Lehigh County Health & Medicine Fall 2021 - 14

FEATURE
Omega 3 Fatty Acids, such as DHA and
EPA, also help optimize the functioning of
dopaminergic neurons. Omega 3s, along with
Omega 6s and 9s, are essential fats for whole
body health and must be taken in through our
diet as the body cannot synthesize them de
novo. Clinical research indicates that at least
a subset of children and adults with ADHD
have lower DHA levels. This is not surprising
since our standard American diet is woefully
deficient in Omega 3 fatty acids compared
to Omega 6 fats. A healthy ratio of dietary
Omega 6 fats to Omega 3 fats is 2 to 1, but
our American Diet provides a ratio of 15 to
1. Most studies supplementing with Omega
3 fatty acids have produced positive results
for children with ADHD, including a 2009
randomized, double-blind, placebo-controlled
study done on French Canadian youth.23-25
Since most children do not consume significant
amounts of high Omega 3 fatty foods in their
diet (salmon, flaxseed, hemp seeds, chia seeds),
a fish oil supplement that contains both DHA
and EPA is advisable.
The above nutrients should be optimized in
concert to maximally support dopaminergic
neuronal function. It would also be prudent
to simultaneously address potential food sensitivities
and blood sugar imbalances.
Our intestinal lining is one cell layer thick and
is vulnerable to " wear and tear " from pesticides
in our food, medication use, and emotional
stress.
A typical American breakfast is carbohydrate
dense, devoid of protein and healthy fat. Greater
insulin spikes from these high glycemic meals
will induce hypoglycemic episodes a few hours
later. The body responds with a compensatory
release of stress hormones, which can create
hyperactivity. Even neurotypical students have
been shown to have better test performance
and less hyperactivity after lower glycemic
meals.27-28
Admittedly, making diet changes
may seem daunting for parents, but there
are several cookbooks and websites that have
kid-friendly meal ideas and recipes specific to
balancing blood sugar.29-31
Nutritionists are also
an underutilized resource for help in this area.
ADHD is a complex condition with multiple
causalities. As such, including comprehensive
nutritional interventions in an ADHD treatment
plan can be a valuable tool for creating
better school success, whether used alone or
in conjunction with stimulant medication.
Research supports the following approach:
assessing ferritin, zinc, and magnesium status
and optimize where needed; start Omega 3
supplementation; eliminate artificial colors and
preservatives in the diet; avoid high glycemic
meals and snacks; investigate the possibility
of food sensitivities. For further reading on
this topic, I direct the reader to a book by
pediatrician Dr. Sanford Newmark, ADHD
without drugs: A Guide to the Natural Care of
Children with ADHD.
Increased intestinal permeability (aka
" leaky gut " ) ensues and allows our immune
system to be exposed to food particles in our
intestines. This can create immune activation,
chronic inflammation, and persistent elevated
levels of stress hormones, thereby producing or
exacerbating ADHD symptoms. And let's not
forget about the increased number of additives
in our processed diet, which by themselves can
create ADHD behaviors in vulnerable children.
A trial of removing the more common usual
offenders like artificial additives, dyes, dairy, and
gluten should be considered while observing
for behavior improvements.26
Although more
work intensive, doing a clinical trial of food
elimination gives more accurate results than
blood testing for food intolerances.
REFERENCES/CITATIONS:
1. More Fire Than Water: A Short History of ADHD - CHADD
2. Managing_medication.pdf (chadd.org)
3. When ADHD Stimulant Medication Fails | Psychology Today
4. Wang Y, Huang L, Zhang L, Qu Y, Mu D (2017) Iron Status in
Attention-Deficit/Hyperactivity Disorder: A Systematic Review and
Meta-Analysis. PLoS ONE 12(1): e0169145
5. Kamirul Islam, Soutrik Seth, et al A study on association of iron
deficiency with attention deficit hyperactivity disorder in a tertiary
care center Indian J Psychiatry. 2018 Jan-Mar; 60(1): 131-134
6. Ping-Tao Tseng , Yu-Shian Cheng Peripheral iron levels in children
with attention-deficit hyperactivity disorder: a systematic review
and meta-analysis Sci Rep. 2018 Jan 15;8(1):788
7. Eric Konofal , Michel Lecendreux, et al Iron deficiency in children
with attention-deficit/hyperactivity disorder Arch Pediatr Adolesc
Med 2004 Dec;158(12):1113-5
8. Eric Konofal, et al Effects of iron supplementation on attention
deficit hyperactivity disorder in children Pediatr Neurol. 2008
Jan;38(1):20-6
