What is ADHD?

How common is it?

The prevalence of ADHD is estimated to be around 2% in children in the UK and is more commonly diagnosed in boys. It is most often diagnosed between the ages of three and seven but it can also be recognised later in life and even adulthood. In the UK, the prevalence of the condition in adults is estimated at 3% to 4%, with a male to female ratio of approximately 3 to 1.

What are the symptoms?

For children and teenagers, the symptoms of ADHD are well defined and are as follows:

Signs of inattentiveness

• a short attention span
• easily distracted
• makes careless mistakes – for example, in schoolwork
• forgetful or prone to losing things
• unable to stick to tasks
• unable to listen to or carry out instructions
• difficulty organising tasks

Signs of hyperactivity and impulsiveness

• unable to sit still, especially in calm or quiet surroundings
• constantly fidgeting
• unable to concentrate on tasks
• excessive talking
• unable to wait their turn
• acting without thinking
• interrupting conversations
• little or no sense of danger

If you think your child is demonstrating these symptoms, speak to their teacher and GP. These professionals may suggest a referral to a paediatrician or child psychiatrist who will be able to carry out a full assessment distinguishing ADHD from other similar conditions.

In adults, symptoms are more difficult to define and may be more subtle. They may include the following:

• continually starting new tasks before finishing old ones
• poor organisational skills
• inability to focus or prioritise
• continually losing or misplacing things
• forgetfulness
• restlessness and edginess
• difficulty keeping quiet, and speaking out of turn
• inability to deal with stress
• extreme impatience
• taking risks, often with little or no regard for personal safety or the safety of others – for example, driving dangerously.

Can diet help or hinder?

Dietary intervention may play a role in managing ADHD – the first step is to ensure meals and snacks are well-balanced and structured at regular intervals through the day. In addition to this, the avoidance of specific foods and additives may support behaviour.

What dietary changes may help?

The following changes may support symptoms however, be aware that this depends on your current diet and your own symptom profile.

• Food and drinks containing caffeine, such as dark chocolate, tea, coffee or cola, may aggravate symptoms if taken in excess. Ideally, aim to reduce your consumption of these items slowly, over a few days or weeks to avoid ‘withdrawal symptoms’. Water, milk, herbal teas and diluted fruit juice are all suitable alternatives.
• High-sugar items that cause a rapid rise in blood sugar, often referred to as a ‘sugar rush,’ may influence irritability and behaviour. Low glycaemic starchy foods such as granary bread, brown pasta and rice may help stabilise blood sugar levels and regulate mood.
• Artificial food colourings – research suggests that artificial food colouring increases hyperactivity in those children who are known to demonstrate hyperactive behaviour. Soft and fizzy drinks, corn snacks and some jams and desserts may contain these additives and are best minimised or, if possible, avoided.
• There is emerging evidence to suggest a potential role for the use of omega-3 fish oils in the management of ADHD. While initial results suggest supplementation may improve memory function, it may have little effect on behaviour. Until more evidence is available it is therefore not recommended to start omega-3 supplements unless your GP, dietician or other health professional has advised you to do so.

If you successfully adapt your diet or that of your child, you should be aware that this new regime will need to be followed for a number of weeks in order to assess its effects. If there are no improvements with symptoms, a restrictive elimination diet may be helpful. Research has demonstrated that an elimination diet may have a beneficial effect on ADHD, for some individuals.

However, the challenging nature of this diet makes it essential to seek specialist advice from your GP or request to see a specialist dietitian.

ADHD is a complex condition that requires specialist input and advice. If you are concerned about a loved one, be that an adult or child, and you believe they may need help, contact your GP and seek advice from a specialist dietitian before embarking on any dietary or supplementary intervention.

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Emer Delaney BSc (Hons), RD has an honours degree in Human Nutrition and Dietetics from the University of Ulster. She has worked as a dietitian in some of London's top teaching hospitals and is currently based in Chelsea.

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