A study by the American Psychiatric Association and published in Journal of Clinical Psychiatry (Dec. 2006) found that children diagnosed with ADHD experienced an improvement in symptoms when they were given omega-3 fatty acid supplements over a period of 4 months.
They showed an improvement both in concentration levels at school, and in their conduct at home.
But could diet alone be responsible for this condition, and could changing diet to include more fats and less refined foods “cure” ADHD?
Or is ADHD merely “a prime example of a fictitious disease” as Dr Leon Eisenberg the “scientific father of ADHD” is allegedly quoted as saying shortly before he died?
Read: Causes of ADHD
The role of diet in ADHD
ADHD is a neurological syndrome characterised by poor concentration and organisational skills, being easily distracted, easily frustrated or bored, having a greater tendency to say or do whatever comes to mind (impulsive) and a predilection for situations with high intensity.
Contrary to the alleged quote from Dr Eisenberg, however, it has since been shown that he did not claim that ADHD is not a real disorder, but rather that it is simply over-diagnosed.
Eisenburg believed that by withdrawing excess carbohydrates and sugar from the diet (we) "could effectively remove this 'condition' almost entirely, no drugs required'.
So how important is diet in ADHD?
There have been many other studies proving the benefits of a diet high in omega-3 fatty acids and low in refined carbohydrates and additives, such as the 2009 Harvard Medical School study that tested whether additives contribute to ADHD and looked at the role of omega-3 fatty acids.
Dr. Natalie Sinn of the University of South Australia in Adelaide says that “the current evidence supports nutritional and dietary influences on behaviour and learning in children, with the strongest support to date reported for omega-3 fatty acids.”
Omega-3 fatty acids are converted to docosahexaneoic acid which is used mainly to optimise functioning in the brain and eyes.
In a 2002 study, Richardson and Puri of the University Department of Physiology, Oxford, England found that highly unsaturated fatty acids (HUFAs) supplementation appeared to reduce ADHD-related symptoms in children with specific learning difficulties.
Read: The role of healthy fats in those with ADD or AHDH
Banting and ADHD
According to Professor Tim Noakes, proponent of the LCHF/ Banting diet which propagates a diet high in fat and low in carbohydrates, a diet such as this for both children and pregnant women, may play a role.
Read: What Tim Noakes eats
He acknowledges that to the best of his knowledge there is “no scientifically-proven link between a particular diet and either the causation, prevention or treatment of ADHD”.
However, he adds: “From my reading of the data I would postulate the following hypothesis:
That the apparent increase in ADHD over the last 30 years is likely to have some link to the large dietary changes, especially to children, in that time.
My bias would be that it is the lower fat intakes of the mothers during pregnancy and of their offspring from the moment of birth that plays a key role."
Tim Noakes and other experts maintain that most of us do not get enough omega-3 fatty acids, and too many omega-6 fatty acids. An imbalance in these fats is linked to disease.
Up your omega-3 fatty acid intake with 2-3 tablespoons of flaxseed or olive oil a day and four salmon oil capsules (buy the best brand you can afford). Avocado, almond and macadamia nuts are also full of good fats and the corner stones of the Banting high fat diet, along with animal fats such as duck fat and ghee.
Read: Babies need fatty acids for brain growth
Fat and protein are essential for normal brain development in children. Mothers who wean their children on to high sugar/carbohydrate foods at a young age may compromise the future brain health of their children (if those diets are deficient in essential fats and protein - the key building blocks for the developing brain).
Even when it comes to sugar and diet soda, two elements which many parents believe can trigger hyperactivity in children, scientific studies have been unable to prove a definitive link.
However, in the New England Journal of Medicine a large-scale study from 2013 concluded that high glucose levels may be a risk factor for dementia.
Read: Why your brain needs fat
It's a fact: fats feed the brain
Despite the controversy surrounding Prof Noakes and his book The Real Meal Revolution, Noakes is not alone in his belief that fats are good for the brain.
Top of the healthy fat list is omega-3 fatty acids, these are considered essential fatty acids for optimal health and found in mackerel, herring, salmon, tuna, sardines, anchovies and trout.
Recently there has been an increase in the production of omega-3 enriched foods such as eggs, bread and milk. Plant sources such as flaxseed, canola, walnut and soya oils are also rich in omega-3.
Also known as polyunsaturated fatty acids (PUFAs), omega-3 fatty acids play a crucial role in brain function as well as normal growth and development.
Aside from the many studies proving the benefits of omega-3 fatty acids in reducing inflammation and the risk of chronic diseases such as heart disease, cancer, and arthritis, scientists have hailed omega-3 fatty acids for the benefits shown in cognitive and behavioural function.
Is our Western diet to blame for ADHD?
A study from Perth's Telethon Institute for Child Health Research and published in the Journal of Attention Disorders looked at the dietary patterns of 1 800 adolescents and classified diets into Healthy or Western patterns. The Healthy diet comprised a high intake of fresh fruit and vegetables, whole grains and fish and was high in omega-3 fatty acids, folate and fibre.
The Western diet tended towards takeaway foods, confectionery, processed, fried and refined foods and were higher in total fat, saturated fat, refined sugar and sodium.
Dr Wendy Oddy, who lead the research, compared the teens' diet against whether or not they had received a diagnosis of ADHD by 14 years of age. 115 adolescent had been diagnosed with ADHD.
They found that a diet high in the Western pattern of foods was associated with more than double the risk of having an ADHD diagnosis, compared with a diet low in the Western pattern. They adjusted the risk for numerous other social and family influences.
Dr Oddy wrote " When we looked at specific foods, having an ADHD diagnosis was associated with a diet high in takeaway foods, processed meats, red meat, high fat dairy products and confetionary.
She noted that a Western diet may not provide the best fatty acid profile and that an omega-3 rich diet could be better for mental health and optimal brain function.
She added that Western diets don't provide enough essential micronutrients that our brains need to function optimally, particularly with reference to attention and concentration.
In closing, there seems to be enough proof that a diet high in omega-3 fatty acids and low in refined carbs can have a positive impact on those suffering from ADHD, although this should be a focus for at least a four month period before any definite improvement can be noted. On the upside, there are no side effects from supplementing with omega-3 fatty acids.
The role of fish oil in fighting inflammation
Why a diet high in omega-3 fatty acids improves your memory
Parenting a child with ADHD
Taking control of ADHD
Talk to our ADHD expert
Image: omega-3 capsules, Shutterstock
ADHD Is Associated With a 'Western' Dietary Pattern in Adolescents. Journal of Attention Disorders,
Consumption of soft drinks and hyperactivity, mental distress, and conduct problems among adolescents in Oslo, Norway: Am J Public Health. 2006 Oct;96(10):1815-20.
Omega-3 fatty acids: University of Maryland Medical Center:
Diet and attention deficit hyperactivity disorder: Health Harvard Publications:
Sinn, N. Nutritional and dietary influences on attention deficit hyperactivity disorder. Nutrition Reviews, Vol. 66, October 2008