Now is the perfect time to make the changes to your children's diet to [...]]]> With your children rested and rejuvenated from the summer holidays and poised and ready to return to school in September, now is the perfect time to make changes to their diet to improve their health and academic performance alike.

Now is the perfect time to make the changes to your children's diet to improve their health and academic performance alike. (5)

Childhood is a very demanding time for the body.  Both physical and mental growth and development are operating at top speed which means that the food and ‘fuel’ children receive at this stage of life is crucial for their present and future development as adults.  As their provider of food, parents and guardians are ultimately responsible for the majority of what their child consumes, however this is often more easily said than done in an age where long hours at work are the norm and time is of the essence.

The easy option would be to give your kids quick processed foods, however these foods are often laden with saturated fats, sugars, and salt and their consumption in childhood has been linked to the formulation of atherosclerosis (where fat deposits stick to the arterial walls) which can increase risks to health and disease in later life. These foods are also heavily associated with childhood obesity which is now an epidemic (1). Therefore it is vitally important to give your kids healthy foods and limit the junk to help them to get the best possible nutrition.

Natural, fresh and nutrient dense foods should form the majority of a child’s daily food consumption.  These foods can include a variety of fruit such as Oranges which contain vitamin C to keep our children’s cells, tissues and organs healthy as well as to strengthen the immune system.  Cherries are full of antioxidants and bioflavonoids to reduce inflammation which can help headaches.  Strawberries contain a wide range of vitamins and minerals especially vitamin C.

Vegetables are also essential such as broccoli for vitamin C and fibre as well as antioxidants.  Peas are an excellent source of fibre and many vitamins especially vitamin K which is good for bones.  Carrots contain vitamin A providing benefits to eyes and skin and sweetcorn provides fibre and the antioxidants lutein and zeaxanthin which are especially good for the eyes.

Wholegrains such as wholemeal bread, pasta and brown rice as well as legumes are also great for keeping our kids blood sugar levels balanced and to prevent snacking.  Low fat dairy is also needed to build strong bones and teeth as well as lean meats such as poultry for protein.  Fish is very important for the ‘good fats’ omega 3’s which are great for brain function, concentration and also for skin, hair and nails.  These foods are packed full of great health boosting nutrients such as antioxidants, vitamins, minerals and fatty acids to help keep kids healthy with strong immune systems, great learning capacity, full of energy and to reduce their risk of disease (3).  They also contain complex carbohydrates (fibre) to balance blood sugar, reducing those dreaded sugar rushes as well as limiting hunger pangs and keeping your child’s digestion on track.  With all of these benefits it’s easy to see why it’s so important to try to include these foods in your child’s diet.

As well as improving your child’s diet, you may wish to consider supplements specifically designed for children to ensure you give them the vital nutrients their developing body needs as the nutrients mentioned previously (e.g. multivitamins, vitamins C and K, omegas, lycopene, lutein and zeaxanthin) can all be found in a supplement form.  There are a good number of supplements appropriate for children and you may which to get some advice from a registered nutritionist for any more complex requirements. However, here are a few that can make life easier for parent and child alike.

• Essential Fatty Acids – Known to aid in behavioural issue, to boost academic performance and to ease skin problems including eczema.

• Pycnogenol – More than 200 studies show this patented pine bark extract to be safe and effective in numerous health conditions including respiratory health in adults and children.

• Echinacea - Offers an immune boosting alternative to antibiotics for minor day to day ailments.

• Probiotics – Immune supporting and digestion boosting.  Look for formulations specifically designed for children.

• Multivitamins – A daily insurance policy to ensure your child has the nutrients required for optimum nutrition.  They have also been shown to aid in behavioural problems.

Don’t miss part 2 of our back to school blogs where we share our top tips for healthy lunch boxes and snack ideas.

Written by Lauren Foster

References

1. Foresight Group (2007). Government Office for Science. Tackling Obesities: Future Choices – Project Report 2nd Edition. London: HM Government.

2. Melanson, K.J. (2008) Nutrition Review: Lifestyle Approaches to Promoting Healthy Eating for Children. American Journal of Lifestyle Medicine, 2: 26.

3. Abdel-Salam, A.M. (2010) Functional Foods: Hopefulness to Good Health. American Journal of Food Technology, 5: 86-99.

4. Singh, P. & Goyal, G.K. (2008) Dietary Lycopene: Its Properties and Anticarcinogenic Effects. Comprehensive Reviews in Food Science and Food Science and Food Safety, Vol. 7, Issue 3, 255-270.

