autism Cookbook. “And they’re not mandatory foods for human survival.” When the body doesn’t absorb these foods properly, it triggers an allergic response (think brain fog and mood swings).

Focused Elimination

If you think changing your child’s diet may help his or her ADHD symptoms, start by eliminating potential triggers for a week or two, suggests Laake. Then test your child by reintroducing foods one at a time and seeing how he behaves. If it turns out your child is sensitive to milk or other major sources of nutrients, remove those foods, but work with a dietitian to ensure your child gets the necessary nutrients for growth and development.

“The more restrictive the diet becomes, the more you need an expert to make sure you’re not treating one problem and creating another,” says Anding. The big risk is malnutrition since children have a greater need for complete nutrition than adults, thanks to growing bones, developing organ systems, and building immunity. And if elimination diets are taken to the extreme, they could cause a deficiency in key nutrients like calcium and B vitamins – the very nutrients associated with reducing symptoms of ADHD.

Whether refined sugars or additives affect behavior or not, most children would do best to avoid sugary, processed foods, Anding notes. Perhaps the best solution for any child – with ADHD or not – is to make sure he or she gets a well-balanced diet of fruits, vegetables, and whole unprocessed foods. After all, the body simply works better when it has the proper fuel.


Vitamins and Supplements for ADHD

vitamins and supplementsSome supplements may help you get a grip on ADHD symptoms and challenges. Others don’t. Find out which is which.

When to Go Beyond Food

Most ADHD professionals recommend eating a diet full of fruits and vegetables, complex carbs, and some lean protein with every meal to help manage symptoms. However, not everyone eats the right foods to achieve beneficial levels of certain nutrients. In other cases, our bodies don’t produce some nutrients we need, so we have to get them from supplements. Find out which vitamins, herbs, and supplements may treat ADHD symptoms.

Go for Omega-3s

If you are looking for a single supplement to add to your diet, it is omega-3 fatty acids. Besides being good for heart health, recent studies have shown that omega-3 fatty acids improve symptoms of ADHD. A comprehensive look at many studies showed that omega-3’s are about 40 percent as effective as stimulants in relieving symptoms.

Take Optimal Amounts of Omega-3s

According to Dr. Newmark, kids between four and eight years old should take between1,000-1,500 mg. a day. Older kids should get 2,000-2,500 mg. daily. Look for a product that has twice the amount of EPA to DHA—the two main types of omega-3’s. Liquid or capsule forms of omega-3 fatty acids are best. The gummy and chewable versions have lower amounts of EPA and DHA, requiring your kid to take too many to reach the recommended dose.

Think about Zinc

Some studies have shown that children with ADHD may have lower levels of zinc and taking supplements may reduce hyperactivity and impulsivity but not inattentiveness. High levels of zinc, however, may be dangerous. Have your doctor check zinc levels before taking a supplement. If you do add a zinc supplement, Dr. Sandy Newmark suggests that children with ADHD take a 20 mg. supplement daily.

Do Not Sell Yourself Short on Iron

Some experts believe that iron deficiencies may contribute to ADHD symptoms in children. A study completed in 2008 showed children who were not anemic but had low ferritin levels, a protein needed to store iron in the blood, showed significant improvement of ADHD symptoms after 12 weeks of iron supplements. Before taking iron supplements, speak with your doctor about checking iron levels: High iron levels can be dangerous.

Calm Down with Magnesium

Low levels of magnesium in the blood can decrease attention span. Some small studies have shown that adding magnesium supplements decreases some symptoms of ADHD. Magnesium also helps with sleep and relaxation – big challenges for children and adults with ADHD.

Vitamin C is Key

Vitamin C, says Dr. Hallowell, is important in modulating the neurotransmitter dopamine at the synapses in the brain. (ADD stimulants are effective because they increase dopamine levels in the brain.) Hallowell recommends vitamin C from food, which is more effective than that found in pills. If your child doesn’t eat foods high in vitamin C, try a daily supplement. (One caution: Don’t take vitamin C less than an hour before or after taking ADD meds. It prevents the med from being absorbed.)

