Attention Deficit Hyperactive Disorder, or ADHD, is one of the most common childhood diagnoses. It can affect a child’s ability to pay attention and control impulses, and can therefore present challenges in school, in social settings, and at home. 

That being said, there are many people in my life who have ADHD and are thriving as adults. So although it presents unique challenges at times, kids with ADHD also have many wonderful gifts!

We don’t know what causes ADHD. We do know certain environmental factors (like, you guessed it, diet!) can play a role in potentially exacerbating and/or managing symptoms. And because nutrition is my lane, let’s look at what current research says about how food can impact ADHD. 

(Also: a note on ADD vs. ADHD: ADD is an outdated diagnosis and is largely now just referred to as ADHD.)

ADHD and diet research

If we take a look at the current ADHD and diet research, we see some interesting patterns. Researchers still need to conduct more studies in this area, but we definitely see the possibility of diet impacting ADHD.

Before we examine supplements, sugar, and elimination diets, let’s first take a look at the big picture of overall diet quality.

An unhealthy dietary pattern, characterized as a diet high in sugar, salt, and saturated and total fat, while low in whole grains, fish, fruits, and vegetables, was associated with increased ADHD symptoms, according to this study. However, we cannot say that this dietary pattern causes ADHD. It’s just as plausible that ADHD behaviors lead to a preference for certain foods.

There is also research that suggests healthy eating patterns, like the Mediterranean diet, are inversely associated with ADHD. But, associations between a low prevalence of ADHD and adherence to healthy dietary patterns do not necessarily imply protective effects of the foods consumed by children.

What does this mean for you as a parent?

Improving overall diet quality is a very low-risk way to try to improve ADHD symptoms. I would not expect miracles, but it’s possible that you could see a decrease in certain symptoms. And, even if it doesn’t impact their ADHD, it’s still a wonderful thing to focus on healthy eating habits.

Starting with the basics, I would read this post on the food groups you should offer daily, and this post with healthy meal plans for picky eaters.

However, research emphasizes that generally improved lifestyle choices may provide more substantial benefits to children with ADHD than dietary changes alone. So it’s important to explore other lifestyle changes beyond the diet as well.

Sugar and ADHD

Let’s explore the link between ADHD and sugar. Does sugar affect ADHD? Does sugar make ADHD worse?

The answer: possibly. It’s one of those things where everyone just assumes that sugar must have an impact. But the research shows no significant association between sugar consumption and ADHD!

That being said, excess sugar intake can cause blood sugar swings in all of us, whether or not we have ADHD. These blood sugar swings can result in energy peaks and crashes, inattentiveness, and jitteriness.

My best tips for keeping blood sugar swings at bay? Serve regularly timed meals and snacks to keep blood sugar stable. Prioritize fat and protein at snacks and meals to increase satiety and provide long-lasting energy. And limit excess added sugar. 

If you feel like all your kid wants is sugar, read my free Sweets and Treats e-book. I tackle the tough topic of sugar and help you navigate many common scenarios around kids and sweets! 

Dietary Interventions and ADHD

Like I mentioned above, some emerging research suggests dietary interventions *could* be helpful for management of ADHD. 

ADHD and diet research is still in the early stages. 

Most studies have design limitations and/or are not conducted on large groups. We can’t just conclude that what one small study found is automatically true. 

But we can look at trends and patterns. And those lead us to examine particular treatments, like supplementation and elimination diets. 

Supplementation for kids with ADHD

As of now, there aren’t any official recommendations regarding supplementation for the treatment of ADHD in children. But one category of supplement has received a little more attention: PUFAs.

PUFAs are polyunsaturated fatty acids. They are essential fatty acids, meaning we all must consume them in our diets to get enough. PUFAs do lots of beneficial things in the body. They can mitigate inflammation, promote cell health, have positive cardiovascular effects, and more. 

Omega-3 is a PUFA that you’re likely familiar with. Supplementation with Omega-3 for kids (and foods rich in Omega-3) with ADHD is an idea that has gained scientific traction. Let’s look at what the most recent research can tell us.

Recent Research on Fatty Acids and ADHD

A new 2024 study has shed light on the relationship between fatty acids and ADHD in children. Here are the key takeaways:

1. No Clear Benefit. The study found no evidence that the 10 fatty acids examined were associated with a reduced risk of ADHD. This challenges some previous studies that suggested certain fatty acids might protect against ADHD.
2. Mixed Results in Other Research. Some studies have shown potential benefits of fatty acid supplementation, such as improved sleep. Yet others have found limited effectiveness in treating core ADHD symptoms.
3. Conflicting Evidence. Recent studies using advanced research methods have reached opposing conclusions about the effects of specific fatty acids (LA and DHA) on ADHD. This highlights the complexity of this topic.
4. More Research Needed. The conflicting results across various studies emphasize the need for further research to better understand the relationship between fatty acids and ADHD.

