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Diet for ADHD Children: A Parent's Guide (page 3)

— Center for Science in the Public Interest
Updated on Feb 15, 2011

Deciding On A Treatment

Until some preventive method or cure is developed, parents of a child with ADHD need to determine what therapies to try. On the basis of their concerns about medications, the effectiveness of different approaches, and their child’s personality and diet, parents may choose to test their child on a restricted diet, to use stimulantdrug therapy, to use only counseling and behavior-modification techniques, or some combination of those methods.

Many parents have qualms about treating their child with a drug to make him or her behave more appropriately at home and in school. Those drugs are simple to use and often effective, but may have side effects. One possible alternative is a dietary approach, which seeks to identify and remove irritants in foods that cause behavioral symptoms. That approach entails eliminating certain foods from the (unmedicated) child’s diet for several weeks to see if his or her behavior improves. In some cases, dietary changes by themselves may adequately reduce behavioral problems. If not, amphetamines or another medication could be tried in addition to, or instead of, a restricted diet.

Treating your child with diet Numerous studies have demonstrated that the behavior of some children improves when they avoid certain foods. Those children may react to any of a variety of different foods and ingredients, and some may be affected by more than one. Your goal is to identify the specific foods or additives, if any, that affect your child. What makes that task especially challenging is that children’s behavior ordinarily is so variable.

Needless to say, controlling the diets of young children can be difficult, especially once children go to school. Foods containing dyes and other potentially provoking ingredients are advertised aggressively and available everywhere: at supermarkets, restaurants, schools, vending machines, parties, theaters, and the homes of friends and relatives. Many young children are already “hooked” on the very foods that may cause problems, though it is getting easier to find acceptable alternatives. And children who do not eat what all their friends eat may feel left out or stigmatized.

Some parents who have put their children on special diets, though, say that their children willingly cooperate in making dietary changes, especially after they discover that those changes make them feel better. Some older children avidly read labels to avoid certain ingredients.

Some studies suggest that the children who respond best to dietary therapy are young (preschool) and those who suffer from asthma, eczema, hives, hay fever, or similar symptoms. Children who still have significant problems after taking stimulant medications might also be good candidates. But, no matter the age of your child or the exact nature of his or her behavioral problem, it could be worth trying diet. It is certainly safer and cheaper than using stimulant drugs, and, if your child has been eating a lot of artificially colored foods, it may also be more nutritious. At worst, a modified diet won’t help and you’ve delayed for several weeks trying another option.

Trying A Modified Diet

Finding a diet that will help your child will require time, patience, and experimentation. We discuss diets that involve varying degrees of change, starting with eliminating only dyes. The most restricted diets begin by eliminating numerous common foods and then add them back one by one to identify any that cause problems.

Numerous studies have demonstrated that some children are sensitive to dyes. Thus, you might start by eliminating only foods (and vitamins, drugs, and toothpastes) that contain artificial colorings.

The Feingold diet, which is based mostly on unconfirmed reports from parents and doctors, eliminates additional additives, as well as “salicylate-containing” foods. That diet eliminates:

  • artificial colorings (look for names like Red 40 and Yellow 5 on labels)
  • artificial flavorings (including vanillin, used in synthetic vanilla)
  • artificial sweeteners (acesulfame-K, aspartame, saccharin, sucralose)
  • BHA, BHT, and TBHQ preservatives

One study suggests that sodium benzoate and benzoic acid should also be on that list. The Feingold diet also excludes certain fruits and vegetables, though, again, studies have not demonstrated that they cause problems (see box on the next page for lists of excluded and permitted foods). While that diet excludes many common foods, later you can add back any to which your child is not sensitive.

Once you have decided which foods and additives you will eliminate, check all the foods in your refrigerator, pantry, and cupboards. Remove or discard any foods that contain banned ingredients. Learn about the ingredients used by the restaurants you frequent, though during the test period it may be best to stick mostly to foods you prepare at home. Major fast-food chains offer lists of the ingredients in their products; ask servers or call their consumer-affairs offices. The Feingold Association publishes lists of selected packaged and chain-restaurant foods that fit into the diet, but you’ll have to become a careful label reader and inquisitive restaurant-goer to learn the ingredients in your children’s favorite foods.

Once you are set to go, put your child (and the rest of the family, if possible) on the modified diet for two or three weeks. Stick to the diet as carefully as you can. If your child mistakenly eats a prohibited food, don’t get upset, just get him or her back on the diet.

Foods Not Allowed on the Feingold Diet (partial list)*

  • almonds
  • cucumbers
  • peppers
  • apples and pickles (bell, chili)
  • apricots
  • currants
  • plums, prunes berries (all) grapes, raisins
  • tangerines
  • cherries
  • nectarines
  • tea
  • cloves
  • oranges
  • tomatoes
  • coffee
  • peaches
  • aspirin (acetyl salicylate) and medications that contain it oil of wintergreen (methyl salicylate; mint flavoring)

*Reactions to these foods are based on unconfirmed reports, not controlled studies.

Foods Allowed on the Feingold Diet (partial list)

Fruits

  • banana
  • honeydew
  • papaya
  • cantaloupe
  • kiwi
  • pears
  • dates
  • lemons
  • pineapple
  • grapefruit
  • mangoes
  • watermelon

Vegetables

  • bean sprouts
  • cauliflower
  • peas
  • beans (all types)
  • celery
  • potatoes
  • beets
  • kale
  • spinach
  • broccoli
  • lentils
  • squash
  • Brussels sprouts
  • lettuce
  • sweet corn
  • cabbage
  • mushrooms
  • sweet potato
  • carrots
  • onions
  • zucchini

 


 

You should use a notebook to keep track of your child’s behavior before and after you put your child on the diet. Prepare a score sheet (see box on next page) based on common characteristics of ADHD, but modify that to include your own child’s most troubling behaviors. Use a separate page for each day. Note when behavior problems arise and which foods your child had eaten recently. You also can ask your child’s teacher if he or she has noticed any improvement in behavior, but don’t say that you’re changing your child’s diet unless you need his or her assistance to provide your child with special snacks.

Improvements in behavior should serve as great positive feedback to stay on the diet. However, it might just be a coincidence that a child’s behavior improved when the diet was introduced. Parents should try to be objective and not let their expectations color their views of their child’s behavior.

To try for even greater improvement, you can try eliminating more of the additives or foods that are suspected of affecting behavior. Likewise, if your child’s behavior did not improve on the initial diet, it could mean that your child is not affected by foods at all or is sensitive to other foods. It is also possible that prohibited ingredients are sneaking into your child’s diet.

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