Cover Your Nutritional Bases

A daily multivitamin, containing the recommended daily allowance of vitamins and minerals, is important for optimal brain health. Many of the multivitamin/multimineral products on the market contain sugar, preservatives, and artificial colors, which may increase hyperactivity in children. Look for brands that are low in sugar with no artificial colors or flavors.

Mix It Up with Protein Supplements

If your child doesn’t eat high-protein foods, which are key to increasing attentiveness and focus, or is a picky eater, give him a protein-powder drink in their place. You can mix it with his favorite juice or milk to help the protein go down easier. Look for brands that are low in sugar and free of artificial flavors and preservatives.

Help for Sleep

There is limited evidence that supports using herbs in treating ADHD. The herb valerian can calm hyperactivity and may reduce anxiety, but it doesn’t improve concentration. Valerian also helps with sleep problems and lessens the “rebound effect” that some kids experience when stimulants wear off. Talk with your doctor or a nutritionist who specializes in herbs about this herb.

More Help at Bedtime

Melatonin is a natural hormone produced in our bodies to help us get to sleep. When we turn off the television, dim the lights, and settle down for bed, our body produces melatonin and we become sleepy. But for those with ADHD, sleep is sometimes difficult to come by. Melatonin supplements can help and are safe to take. Always start with the smallest possible dose.

Give Ginkgo and Ginseng a Try?

Some small studies show that Ginkgo biloba helps improve memory and, when taken with ginseng, can decrease impulsiveness and distractibility. Other studies have shown no or minimal improvement. Talk with your doctor or a nutritionist who specializes in herbs before trying them. These herbs can cause health problems, especially if you have a history of diabetes, seizures, or schizophrenia. They may also interfere with other meds.

Heed the Warning

“All natural” is not synonymous with “safe.” Many herbs and supplements have side effects, may cause or worsen health problems, or interfere with prescription medications. Talk with your doctor before taking any supplements. When your doctor asks if you are taking any medications, be sure to tell him about all vitamins and supplements you take on a daily.

Listen to Your Body

For many supplements, there isn’t a lot of research to determine a recommended daily dose. Pay attention to your body and adjust the dosage if you notice something is wrong. For example, you may be taking zinc supplements and find yourself getting stomachaches. Discontinue or cut back on the supplement to see if the stomachaches disappear.

 

Published on ADDitudeMag.com


8 Healthy Snacks for Kids With ADHD

By Beth W. Orenstein
Medically reviewed by Lindsey Marcellin, MD, MPH

Foods that are rich in fiber and protein can help kids with ADHD stay alert, calm, and focused. Keep these easy snacks on hand for both their appetite and their ADHD.

boy eating watermelonLike all kids, children with attention deficit hyperactivity disorder (ADHD) need to eat a healthy diet, and that includes choosing healthy snacks. But feeding kids who have ADHD can be extra challenging for several reasons. First, medications can decrease their appetite. Second, kids who experience hyperactivity expend more energy and may need more calories than some of their peers. And third, if they eat too many sweets, they can suffer from mood swings when their blood sugar spikes and then crashes. As a parent, you have to know the right balance to strike. These eight kid-friendly ideas can help take the guesswork out of snack time.

Smoothies

Kids who have ADHD benefit from the vitamins, minerals, and fiber that fruit provides. If your child turns up his nose at a whole banana, try making a fruit shake from fresh fruit and yogurt instead. Blend bananas, strawberries, peaches, orange juice, and ice in the blender, add some yogurt for thickness, and serve. Choosing nonfat Greek yogurt will give your smoothie extra protein. “Don’t be afraid to be creative when it comes to what you put in your smoothie,” says Jessica Crandall, RD, a spokeswoman for the American Dietetic Association. You can use any mix of fruits — try mangoes or pineapples for a tropical flavor. For a boost of protein, add a scoop of peanut butter. And you can sneak in extra fiber and omega-3 fatty acids with ground flax seeds.