For parents, this means that while fatty acid supplements might have some benefits, they may not directly reduce ADHD symptoms or risk.

Should we try fatty acid supplementation?

There’s some evidence that it could be beneficial for children who have a deficiency. Your doctor can test for omega-3 deficiency in a blood test. A study found that children who were deficient became more attentive after 12 weeks of a supplement.

I would not start a supplement without first consulting a doctor. You could see negative results if your child gets improper supplementation.

Other supplements to explore

Zinc, iron, and magnesium are also commonly mentioned as potentially helpful supplements for the treatment of ADHD. Let’s look at the recent research on all of these.

Zinc supplementation for ADHD

Zinc deficiency has been suggested to increase the risk of ADHD. Sufficient zinc supply is thought to improve ADHD symptoms. But various studies regarding the zinc status in ADHD yielded inconsistent results.

I wish I could give a more helpful answer here! It seems that screening for zinc deficiency is a reasonable course of action at the time of ADHD diagnosis.

Iron supplementation for ADHD

Iron is an essential cofactor required for a number of bodily functions. These include transport of oxygen, immune function, cellular respiration, neurotransmitter metabolism (dopamine production), and DNA synthesis.

Getting enough iron in the diet is critical for all children! This post gives you ideas on getting more iron in if they don’t eat much meat.

Three studies investigating iron concentration in the brain reported significantly reduced levels in the thalamus of children with ADHD. The limited evidence provided suggests that brain iron rather than systemic iron concentrations may be a biomarker of the pathophysiology of ADHD in children.

Combining Iron and Zinc

Recent research on iron and zinc supplementation for children with ADHD has shown more promising results than supplementing just one or the other.

• Low levels of zinc and iron were linked to more severe ADHD symptoms and poorer treatment outcomes.
• Dietary supplements containing zinc and iron improved some ADHD symptoms compared to placebo.
• The benefits were modest and affected specific ADHD symptoms.

While these findings are encouraging, it’s important to note that the effects were small and varied among individuals. Parents should consult with their child’s healthcare provider before starting any supplementation regimen, as individual needs differ.

Magnesium supplementation for ADHD

Research does not show a causal relationship between magnesium levels and ADHD. But there is some evidence that supplementation of magnesium with vitamin D could improve ADHD symptoms.

A randomized, double-blind, placebo-controlled clinical trial of 66 children with ADHD examined the effect of both magnesium (6 mg/kg/day) and vitamin D (50,000 IU/week) supplementation for 8 weeks. They found a significant reduction in symptoms with this treatment compared to placebo. However, more studies with a larger sample size are needed.

Discuss with a doctor who is very familiar with the research and treatment of ADHD to determine whether this is something your child should try.

Elimination diets for kids with ADHD

Circling back to elimination diets! You need to highly personalize elimination diets to your child’s case and sensitivities. They also have to be nutritionally adequate.

A quick internet search of popular elimination diets left me worried. Many of them would not be safe to do for any measurable period of time! 

You may feel like you should start by cutting our dairy or gluten just to see how it goes. But cutting out entire food groups or large calorie sources in the diet can also cut out specific nutrients that your child really needs. 

If and when you explore an elimination diet route, get both a doctor and dietitian on board. They should supervise the plan and ensure that your child gets adequate nutrition even during the elimination phase. 

The Few Foods Diet

The Few Foods Diet is also known as the elimination or Oligoantigenic Diet. It is a short-term intervention designed to identify potential food triggers for ADHD symptoms in children.

A healthcare provider should administer this diet– please do not attempt it on your own. There is an initial few week period where the child eats a very limited diet. Then, individual foods are slowly reintroduced. This way you can examine which specific foods (if any) impact ADHD symptoms.

Emerging evidence suggests that subgroups of children and adolescents with ADHD may see behavioral improvements as a result of eliminating certain foods.

HOWEVER, please do not interpret this as an invitation to eliminate a bunch of foods from your child’s diet.  I do not recommend starting an elimination diet with your kid for any reason unless under the care of a doctor/dietitian. ADHD elimination diets can cause more harm than good.

That means if you just start cutting things out you because you heard it helped so-and-so, that’s not going to be individualized enough for your child. 

Suspected food intolerances could be playing a role in the pathophysiology of ADHD. And one person’s food intolerances won’t be the same as someone else’s. 

ADHD and food dye

Synthetic food dye safety is a major topic of concern in the nutrition world right now. You’ve probably heard about it in the news and seen a few alarming headlines! 

