Iron Supplements Reduce ADHD in Low Birth Weight Infants

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Dec. 10, 2012 — In a study published December 10 in Pediatrics, scientists at Umeå University in Sweden conclude that giving iron supplements to low birth weight infants reduces the risk of behavior problems like ADHD later in life.

The study, Effects of Iron Supplementation on LBW Infants on Cognition and Behavior at 3 Years, is published in the January 2013 issue, released online Dec. 10, 2012.

In the randomized controlled trial, researchers in Sweden gave 285 marginally low birth weight infants either 0, 1 or 2 mg/kg and day of iron supplements from 6 weeks to 6 months of age. At age three-and-a-half, these infants and 95 who had a normal birth weight were assessed for intelligence and behavior. There were no significant differences in IQ between the low birth weight groups and the normal-weight control group. However, for behavioral problems like ADHD, there was a significant effect from the iron supplements. Of the low birth weight infants who received no iron supplements, 12.7 percent showed signs of behavior problems, compared to 2.9 percent of infants in the 1-mg group and 2.7 percent of the 2-mg group. In the control group, 3.2 percent of children showed signs of behavioral problems.

Study authors conclude the results demonstrate long-term health benefits of early iron supplementation of otherwise healthy, marginally low birth weight infants.

The study was done in collaboration with colleagues at the Karolinska Institute, Stockholm, by researchers at the Department of Clinical Sciences, Umeå University.


How Food Can Affect Your Child’s ADHD

The latest scientific findings show that certain foods might play a role in worsening ADHD symptoms. Here’s what you need to know to create a better ADHD diet.

By Wyatt Myers
Medically reviewed by Pat F. Bass III, MD, MPH

For years, doctors have speculated that certain foods may play a role in ADHD. Although much research has been done on the subject, it’s still not believed that food actually causes ADHD. What diet does seem do, however, is worsen ADHD symptoms or trigger symptoms that mimic the signs of ADHD in children. “Excessive caffeine and excessive use of fast foods and other foods of poor nutritional value can cause kids to display behavior that might be confused with ADHD,” says Frank Barnhill, MD, an expert on ADHD and the author of Mistaken for ADHD. The following foods in particular have been implicated in ADHD in one way or another.


Candy is loaded with sugar and artificial colors, which is a bad combination when it comes to children with ADHD who often need to follow an ADHD diet. Both of these components have been shown to promote ADHD symptoms in studies. “With the high content of sugar and artificial coloring, candy is a huge contributor to ADHD,” says Howard Peiper, author of The ADD and ADHD Diet.


If you have ADHD, consider eliminating soda. These sweet drinks often have many of the same sugars and sweeteners that make candy a bad idea for kids on the ADHD diet. Soda also has other ingredients that can help worsen ADHD symptoms, such as high-fructose corn syrup and caffeine. “Excessive sugar and caffeine intake both cause symptoms of hyperactivity and easy distractibility,” says Dr. Barnhill.

Cake Mixes and Frostings

Cake mix and frosting contain the high amounts of sugar and artificial colors that can lead to hyperactivity and other ADHD symptoms. Naheed Ali, MD, ADHD expert and the author of Diabetes and You: A Comprehensive, Holistic Approach, adds that these products are often also loaded with several artificial sweeteners. “When frosting and cake mix contain artificial sweeteners, they increase the risk of ADHD symptoms more than natural sweeteners would,” he says.

Energy Drinks

Energy drinks are becoming increasingly popular among kids, especially teens. Unfortunately, they also have a veritable treasure trove of ingredients that can worsen ADHD symptoms: sugar, artificial sweeteners, artificial colors, caffeine, and other stimulants. “Energy drinks are high on the list of things that cause teens to display behaviors mimicking ADHD,” says Barnhill. They have no place in a healthy ADHD diet.

Frozen Fruits and Vegetables

Most fruits and vegetables are healthy choices for an ADHD diet, but some frozen varieties can contain artificial colors, so check all labels carefully. Barnhill says these can cause ADHD symptoms for another reason as well. “Foods treated with organophosphates for insect control have been shown to cause neurologic-based behavioral problems that mimic ADHD and many other behavior problems,” he says.