Mini Pizzas

Mini pizzas are a fun, quick snack — and you don’t have to tell your kids they’re healthy. Make a mini pizza on a whole-wheat English muffin (that’s the fiber) with low-fat cheese (that’s the protein). Protein helps feed the brain and reduces hunger-induced mood swings. It also fills kids up for longer because it slows the food on its path from the stomach to the small intestines. Fiber, a complex carbohydrate, takes longer to digest and keeps blood sugar levels stable longer.

Hummus Spread on Pita

hummus and pitaHummus is a Middle Eastern spread made from ground chickpeas and tahini (sesame seeds). It’s a great source of protein, fiber, and many of the vitamins that kids with ADHD need to stay calm and focus better, says Heather R. Mangieri, RD, LDN, a spokeswoman for the American Dietetic Association and owner of Nutrition Check Up in Pittsburgh. Serve it on fiber-rich whole-wheat pita that you’ve cut into pie-shape pieces. Try including colorful veggie spears for dippers as well.

PB&J on Whole Grain Bread

For kids with ADHD, Mangieri says, snacks should contain protein — which helps with memory and learning — and a couple of other food groups. “Think of a snack as a mini-meal,” she explains. One classic idea: Peanut butter — an excellent source of protein — on whole grain bread. Or try a PB&J-banana sandwich. Bananas, a great source of potassium and vitamins B and C, have been found to boost immunity and even lift moods.

Whole-Grain Crackers or Pretzels

What kid doesn’t crave potato chips? The problem is, potato chips are loaded with fat and have little to offer in the way of nutrition. To satisfy your child’s craving for crunch-worthy foods, offer whole grain crackers, baked chips, or pretzels instead. Hot-air popcorn is another healthier alternative that provides lots of fiber and can be a nice addition to your child’s ADHD diet. Pack some in your child’s backpack for when hunger strikes.

Veggie Sticks With Tasty Dips

veggies and dipWhen your child opens the refrigerator or kitchen cabinets, “you want them to see healthy snacks, not cookies, candies, or salty snacks,” Mangieri says. Cut up fresh vegetables — for example, carrots, celery, and sweet peppers — into bite-sized pieces, and leave them in the fridge for easy snacking. Peanut butter, cottage cheese, and low-fat dressings make great dips for cut-up veggies and may entice kids whose ADHD medications dampen their hunger, Crandall says.

Dried Fruits and Nuts

Dried fruits are another great source of fiber for your child. They have little protein, but they go well with nuts, which can provide the protein needed in an ADHD diet. A dozen almonds will net about 3 grams of protein. However, if you don’t watch portion sizes, dried fruits and nuts can quickly add extra calories to your child’s diet. That may not be a concern, since many kids with ADHD are hyperactive and need more calories anyway, Mangieri says. But it’s a good idea to divide the snack into small servings so your child doesn’t overeat.

Snacks With Hidden Nutrients

If your child with ADHD is a fussy eater, one way to get him or her to eat healthy snacks is to disguise the healthy ingredients. Try baking carrot cake or zucchini bread. “A diet high in sugar can cause swings in your child’s blood sugar levels, exacerbating ADHD symptoms,” Mangieri says, but you can usually cut the amount of sugar in the recipe by a quarter or a third without affecting the taste too much. You also may be able to substitute applesauce for the oil.


Managing ADHD with Diet

By JANE COLLINGWOOD

In recent years there has been an increasing focus on the role of diet in attention deficit hyperactivity disorder (ADHD), both in children and adults.

balanced nutritionThe development of ADHD, along with many other mental illnesses, has been linked to nutrition. Research has shown that those with ADHD may be deficient in some vitamins, minerals, and omega-3 fatty acids.

