ADD/ADHD


Attention deficit disorder (ADD) is a condition that involves inattention and distractibility. When hyperactivity is accompanied and predominant, it is called attention deficit hyperactivity disorder (ADHD). ADD and ADHD mostly affect developing children, beginning before age seven, and many of these children continue having distractibility into adulthood.

 
  • Overview
  • Action Plan
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Overview


ADHD is estimated to affect approximately 5% of the U.S. population (adults and children) and approximately 9% of the population of children in the U.S.1 and is more common in boys.

It is natural and normal to occasionally have symptoms of inattention, especially in children, but when it interferes with development, then it becomes abnormal. The following signs may be noticed in someone with ADHD:

  • difficulty organizing things and tasks
  • forgetful
  • easily distracted
  • difficulty following through
  • fidgeting
  • impulsivity
  • restlessness
  • difficulty engaging in activities quietly

There is little known about the cause of ADHD. There is clearly a familial risk pattern associated with ADHD, but there may be environmental influences that could be modified to lower the risk of or the severity of this condition. Some evidence suggests that toxin exposures or allergic reactions in utero or as a young child may be contributing to a person’s risk, whereas other observations indicate perhaps nutritional deficiencies related to brain health such as iron, zinc, omega-3 fatty acids, folate, and other phytonutrients may play a role. A Western diet low in these and many other nutrients and high in dairy, processed and red meats, salt, and refined sugar has been associated with higher risk of ADHD.2

 
References
  1. Akinbami LJ, Liu X, Pastor PN, Reuben CA. Attention deficit hyperactivity disorder among children aged 5-17 years in the United States, 1998-2009. NCHS Data Brief 2011:1-8.
  2. Howard AL, Robinson M, Smith GJ, et al. ADHD is associated with a "Western" dietary pattern in adolescents. J Atten Disord 2011, 15:403-411.

Action Plan


Diet

  • The most important dietary goal may be to eat a large amount of micronutrient-rich foods every day, as in the Nutritarian eating style, which includes such foods as vegetables, legumes, seeds, nuts, and fruit. These foods will provide sufficient amounts of a variety of specifically brain-supportive nutrients.1
  • Reduce exposures to toxins and pollutants in general. One way to do this is to seek out whole, unprocessed foods that have no additives and are low in sodium (no refined flours, no refined sugar, no added coloring or artificial ingredients, etc.). 
  • Reduce or eliminate animal products (particularly dairy and meats). 
  • Consume omega-3-rich nuts and seeds daily: flax, hemp, and chia seeds and walnuts
  • Some children with ADHD may be sensitive to wheat, gluten, or dairy.

Supplements

  • Dr. Fuhrman’s general supplement protocol for adults (see Vitamin Advisor for details) includes:
  • Additional notes:
    • Omega-3 fatty acids (DHA and EPA) are important structural components of the brain.  Additional supplementation with DHA and EPA may be helpful for ADHD.2-4
    • Gamma-linolenic acid (GLA), an omega-6 fat found in borage oil, combined with omega-3 supplementation, may offer additional benefit.4,5

For supplement recommendations personalized to you, your health condition and goals, visit the Personalized Vitamin Advisor and answer a few questions. 

Exercise

  • Several studies have reported that exercise improves symptoms in children with ADHD.6-8

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Find additional help

ONLINE: All members of DrFuhrman.com can search the Ask the Doctor archives for discussions on this topic. Platinum and Diamond members can connect with Dr. Fuhrman by posting questions in the forum. Not a member? Join now.