5.  Image courtesy of Ambro.

Related posts:

1. Back To School – Part 2- Healthy Lunch Boxes & Nutritious Snacks
2. Boosting immune health. Can ‘back to school’ coughs and colds be prevented?
3. Can a multi-nutrient supplement benefit child intelligence?

The researchers involved in this study, known as the Impact [...]]]> ADHD, attention-deficit hyperactivity disorder, has been in the limelight again.  A new study, published in the well respected medical journal The Lancet, has found that “A strictly supervised restricted elimination diet is a valuable instrument to assess whether ADHD is induced by food” (1)

The researchers involved in this study, known as the Impact of Nutrition on Children with ADHD (INCA) study, wanted to investigate whether there was a connection between diet and behaviour in children with ADHD.   The research took place in children with ADHD in the Netherlands and Belgium.  Specifically the research was looking to see whether it was helpful to put children on a special restricted diet for several weeks to establish whether particular foods were related to their ADHD.

100 children with diagnosed ADHD, but who were NOT already receiving drug, behavioural or diet treatment for ADHD, were included in the study (1).  The children were aged between 4 and 8 years old.  The study had two phases:

 In phase one, 50 children were randomly assigned to ‘an individually tailored’ restricted diet, and 50 were given advice to follow a healthy and balanced diet (this was the control group).   The restricted diet included only a small number of foods such as rice, turkey, lamb, a range of vegetables (lettuce, carrots, cauliflower, cabbage and beet), pears and water. These foods were selected because they were hypoallergenic (non-allergy producing).  The children’s diets were also supplemented with specific foods such as potatoes, fruits and wheat on an individual basis to make it easier for them and their parents to comply with the restrictive diet. These additional foods were removed if the child showed no improvement after two weeks of the diet. The children were also given a non-dairy rice drink with added calcium to ensure that they did not develop calcium deficiency (1,2).

In phase two, a four-week phase, the children who had responded to the restricted diet, as demonstrated by at least a 40% decrease in their ADHD symptoms, were randomised to one of two dietary challenges.  Each challenge involved a different set of foods: one group was given foods expected to induce a hypersensitivity/allergic response if the child was susceptible, and the other group were given foods that are not expected to induce allergic response.  During this phase of the trial both parents, children and assessors did not know whether the food challenges being given were likely to induce an allergic response (1,2).

ADHD symptoms were assessed in the children using two specialised questionnairs:  the 18-item ADHD Rating Scale (where scores range from 0 to 54) and the 10-item Abbreviated Conners’ Scale (where scores range from 0 to 30). Tests were conducted at the start of the study, after the eight-week diet, after the first two weeks of the food challenge phase, and then after the remaining two weeks of the food challenge.  The tests were completed by parents and teachers but not the children themselves due to their young age.

86% of the children involved in the study were boys.  41 out of the 50 children in the restricted diet group completed phase one of the study.  Of these 41, 78% had a reduction, of at least 40%, in their ADHD symptoms.  Between study start and the end of the first phase, the difference between the diet group and the control group in the mean ADHD Rating Scale (ARS) total symptom score was 23.7 points .  There was a 53.4% reduction in score in the diet group (from mean score 45.3 at study start to 21.1 post-diet), and a 2.7% reduction in the control group (from mean score 47.6 at study start to 46.2 post-diet).  There was also a significant difference between the groups in mean Abbreviated Conners’ Scale (ACS) symptom score from study start to the end of the diet phase (11.8 point score difference between groups), with a 50.7% score reduction in the diet group compared with 0.3% reduction in the control group (1,2).

29 children who responded to the restricted diet completed the second, food challenge, phase of the study.    The food challenge involved giving children foods that had not been allowed in the restricted diet, some of these foods were expected to induce an immune response (allergenic foods) and others were not.  After the food challenge ADHD symptoms increased in the children – the ARS total score increased by an average of 20.8 points and the ACS score increased by an average of 11.6 points.  During this challenge phase, relapse of ADHD symptoms occurred in 18 of 29 children tested (62%), but this was not related to whether they received foods expected to induce an immune response or to their IgG (antibody) blood levels  (a measure of allergic response) (1,2).

The authors conclude that “A strictly supervised restricted elimination diet is a valuable instrument to assess whether ADHD is induced by food” but that “The prescription of diets on the basis of IgG blood tests should be discouraged” (1). 