Studies have found a reduction in symptoms when patients have taken daily vitamin and mineral supplements, but the evidence for a benefit is not fully established.

Scientists have reported that various aspects of a child’s diet–including food additives, refined sugars, food allergies and fatty acid metabolism–may have adverse effects on behavior. There is no definitive proof that any of these are responsible for ADHD symptoms, but there is some evidence for a role for omega-3 fatty acids, found in oily fish (such as salmon, herring, mackerel, anchovies and sardines), flaxseeds and linseeds.

Dr. Natalie Sinn of the University of South Australia in Adelaide says that “the current evidence supports nutritional and dietary influences on behavior and learning in children, with the strongest support to date reported for omega-3 fatty acids.”

Omega-3 fatty acids are converted to docosahexaneoic acid which is used mainly in the brain and eyes. A growing number of studies are investigating its relationship with ADHD. Taking supplements often leads to a small benefit compared with placebo. This has led to the suggestion that lack of omega-3 fatty acids affects brain function in such a way as to cause or worsen the symptoms of ADHD.

But in a recent 2010 review, experts from the Netherlands conclude, “There is a theoretical rationale for the effectiveness of fatty acids in the treatment of ADHD. At the moment, however, treatment of ADHD with omega-3 fatty acids is not recommended because it does not qualify as being evidence-based.”

Research has also been conducted on iron, zinc and food sensitivities. Iron deficiency is found in some children with ADHD. It is vital for brain function and individuals with iron-deficiency anemia can experience apathy, depression and fatigue, but tests of supplements are so far inconclusive. Zinc supplements “may be of great benefit” for ADHD, according to one study, but are not conventionally recommended.

A diet high in processed foods and soft drinks may lead to peaks and troughs in blood sugar, triggering periods of hyperactivity. While sugar intake has been linked with hyperactivity in a number of observational studies, more rigorous studies do not support a link.

The question of whether food additives such as preservatives, artificial flavorings, and artificial colorings trigger hyperactivity has been debated for more than 30 years. Research generally has not supported food additives as influencing traits linked to ADHD, but some studies have found small effects.

A 2007 study suggested that the preservative sodium benzoate and several other commonly used artificial food colorings may exacerbate hyperactive behavior in young children. The researchers, from Southampton University, UK, say, “The outstanding feature of the results was the similar pattern of an adverse effect across three-year olds and eight- and nine-year-olds.”

The researchers do not claim that food additives cause ADHD, but the British Food Standards Agency now advises parents to consider eliminating the colorings used in the study from the diets of children who exhibit hyperactive behavior. Further studies are needed to find out whether different additives could have a similar effect, and whether they can also affect ADHD symptoms in adults.

Much of the dietary research on children with ADHD may be of interest to adults with the condition. For example, a 2005 study found that omega-3 supplements improved attention in healthy adults, probably due to their beneficial effect on the central nervous system. A trial of young adult prisoners also found a reduction in antisocial behavior with a supplement that included essential fatty acids.omega 3

A further review of research on adults found that “adequate levels of glucose in the blood facilitate attention control.” The researchers say, “Acts of self-control deplete relatively large amounts of glucose. Self-control failures are more likely when glucose is low. Restoring glucose to a sufficient level typically improves self-control.”

Blood glucose is controlled by hormones, but can be negatively affected by lack of food for extended periods, alcohol, very heavy exercise, “stress” hormones such as adrenaline, steroids and infections.

Proper medical diagnosis and a discussion of all possible treatment options should always be the first plan of action when treating ADHD. Psychiatrists need to be aware of the available nutritional therapies, appropriate doses, and possible side effects in order to provide alternative and complementary treatments for their patients.

But the decision on whether to alter diet or try nutritional supplements must be made by the patient or their parent, and as with any form of treatment, nutritional therapy should be supervised and doses should be adjusted as necessary to achieve the best results.