9. Ghoreishy, S.M., Ebrahimi Mousavi, S., Asoudeh, F. et al. Zinc
status in attention-deficit/hyperactivity disorder: a systematic review
and meta-analysis of observational studies. Sci Rep 11, 14612
(2021)
10. Alexey A Tinkov, Anna L Mazaletskaya Assessment of Hair
Essential Trace Elements and Minerals in Russian Preschool and Primary
School Children with Attention-Deficit/Hyperactivity Disorder
(ADHD), Biol Trace Elem Res. 2020 Aug;196(2):400-409
14 Lehigh County Health & Medicine | FALL 2021
11. L Eugene Arnold Serum zinc correlates with parent- and
teacher- rated inattention in children with attention-deficit/
hyperactivity disorder J Child Adolesc Psychopharmacol. 2005
Aug;15(4):628-36
12. Akhondzadeh, S., Mohammadi, MR. & Khademi, M. Zinc
sulfate as an adjunct to methylphenidate for the treatment of attention
deficit hyperactivity disorder in children: A double blind and
randomized trial BMC Psychiatry 4, 9 (2004)
13.Mustafa Bilici, Fatma Yıldırım, et al Double-blind, placebo-controlled
study of zinc sulfate in the treatment of attention deficit
hyperactivity disorder, Progress in Neuro-Psychopharmacology and
Biological Psychiatry, Volume 28, Issue 1,2004,Pages 181-190
14. T Kozielec, B Starobrat-Hermelin Assessment of magnesium
levels in children with attention deficit hyperactivity disorder
(ADHD) Magnes Res. 1997 Jun;10(2):143-8
15. Mohammad Effatpanah, Mahdi Rezaei, Magnesium status and
attention deficit hyperactivity disorder (ADHD): A meta-analysis
Psychiatry Res. 2019 Apr;274:228-234
16. Yu-Hui Huang, Bing-Yan Zeng Significantly lower serum and
hair magnesium levels in children with attention deficit hyperactivity
disorder than controls: A systematic review and meta-analysis Prog
Neuropsychopharmacol Biol Psychiatry 2019 Mar 2;90:134-141
17. Farida El Baza, et al Magnesium supplementation in children
with attention deficit hyperactivity disorder, Egyptian Journal of
Medical Human Genetics,Volume 17, Issue 1,2016,Pages 63-70
18. M Mousain-Bosc, M Roche, et al Improvement of neurobehavioral
disorders in children supplemented with magnesium-vitamin
B6. I. Attention deficit hyperactivity disorders Magnes Res2006
Mar;19(1):46-52
19. Starobrat-Hermelin, B, Kozielec, T The effects of magnesium
physiological supplementation on hyperactivity in children with
attention deficit hyperactivity disorder (ADHD). Positive response to
magnesium oral loading test Magnes Res 1997 Jun;10(2):149-56
20. Marianne Mousain-Bosc, Michele Roche, Jean Rapin, JeanPierre
Bali Magnesium VitB6 intake reduces central nervous
system hyperexcitability in children J Am Coll Nutr 2004
Oct;23(5):545S-548S
21. Mostafa Hemamy , Naseh Pahlavani , et al The effect of vitamin
D and magnesium supplementation on the mental health status
of attention-deficit hyperactive children: a randomized controlled
trial BMC Pediatr 2021 Apr 17;21(1):178
22. Mostafa Hemamy, Motahar Heidari-Beni, et al Effect of Vitamin
D and Magnesium Supplementation on Behavior Problems in
Children with Attention-Deficit Hyperactivity Disorder Int J Prev
Med 2020 Jan 24;11:4
23. Stacey Ageranioti Bélanger Omega-3 fatty acid treatment of
children with attention-deficit hyperactivity disorder: A randomized,
double-blind, placebo-controlled study, Paediatr Child Health.
2009 Feb;14(2):89-98
24. Michael H Bloch, Ahmad Qawasmi Omega-3 fatty acid
supplementation for the treatment of children with attention-deficit/
hyperactivity disorder symptomatology: systematic review and
meta-analysis J Am Acad Child Adolesc Psychiatry. 2011
Oct;50(10):991-1000
25. Jane Pei-Chen Chang, et al Omega-3 Polyunsaturated Fatty
Acids in Youths with Attention Deficit Hyperactivity Disorder: a Systematic
Review and Meta-Analysis of Clinical Trials and Biological
Studies Neuropsychopharmacology (2018) 43, 534-545
26. Laura J Stevens, Thomas Kuczek, et al Dietary sensitivities and
ADHD symptoms: thirty-five years of research Clin Pediatr (Phila).
2011 Apr;50(4):279-93
27. David Benton, Alys Maconie, Claire Williams, The influence of
the glycaemic load of breakfast on the behaviour of children in school,
Physiology & Behavior, Volume 92, Issue 4,2007, Pages 717-724
28. Benton D, et al The delivery rate of dietary carbohydrates affects
cognitive performance in both rats and humans. Psychopharmacoogy,
Feb 2003 166(1): 86-90
29. The Kid-Friendly ADHD & Autism Cookbook, Updated and
Revised: The Ultimate Guide to the Gluten-Free, Casein-Free Diet
by Dana Laake
30. Cookbook_for_Busy_Minds.pdf (chadd.org)
31. Attention Deficiency Disorder Cookbook: Nutritious and
Delicious Recipes to heal from ADHD in Adults and in Children
by Basil Pickard MD
Lehigh County Health & Medicine Fall 2021

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