Food dyes are not known to cause ADHD (or any other condition). However, we do know that some kids may be sensitive to food dyes. This applies particularly to Red 40 food dye, which garners the most attention. 

Some kids with ADHD may experience exacerbation of their symptoms when consuming synthetic dyes. Since there is no nutritional benefit to consuming dyes, there is little downside to avoiding it in their diet.

If you want to minimize food dyes at home, there are several dye-free snacks I love on my healthy packaged foods list. 

See related: all about the use of food dyes and their safety

I do want to note that just because something is dye-free doesn’t necessarily mean its a health food. There is dye-free candy that’s great if you’re looking for something dye-free. Keep in mind that many of them are still pretty high in sugar. 

ADHD and picky eating

Kids with ADHD may be more likely to experience sensory overload or sensory sensitivities. And eating is a highly sensory experience, engaging all five senses. So it makes sense that it can sometimes be difficult for kids with ADHD. 

If you are experiencing picky eating in conjunction with ADHD, check out my free Picky Eater Starter Guide.

In it, there’s a Safe Foods Sheet that can help guide your understanding of your child’s sensory preferences. Once you know their safe foods, it gets a lot easier to build meals and snacks that they will actually eat.

If your child is sensitive to strong aromas

1. Offer cold or frozen foods. Cold/frozen foods are less fragrant, and are often less off-putting that their heated counterparts. This is especially true for things like veggies (my kids love frozen peas!). And you can always serve foods like pasta and tomato sauce cold instead of hot and steamy.
2. Always cook with the exhaust fan on, and consider opening windows or running other fans when weather allows. This will help minimize strong smells while cooking that could aggravate them.
3. Give warning. Your child may appreciate a heads up before you start cooking foods with smells that are difficult for them.
4. Respect their sensitivity. Remember that they didn’t choose this and they’re not just trying to be difficult. I was extremely sensitive to smells during pregnancy, and certain aromas made me sick. I couldn’t control it, and I definitely didn’t want it to be that way.

If your child is sensitive to big or bold flavors

1. Gradual introduction. Slowly introduce new flavors by mixing them with familiar foods. Start with small amounts of a new flavor to avoid overwhelming them. For example, start with just one drop of a new sauce mixed in with a whole serving of spaghetti.
2. Consider texture preferences. Some children may be more accepting of new flavors if the texture is appealing. For example, some kids will try fish sticks because they resembled chicken nuggets. While potato chips aren’t the *most* nutritious, they do provide an excellent way to try new flavors for hesitant eaters! A taste test with 3 or 4 different potato chip flavors can introduce them to new seasonings and spices.
3. Cook together: Involve your child in the cooking process. This can make them more curious about exploring new foods and flavors in a relaxed setting. Smelling foods like herbs, spices, lemons, etc. is often easier when they are not feeling pressured to eat it.

What if your child is very particular about flavors and textures, melts down around new foods, and/or can’t eat the food that the rest of the family is eating? You may consider feeding therapy if that’s the case. Feeding therapy can increase their number of accepted foods and make mealtimes easier on both you and your child.

Bottom line on ADHD and diet research

None of what I can offer you on this topic is medical advice. And though I always hope to give you helpful nutrition insight, I recommended working with your child’s doctor for any of your concerns. 

Unfortunately, when it comes to ADHD and diet research, there’s not a one size fits all conclusion. I wish it was as easy as cut this food out or take this supplement, but it’s a lot more individualized than that. It’s a good idea to find a clinician who specializes in ADHD treatment who can tailor a plan specifically for your child. 

Here’s what you can do

1. Focus on overall diet quality. Try to offer a variety of healthy foods daily. Offer balanced meals that have protein, healthy fats, carbohydrates, and fruit/vegetables, as often as possible.
2. Limit excess sugar. Avoid sugar sweetened beverages, and save candy for special occasions, not a daily kind of thing. Prioritize buying snacks that have low added sugar.
3. Talk to your child’s doctor about testing for nutrient deficiencies. It’s possible that they have deficiencies that would benefit from supplementation.
4. Discuss with your child’s doctor/dietitian the possibility of exploring an elimination diet to see if that could potentially help symptoms.
5. Get support if they are picky. I have tons of blog posts to help, as well as a course to reverse picky eating.

Managing the diet of your child can be hard! It takes lots of thoughtfulness and care. It’s impossible for it to be perfect all the time. And even with a carefully planned diet, there is still so much out of your control.

And know that even if you see someone online claim that, “xyz supplement cured my kid’s ADHD symptoms.” Or, “we eliminated sugar and they listen to everything I say!”

When it sounds too good to be true, it always is.

You are not failing when you haven’t found some magic bullet that makes everything better. The magic bullet is never real!