Written by Judy Cho | Wednesday, 6 September 2023
Dietary intervention can serve as a complementary approach to managing symptoms of ADHD holistically. Current scientific literature shows diet patterns may affect the risk for ADHD symptoms.
The oligoantigenic, gluten-free, Feingold and other elimination diets have reported improvements in ADHD symptoms in some individuals. However, due to the potential bias and varying results of elimination diets on individuals with ADHD, their efficacy remains inconclusive. Additionally, elimination diets are often highly restrictive and, without the guidance of a registered nutritionist or dietitian, could lead to nutrient deficiencies and poor compliance.
Recently, researchers have begun to explore the role of nutrients and supplementations for ADHD. While no pill or diet can cure ADHD, certain nutrients have demonstrated their beneficial role in managing ADHD symptoms. These include zinc, omega-3 fatty acids, choline, magnesium, and iron.
Zinc supports cognition and brain function; it is an essential cofactor for the metabolism of neurotransmitters and indirectly affects dopamine metabolism. Zinc deficiency may lead to the disrupted synthesis of neurotransmitters, cognitive impairment, delayed information processing and increased severity of ADHD symptoms.
The richest food sources of zinc include oysters, red meat, pumpkin seeds, legumes, and shellfish. Individuals considering supplementation should seek professional guidance, as high doses of zinc can cause nausea, appetite loss and low copper levels.
Omega-3 fatty acids, an essential polyunsaturated fatty acid (PUFA), play a role in optimal brain function, neurotransmission, and neuroprotection. Omega-3 fatty acids are a family of fats, and the three main types are eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and alpha-linolenic acid (ALA). Studies have found individuals with ADHD have lower levels of PUFAs and supplementation with omega-3 fatty acids can improve inattention, hyperactivity, and irritability in children with ADHD. In adult studies, high doses of PUFAs modestly improve inattention but reduce the level of psychopharmacologic medication required. Omega-3 supplementation containing a higher ratio of EPA to DHA or EPA appears to have the most therapeutic effect for ADHD. EPA and DHA are mainly in fatty fish (including salmon, sardines, and mackerel).
Choline is an essential nutrient and precursor to the neurotransmitter acetylcholine. Acetylcholine is responsible for memory regulation and focus and supports the development of the brain’s frontal lobe. Higher intakes of choline are associated with better cognitive performance. Dietary sources rich in choline include whole eggs, fish, milk, broccoli, and organ meats.
Magnesium, an essential trace mineral, is involved in over 300 metabolic reactions in the body. Magnesium deficiency symptoms present similarly to ADHD-like symptoms (mood swings, irritability, and poor focus). Due to the overlapping symptoms of magnesium deficiency and ADHD, researchers hypothesised that individuals with ADHD may also have a magnesium deficiency. The findings of a recent meta-analysis supported this hypothesis when their study demonstrated individuals with ADHD had lower serum levels of magnesium compared to non-ADHD individuals.
Foods high in magnesium include dark leafy greens, bananas, almonds, and cacao.
Iron is an essential mineral required in neurotransmitter synthesis, and deficiency can result in altered dopaminergic synthesis and activity. Iron deficiency is a prevalent problem worldwide, and scientific literature found iron deficiency increases the risk for neurological disorders. Iron deficiencies are also common in the ADHD population. Symptoms of iron deficiency (poor focus, brain fog and reduced attention) parallel ADHD symptoms. Rich sources of iron are red meat, liver, lentils, tofu, and dark leafy greens.
The brain requires adequate nutrition to function optimally, and diet can play a huge factor in supporting brain function, focus and a healthy mood. Due to the heterogeneous and complex nature of ADHD, it is unlikely a single blanket treatment will be effective for everyone; thus, an individualised treatment approach is recommended.
Disclaimer: This blog post is for informational purposes only and does not substitute medical advice, nor diagnose and treat any health conditions. Consult with your qualified healthcare provider before implementing any dietary changes or supplementation.
Make an appointment with a naturopath or nutritionist to discuss the management of ADHD symptoms.
Afifi, D. et al. (2019) ‘Effect of zinc supplementation in zinc-deficient children with attention-deficit hyperactivity disorder’, Egyptian Journal of Psychiatry, 40(2), p. 86. doi:10.4103/ejpsy.ejpsy_10_19.