Fish and Other Seafood

Dr. Ali says that eating fish and other seafood with trace amounts of mercury can cause ADHD symptoms in the long term. Some of the worst culprits are shark, king mackerel, swordfish, and tilefish. “Mercury, like cellulose, is extremely hard to digest and can accumulate in the brain over time,” explains Ali. “This can lead to hyperactivity.” Talk to your doctor or ADHD nutritionist about the best types of fish to include in your ADHD diet.

Other Food Sensitivities

According to a recent study, many children with food sensitivities can exhibit ADHD symptoms after they are exposed to certain foods. Based on the results of the research, some of the common foods that can cause ADHD reactions include milk, chocolate, soy, wheat, eggs, beans, corn, tomatoes, grapes, and oranges. If you suspect a food sensitivity may be contributing to your child’s ADHD symptoms, talk to your doctor about the possibility of trying an elimination diet.

Omega-3 Fatty Acids “Improves Reading and Behaviour”

DHA is a key omega-3 fatty acid found in fish and seafood, but in this study the source was algae, making it suitable for vegetarians.

A new study by the University of Oxford has shown that daily supplements of omega-3 fatty acids (Docosahexaenoic acid, or DHA) improved the reading and behaviour of underperforming children in mainstream primary schools.

The researchers worked with children aged between seven and nine who had underperformed in standardised reading tests.

The research suggests that DHA supplementation is a simple and effective way to improve reading and behaviour in healthy but underperforming children. DHA is a key omega-3 fatty acid found in fish and seafood, but in this study the source was algae, making it suitable for vegetarians.

The DHA Oxford Learning and Behaviour (DOLAB) study, which compared daily supplements of omega-3 DHA with placebo, will be published in the journal PLOS ONE on Thursday 6 September.

Dr Alex Richardson, a senior research fellow at the Centre for Evidence-Based Intervention at Oxford University, said: ‘Our results showed that taking daily supplements of omega-3 DHA improved reading performance for the poorest readers (those in the lowest fifth of the normal range) and helped these children to catch up with their peer group.’

Paul Montgomery, Professor of Psychosocial Intervention at the Centre for Evidence-Based Intervention at Oxford University, said: ‘Previous studies have shown benefits from dietary supplementation with omega-3 in children with conditions such as ADHD, Dyslexia and Developmental Coordination Disorder, but this is the first study to show such positive results in children from the general school population.’

The researchers worked with Oxfordshire County Council’s Education Department to identify 362 healthy children from mainstream state schools in Oxfordshire, aged between seven and nine, who underperformed on a standardised reading test.

The treatment was a fixed dose of 600 mg/day of omega-3 DHA from algal oil. For 16 weeks, the school provided the capsules to the children on school days with the parents giving them to their children at all other times.

Although no significant treatment effect on reading was found in the overall study sample (children whose initial reading placed them in the lowest third of the normal range), supplementation with DHA did significantly improve the reading of children whose initial performance fell within the lowest fifth of the general population range.

In the 224 children initially reading at or below the 20th centile, the improvement in reading over the trial period was 20 percent greater than would normally be expected. In the subgroup of 105 children whose initial reading was below the 10th centile, the improvement in reading was nearly 50 percent greater than would be expected.

Children’s reading ages would normally be expected to increase by four months over the 16-week treatment period. The children whose initial reading was below the 20th centile gained an additional 0.8 months inreading age if they received DHA rather than placebo. Those below the 10th centile gained an additional 1.9 months from the active treatment.

In addition to the improvements in reading seen in those children whose initial performance in this area was lowest, parents also reported an overall improvement in behaviour.

The study used validated assessment measures that typically screen for Attention-Deficit Hyperactivity Disorder (ADHD). Although average scores for these children were within the normal range before treatment, significant benefits were reported for the children taking omega-3 DHA compared with placebo on eight of 14 scales assessing a wide range of ADHD-type symptoms.  For example, in the children who received the DHA supplement, parents reported significantly less hyperactivity and defiant behaviour than parents of children in the control group.

