Our doctors praise the Mediterranean diet for adults and children alike. They tell us that a diet of vegetables, fruits, “good” oils like olive oil, nuts. legumes, pasta, whole grains and fish contributes to our mental as well as physical health. They advise against eating fast foods cooked in unhealthy oils, drinking sugary drinks and skipping breakfast.
There is also an increasing number of studies about the role of diet in ADHD. Studies have shown that ADHD is linked to nutrient deficiencies (for example, a deficiency in Omega-3 fatty acids) and unhealthy diet (for example, a diet high in processed foods, refined sugars, and artificial food dyes).
But now a recent study in Pediatrics (the journal of the American Academy of Pediatrics) specifically looks at the relationship between the Mediterranean diet and ADHD. Could not adhering to the Mediterranean diet be associated with an increased risk of an ADHD diagnosis?
The study was conducted in Spain, which is experiencing a rising rate of ADHD diagnoses (5 to 8 percent of children), along with a trend of moving away from their traditional Mediterranean diet. The Spanish population is increasing their consumption of processed foods and refined sugars, while decreasing vegetable and fruit intakes.
The cause of ADHD-type symptoms continues to be debated. No genetic or brain chemistry deficiency has been discovered that is universally accepted by the medical community. Moreover, some contributing factors like diet, physical activity and family dynamics have been acknowledged in the etiology of ADHD.
The authors of the Pediatrics study write: “research on the relationship between ADHD and nutrients and food components thus far has yielded inconsistent results.” Therefore, a dietary approach to ADHD treatment is still regarded as controversial and without a solid base of evidence.
The findings of the study are fascinating: Children and adolescents with ADHD showed statistically significantly lower scores on adherence to a Mediterranean diet than controls. Moreover, the percentage of children with ADHD who ate more frequently at fast-food restaurants and skipped breakfast was higher than that of controls. They also found that fatty fish intake, which is the main source of omega-3 fatty acids in the Spanish diet, was significantly lower in subjects not on the Mediterranean diet than in the control group.
Interestingly, the study found a correlation between a dysfunctional family environment—as well as an unhealthy diet—with an increased risk of an ADHD diagnosis:
“The role of the family cannot be dismissed considering that a healthy diet is related to a better functioning family. Parents of individuals with ADHD often report a more dysfunctional family environment, so it is plausible that the relationship between low adherence to a healthy diet and ADHD diagnosis may be exacerbated by a dysfunctional family environment.”
The findings suggest that dietary habits may play a role in ADHD development, even though further work is required to investigate causality and to determine if manipulating diet could reverse the symptoms of ADHD. The authors’ “main recommendation is that clinicians focus on diet not with the expectation of dietary changes improving behavior but with the concern that children with ADHD are more likely to be eating unhealthy diets; this component should therefore be part of the evaluation to improve their health.”
This study’s findings raise some fascinating questions if we apply them to the dietary habits of American children. In the United States, the birthplace of the fast-food restaurant, 11 percent of children are diagnosed with ADHD. Could more adherence to an unhealthy diet be at least a contributing factor to the increased risk of getting an ADHD diagnosis in the United States?
As the research on the connection between diet and ADHD increases, we may soon get an answer to this question.
Learn more on the role of diet and ADHD in Dr. Wedge's 90 minute webinar on September 12, 2017. It's at 1 PM Eastern time, 10 AM Pacific time. Questions will be taken. To register, click here
Alejandra Ríos-Hernández, José A. Alda, Andreu Farran-Codina, Estrella Ferreira-García, Maria Izquierdo-Pulido. "The Mediterranean Diet and ADHD in Children and Adolescents" Pediatrics, January, 2017.