Cespedes, E.M. and Hu, F.B. (2015) ‘Dietary patterns: From nutritional epidemiologic analysis to national guidelines’, The American Journal of Clinical Nutrition, 101(5), pp. 899–900. doi:10.3945/ajcn.115.110213.
Demirci, K. et al. (2017) ‘The investigation of symptoms and diagnoses of adult-attention Deficit/ hyperactivity disorder in women with iron deficiency anemia’, Noro Psikiyatri Arsivi, 54(1), pp. 72–77. doi:10.5152/npa.2016.12464.
Derbyshire, E. (2017) ‘Do omega-3/6 fatty acids have a therapeutic role in children and young people with ADHD?’, Journal of Lipids, 2017, pp. 1–9. doi:10.1155/2017/6285218.
Edwards, C.G. et al. (2019) ‘Dietary choline is related to neural efficiency during a selective attention task among middle-aged adults with overweight and obesity’, Nutritional Neuroscience, 24(4), pp. 269–278. doi:10.1080/1028415x.2019.1623456.
Effatpanah, M. et al. (2019) ‘Magnesium status and attention deficit hyperactivity disorder (ADHD): A meta-analysis’, Psychiatry Research, 274, pp. 228–234. doi:10.1016/j.psychres.2019.02.043.
El Baza, F. et al. (2016) ‘Magnesium supplementation in children with attention deficit hyperactivity disorder’, Egyptian Journal of Medical Human Genetics, 17(1), pp. 63–70. doi:10.1016/j.ejmhg.2015.05.008.
Liu, L. et al. (2021) ‘Choline intake correlates with cognitive performance among elder adults in the United States’, Behavioural Neurology, 2021, pp. 1–11. doi:10.1155/2021/2962245.
Nigg, J.T. and Holton, K. (2014) ‘Restriction and elimination diets in ADHD treatment’, Child and Adolescent Psychiatric Clinics of North America, 23(4), pp. 937–953. doi:10.1016/j.chc.2014.05.010.
Pei-Chen Chang, J. (2021) ‘Personalised medicine in child and adolescent psychiatry: Focus on omega-3 polyunsaturated fatty acids and ADHD’, Brain, Behavior, & Immunity - Health, 16, p. 100310. doi:10.1016/j.bbih.2021.100310.
Pinto, S. et al. (2022) ‘Eating patterns and dietary interventions in ADHD: A narrative review’, Nutrients, 14(20), p. 4332. doi:10.3390/nu14204332.
Poly, C. et al. (2011) ‘The relation of dietary choline to cognitive performance and white-matter hyperintensity in the framingham offspring cohort’, The American Journal of Clinical Nutrition, 94(6), pp. 1584–1591. doi:10.3945/ajcn.110.008938.
Puri, B.K. and Martins, J.G. (2014) Which polyunsaturated fatty acids are active in children with attention-deficit hyperactivity disorder receiving PUFA supplementation? A fatty acid validated meta-regression analysis of randomized controlled trials, 90(5), pp. 179–189. doi:10.1016/j.plefa.2014.01.004.
Rucklidge, J.J., Johnstone, J. and Kaplan, B.J. (2009) ‘Nutrient supplementation approaches in the treatment of ADHD’, Expert Review of Neurotherapeutics, 9(4), pp. 461–476. doi:10.1586/ern.09.7.
Skalny, A.V. et al. (2020) ‘Serum zinc, copper, zinc-to-copper ratio, and other essential elements and minerals in children with attention deficit/hyperactivity disorder (ADHD)’, Journal of Trace Elements in Medicine and Biology, 58, p. 126445. doi:10.1016/j.jtemb.2019.126445.
Judy Cho is degree qualified clinical nutritionist who takes a ‘non-diet', holistic approach to health. Judy's four main passion areas are women's health, men's health, digestive health and mental health. Judy offers both in-person and online consultations in addition to functional testing, custom meal plans and dietary analysis. She guides and educates her clients with practical and sustainable dietary and lifestyle changes to support them in feeling their most vibrant and healthiest selves.