The DOLAB trial is an independent study conducted at the University of Oxford, and was conducted in collaboration with Oxfordshire County Council Education Department. It was funded by a grant from DSM Nutritional Products, who also provided the active and placebo supplements.

The study was a parallel group, fixed-dose, randomised, double-blind, placebo-controlled trial. A follow-on study is currently underway at the University of Oxford to explore the effects of DHA supplementation in a larger sample of underperforming children.

University of Oxford

The Link Between ADHD and Nutrition 1

How Simple Diet Modification Can Minimize the Symptoms of ADHD

Your child has a hard time sitting still in class, but you detest the idea of having him take medication and lose his sparkle. And yet, he does need to stop bouncing off the walls. Fortunately, parents are looking at their child’s diet before turning to medication to treat attention deficit hyperactivity disorder (ADHD).

Characterized by hyperactivity, impulsiveness, and the inability to focus, ADHD is the most commonly diagnosed behavioural disorder in childhood, affecting from 8 to 10 percent of North American.  Unfortunately, most parents and physicians treat ADHD with medication and, sadly, the use of medication has tripled worldwide between 1993 and 2003, with the United States prescribing more medication for ADHD than any other country. Thankfully, some parents have taken a rigorous look at their child’s diet as a substitute minimize symptoms and ultimately sidestep a dependency on drugs.

Medication produces fast results and is preferred by many physicians, parents, and teachers. “It does improve behaviour, it is easy, it is quick, but the problem is it doesn’t heal anything,” says clinical nutritionist Marcia Zimmerman, a former research scientist at Stanford University Medical Centre and author of the book ‘The ADD Nutrition Solution: A 30-Day Drug-Free Plan’. “And moreover, when a child has been on these meds for a period of time they may develop side effects and you have to use more drugs to relieve the side effects.”  This is nothing but a lose-lose situation.

On successful option is an elimination diet, in which parents take away multiple food categories and then reintroduce them one by one to see how they affect mood and behaviour of their child.

Whichever approach you choose, make sure the changes are realistic for your family and don’t create additional stress as you attempt to follow them.  Changing a diet should be simple and, for some reason, there are diets out there that are incredibly strict.  Those diets could have credibility, but it is recommended picking some aspect of the diet – for example, sugar – and really watching that to see if your child has a change in behavior.”

Zimmerman says it’s OK to relax and let your child enjoy the food at a birthday party, for example, but she says it’s easier for a child to adjust to a new, restricted diet when the whole family takes part.  This is crucial as the child doesn’t want to feel as if there is something wrong with him by being excluded from normal daily family activity.  When the entire family takes part in the diet changes, the chances of the new diet sticking are highly successful.

The backbone of a food-based approach is stabilizing blood sugar levels and feeding the brain the right types of foods at the optimal times. Protein and whole grains are high on the list.  Another successful approach is small healthy meals throughout the day to regulate energy, and convert food into the glucose the brain needs to function.  This has a far better effect on the child rather than having him eat 3 large meals per day – doing this will make his blood sugar levels quite inconsistent.

“About 50 percent of what a child eats goes to feed their brain,” Zimmerman says. “The brain’s only fuel is sugar—glucose, not sucrose. We have to have a steady supply of glucose for the brain. If they get too much, the ADHD child can’t handle it.  Alternately, if they don’t get enough, they can’t handle it. The theory is to supply the brain with glucose when they need it but also to supply protein. You want the messages between the brain cells to be activated at the right time.”

Finding the right nutrient mix that’s best for your child can be a lot of trial and error and it is important to consult a physician before taking a food-based approach.  Think of a food-based approach as medicine for the brain.  Just like any illness, when your child needs medication it’s important to give medication – think of food in this way as well.

If your child is already taking medication, don’t pull him off without a plan.  It is crucial that you work with his doctor.  Once he is off the medication completely, diet and supplements can remedy the situation successfully for long term effects.

 – Karen Ryan