Note: Prescription medication and Behavior Management (i.e. Parent Training) are first line treatments for kids with ADHD and related challenges. However, parents are always asking us about “natural”approaches. So we’ve invited functional medicine practitioner, Chantell Reagan, to write a series of articles to bring us all up to speed on “alternative” approaches to managing your child’s complex issues. Please consult your child’s physician to explore these ideas further. This is the third of five articles. You may want to start with the first articles in the series, “ Taking an Integrative Approach to Raising Complex Kids ”and “ The Gut-Brain Connection in Complex Kids” ~Elaine & Diane
Many non-traditional health practitioners believe that there is a strong correlation between food and behaviors. Several studies, including a 2004 meta-analysis (a compilation of many studies) by Dr. Schab from Columbia University, confirm that artificial food dyes are linked to behavioral issues, for example.
Despite all the medical evidence, in 2011 the Food and Drug Administration (FDA) voted against warning labels for food dyes, while Europe voted in favor of the labeling. Today, many international food manufacturers use artificial color only in the US version of a product, while using only natural dyes in the European version.
It’s not just food dyes and additives that can contribute to ADHD symptoms. If there is an underlying sensitivity to the most common allergenic foods (wheat/gluten, corn, dairy, eggs, soy), there is potential for the foods to have an impact on ADHD behaviors.
Medical literature both supports and negates associations between ADHD symptoms and gluten, dairy and sugar. We do know that all 3 can cause inflammation, which in turn can decrease blood flow to the brain. Clinical trials linking sugar to ADHD have had mixed results. Still, it’s important to note that excess sugar causes a range of health problems, including immune suppression, diabetes, obesity and cavities.
Allergy vs. Food Sensitivity
When someone experiences a “classic” true food allergy, an antibody called immunoglobulin E (IgE) can cause serious symptoms like swelling, hives, and even anaphylaxis. An epinephrine pen or other antihistamine medication is usually needed to stop the reaction.
Conversely, when someone has a food sensitivity, another antibody called immunoglobulin G (IgG) can cause benign symptoms that often get mistaken for other conditions. Food sensitivities can be masked as hyperactivity, inattentiveness, eczema, headaches, constipation, diarrhea, gas or bloating, to name a few. However, testing for IgG sensitivities is controversial. Some say it’s unreliable, while others find it to be useful as a baseline.
A 2011 study in the Lancet discredits IgG testing, but promotes an elimination-type diet, which removes one or more foods from the diet for a fixed period of time. In this study, 50 children with ADHD were placed on a hypoallergenic diet. The majority of children (64%) had a significant remission of symptoms, with most of them relapsing after stopping the diet.
Investigating Food Sensitivities
In an elimination diet, suspect foods are slowly reintroduced into the diet, while behavior and other symptoms are observed and tracked. Though it can be challenging to follow, most agree it is the most effective way to rule out food sensitivities. Even the American Academy of Pediatrics (AAP) noted in 2012 that “…omitting items shown to predispose to ADHD is perhaps the most promising and practical complimentary or alternative treatment of ADHD.” In an integrated approach, I always recommend identifying food stressors first before considering other treatments.
What can you do to investigate potential food sensitivities?
1. Eliminate the obvious toxins from the diet like food dyes, additives and refined sugars. Buying organic products alleviates questionable additives.
2. Work with a functional/integrative medicine practitioner to target food allergy or sensitivity using an IgG or other test based on your needs.
3. Consider an elimination diet to determine if there is an improvement in symptoms when one or more foods is removed for a period of time. Using a food journal can be especially helpful when undergoing an elimination diet.
For Further Reading:
“ Differences Between IgE and IgG Testing for Allergies and Sensitivities ” (Blog Post) by Christa Orecchio of The Whole Journey.
The Elimination Diet (Book) by Alissa Segersten and Tom Malterre, MS, CN
References (Accessed in hyperlinks below on Feb. 9, 2016):
“Food coloring ban in the UK but usage continues for USA .” October 2014.
Schab DW, Trinh NH. “ Do artificial food colors promote hyperactivity in children with hyperactive syndromes? A meta-analysis of double-blind placebo-controlled trials.”Journal of Developmental and Behavioral Pediatrics, 2004 Dec;25(6):423-34.
Ahmad Ghanizadeh and Behzad Haddad . “The effect of dietary education on ADHD, a randomized controlled clinical trial. ” Ann Gen Psychiatry. 2015; 14: 12. Published online 2015 Mar 1. doi: 10.1186/s12991-015-0050-6.
Pelsser, Lidy M et al. “ Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial.” The Lancet , Volume 377 , Issue 9764 , 494 – 503.
Millichap JG,Yee MM. “ The diet factor in attention-deficit/hyperactivity disorder.” Pediatrics. 2012 Feb;129(2):330-7. doi: 10.1542/peds.2011-2199. Epub 2012 Jan 9.