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References
  1. Esparham A, Evans RG, Wagner LE, Drisko JA. Pediatric Integrative Medicine Approaches to Attention Deficit Hyperactivity Disorder (ADHD). Children (Basel) 2014, 1:186-207. doi: 10.3390/children1020186

  2. Bloch MH, Qawasmi A. Omega-3 Fatty Acid supplementation for the treatment of children with attention-deficit/hyperactivity disorder symptomatology: systematic review and meta-analysis. J Amer Acad Child Adolescent Psych 2011, 50:991-1000. doi: 10.1016/j.jaac.2011.06.008

  3. Milte CM, Parletta N, Buckley JD, et al. Increased Erythrocyte Eicosapentaenoic Acid and Docosahexaenoic Acid Are Associated With Improved Attention and Behavior in Children With ADHD in a Randomized Controlled Three-Way Crossover Trial. J Atten Disord 2015, 19:954-964. doi: 10.1177/1087054713510562

  4. Transler C, Eilander A, Mitchell S, van de Meer N. The impact of polyunsaturated fatty acids in reducing child attention deficit and hyperactivity disorders. J Atten Disord 2010, 14:232-246. doi: 1087054709347250 [pii]

    10.1177/1087054709347250

  5. Huss M, Volp A, Stauss-Grabo M. Supplementation of polyunsaturated fatty acids, magnesium and zinc in children seeking medical advice for attention-deficit/hyperactivity problems - an observational cohort study. Lipids Health Dis 2010, 9:105. doi: 10.1186/1476-511X-9-105

  6. Cerrillo-Urbina AJ, Garcia-Hermoso A, Sanchez-Lopez M, et al. The effects of physical exercise in children with attention deficit hyperactivity disorder: a systematic review and meta-analysis of randomized control trials. Child Care Health Dev 2015, 41:779-788. doi: 10.1111/cch.12255

  7. Vysniauske R, Verburgh L, Oosterlaan J, Molendijk ML. The Effects of Physical Exercise on Functional Outcomes in the Treatment of ADHD: A Meta-Analysis. J Atten Disord 2020, 24:644-654. doi: 10.1177/1087054715627489

  8. Zang Y. Impact of physical exercise on children with attention deficit hyperactivity disorders: Evidence through a meta-analysis. Medicine (Baltimore) 2019, 98:e17980. doi: 10.1097/MD.0000000000017980

     

Ask The Doctor


The following are sample questions from the Ask the Doctor Community Platinum and higher members can post their health questions directly to Dr. Fuhrman. (All members can browse questions and answers.)

Q.

My son was diagnosed with ADHD about two years ago and was put on Ritalin and more recently Adderall. I recently told his doctor that I want to take him off the meds completely. The doctor was surprisingly supportive. He said to look into the Feingold Diet. Are you familiar with this Program? What would you suggest?

A.

This diet has been tested in numerous studies with variable results and is not very effective. This food-additive-free diet is a start, and our children should not consume dyes and chemicals in their food, but eliminating them is not enough. Optimal brain function requires more than just removing food additives and food coloring in processed foods when the diet remains poor and deficient in essential nutrients and essential fatty acids necessary for normal brain function. What studies have shown to be highly effective is a high-nutrient diet, removal of processed foods, and supplementation with omega-3 fatty acids.

 
Q.

My daughter is 10 and was diagnosed with ADHD. We opted not to treat her with meds. We have been giving her a product which contains 100 mg of DMAE and fish oil. Is this safe? We have been working toward changing her diet. I have noticed that red dyes and processed foods are the worst for her, especially sugar. How much DHA would she need in addition to your multi?

A.

I wouldn’t use the product with DMAE in it, as the research isn’t convincing, and we don’t have enough safety information on it. Test her on a sort of elimination diet if you haven’t done so, by eliminating all processed foods and additives in general, including sugar and white flour, as well as no dairy or gluten (wheat, barley, rye). Keep working on improving her diet to involve more vegetables and see how she does. She needs to eat nuts, seeds, greens, mushrooms, and fruit daily. Don’t forget that pesticides have been associated with many cases of ADHD, so organic is best. Read this article for supplementation information.

The entire family has to make a radical dietary change in these cases and not just eliminate some of the marginal foods. You really have to go for nutritional excellence as a total