A “Food First Approach” to ADHD in Children

A case study by Rebecca Finn, holistic children’s nutritionist and founder of Inner Bliss Kids.

The statistics on neurodevelopmental conditions and mental health in children are alarming. One in ten children are diagnosed with Attention-Deficit-Hyperactivity-Disorder (ADHD) – a neurodevelopmental condition that affects their attention, impulse control and activity levels – and the numbers keep going up. While it is a complex condition, with symptoms often varying from child to child, diet and nutrition can have a significant impact on how their body and ADHD brain work influencing cognition, moods and behaviour. This is true whether or not a child is taking pharmaceutical medication.

This case highlights the significant role diet and nutrition plays in managing ADHD symptoms in children and how a “food first approach” can help reduce brain inflammation, support neurotransmitter production and fuel brain cells with the right nutrients for optimal focus, behaviour and moods.

Initial Consultation

A 5-year-old boy presented with recently diagnosed ADHD. He had just started school (Prep) and his parents faced mounting pressure from the teachers to medicate. Upon meeting with a Paediatrician, they reluctantly started a trial of Ritalin gradually increasing the dose to 1 tablet (10mg) twice daily over a 6-week period. They came to see me wanting to explore natural options as they did not want him on medication long-term.

Key presenting symptoms:

Hyperactive, unable to sit still
Difficulty concentrating at school
Impulsive
Aggressive outbursts, hitting other kids
Energy 9/10 despite history of iron deficiency
Intermittent tummy pain
Poor sleep onset and quality
Night terrors and teeth grinding
Excessive fruit intake (5 serves daily)
Limited vegetable intake
Loves processed cereals, fruit loops etc

Prescription:

Omega-3 fish oil liquid: 5 mL daily; containing EPA 346 mg, DHA 1.15 g, phosphatidylcholine 575 mg, Vitamin D3 800 IU, to reduce inflammation and support healthy brain function
Iron capsule: 1 capsule every second day; containing iron amino acid chelate 20 mg, Vitamin C 50 mg, Vitamin B2 2 mg, Vitamin B9 450 mcg, to address deficiency in blood test

Low iron levels are very common in children with ADHD and are associated with more pronounced symptoms of hyperactivity, impulsivity and poor focus/attention, due to its crucial role in making dopamine. Interestingly, a study from 2004 showed that the average iron level of children with ADHD (measured as Ferritin) was 22, compared with 44 in children without ADHD.¹

Diet & lifestyle advice:

Anti-inflammatory wholefoods diet prioritising nutrient-dense wholegrains, lean proteins, healthy fats and vegetables
Quality protein with each main meal to help regulate blood sugar levels and support neurotransmitter production
Avoid artificial food additives, colours, flavours (AFCs) known to worsen ADHD symptoms in children
Increase consumption of iron-rich foods
Support sleep onset and quality by turning off screens 2 hours before bedtime and establishing a calming bedtime routine (i.e. cooled chamomile tea after dinner, Epsom salt bath, mindfulness apps (e.g. Moshi, Headspace)

Follow-up Consultation - 6 weeks

After implementing the suggested dietary and lifestyle changes, along with the initial prescription, the young boy’s parents noticed a significant improvement in his irritability, hyperactivity and restlessness. He was able to sit still and focus for longer periods of time and they were not receiving regular negative feedback from his teachers. He was now falling asleep faster but was still waking during the night and having night terrors. Only a slight improvement in aggressive behaviour was noted and he was still occasionally complaining of tummy pains.

The initial supplementation was continued with the iron reduced to once every third day, and the treatment altered to focus on supporting his gut-brain axis.

Prescription

Selective antimicrobial capsule: 1 capsule daily; containing Carum carvi (Caraway) oil 100 mg, Punica granatum (Pomegranate) 283 mg, Allium sativum (Garlic) 50 mg and Nigella sativa (Black Seed) 100 mg, to reduce bacterial overgrowth
Gut healing powder: 1 tsp daily; containing Glutamine, PHGG, Slippery Elm, Zinc, Licorice, Quercetin, Chamomile, Aloe vera, Marshmallow, Okra and Pectin, to support gut-brain axis and reduce GIT inflammation
Multi-strain probiotic: 1 capsule daily, for microbiome balance
Continued Omega-3 liquid, Iron and Wholefoods AFC-free Diet

Follow-up Consultation- 12 weeks

After supporting his gut-brain axis with antimicrobial herbs, gut healing nutrients, prebiotics and probiotics, there was an 80% reduction in aggressive outbursts. His parents reported that the night terrors were gone, and he was having much deeper and better quality sleep. He was no longer complaining of tummy pains.

Over the following 6 months, he continued to improve and gradually reduced Ritalin under the guidance of his Paediatrician.

His treatment was adjusted accordingly to focus on maintaining optimal nutrient levels and neurotransmitter production.

Prescription

Multi-Nutrient powder: 1/3 scoop twice daily; containing Magnesium citrate 200 mg, Bacopa monniera (Bacopa) 4.5 g, Crocus sativus (Saffron) 15 mg, acetyl L-carnitine 1 g, tyrosine 1 g, Zinc 5 mg, and activated B vitamins, to support nervous system and cognition
Continued Omega-3 liquid

Clinical Reflections

While there is no one-size-fits-all diet for children with ADHD, it is evident that a nutrient-dense well-balanced diet, avoiding foods that negatively affect behaviour and brain development, and using targeted supplements to address nutrient deficiencies can have a powerful effect on ADHD symptoms.

This case further highlights the important role of the gut microbiome in neurodevelopmental conditions and its clinical significance in achieving long-term improvements in behaviour, moods and learning in children.

References

Konofal E, Lecendreux M, Arnulf I, Mouren M. Iron Deficiency in Children With Attention-Deficit/Hyperactivity Disorder. Arch Pediatr Adolesc Med. 2004 Dec 1;158(12):1113. DOI:10.1001/archpedi.158.12.1113