The study was well-designed but quite small and larger studies would be needed to confirm the findings and before any firm recommendations can be made.  Studies in other age groups of children and adults would also be needed.  The study was relatively short term, and it is not known what the longer-term effects of dietary change would be.  It is also not known whether certain foods would have to be permanently withdrawn, or whether they could be gradually reintroduced.  No adverse effects were seen during this eight-week study, however the  longer-term use of a restrictive diet would need to be carefully monitored by doctors, or other registered health professionals to ensure that no nutrient deficiencies were occurring.

In an NHS article (2) the NICE (National Institute for Health and Clinical Excellence) 2008 guidelines regarding the restriction of food on ADHD are given:

If there is a clear link, healthcare professionals should advise parents or carers to keep a diary of food and drinks taken and ADHD behaviour

If the diary supports a relationship between specific foods and drinks and behaviour, then referral to a dietitian should be offered

Further management (for example, specific dietary elimination) should be jointly undertaken by the dietitian, mental health specialist or paediatrician, and the parent or carer and child or young person

It is crucial that if your child has been diagnosed with ADHD you do not begin a food restriction or food elimination plan without consulting a doctor.  If your doctor agrees that such a plan is worth trying he/she may well refer you to an NHS dietician, or your doctor may agree to work with a registered nutritionist or nutritional therapist 

In a comment (3) on the study article Dr Jaswinder Kaur Ghuman, underlines that an elimination diet trial should be implemented only under the supervision of the child’s primary health-care provider and a nutritionist to ensure that growing children do not suffer from nutritional deficiencies with the restricted diet. She concludes: “Diagnosing food sensitivity is complex, can take several weeks, and can be burdensome for families to implement. The restricted diet can be tried for 2-5 weeks. If there is benefit, the restricted foods can be added back weekly, one food component at a time, to identify the problem foods to be excluded from a less restrictive permanent diet. In my opinion, a stringent elimination diet should not continue for more than 5 weeks without obvious benefit because of the time, effort, and resources required to implement the restricted diet and because long-term effects of dietary elimination on the child’s nutritional status are not known.“ (3)

To find a registered nutritionist or nutritional therapist in your area please use the following websites:

Registered nutritionist

Nutritional therapist

And please remember that even with the help of one of these registered professionals it is important to consult your medical doctor so that they are fully aware of your plans.

For more information on the links between nutrition and ADHD please read my previous blog posts: http://blog.bodykind.com/category/adhd/

(1)Pelsser LM et al.  2011.  Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial.  The Lancet.  377: 494 – 503,

(2) NHS Knowledge service.  Behind the Headline.  Friday February 4 2011. ADHD children ‘should have diets assessed’ .   http://www.nhs.uk/news/2011/02February/Pages/ADHD-children-should-have-diets-assessed.aspx

(3)Ghuman JK.  2011.  Restricted elimination diet for ADHD: the INCA study.  Comment.  The Lancet.  377:446-448

Related posts:

1. Unhealthy ‘Western’ style diet linked to ADHD
2. Can essential fatty acids help children with Attention Deficit Hyperactivity Disorder (ADHD)?
3. Are there alternatives to stimulant drugs for adults with ADHD?

Folate is in the news again, this vitamin of the B group is one that I have often written about especially with regards pregnancy and the prevention of birth defects, as well as links to premature births and low birth weights.  This time researchers (1) have linked low folate during pregnancy and ADHD in [...]]]>

Folate is in the news again, this vitamin of the B group is one that I have often written about especially with regards pregnancy and the prevention of birth defects, as well as links to premature births and low birth weights.  This time researchers (1) have linked low folate during pregnancy and ADHD in the child after birth.

The researchers (1) started their investigation by introducing the fact that good nutrition during pregnancy is really important and has been linked to foetal brain development.  Poor nutrition during pregnancy may adversely affect brian development and contribute to problems in childhood.  The researchers wanted to assess whether maternal folate status and maternal dietary folate intake during pregnancy was linked to brain growth and childhood behavioural difficulties in the children.

The study (1) followed a cohort of women from early pregnancy.  The mothers red blood cell folate levels were measured at 14 weeks of pregnancy and the total folate intake from food and supplements was assessed in early and late pregnancy.  When the children were born their head circumference and body weight were measured and then at the age of 8.75 years old 100 mothers reported on their children’s behaviour.

Lower maternal red blood cell folate levels and lower total folate intake were associated with higher incidence of childhood hyperactivity and problems with peer group at school in the children.  A higher red blood cell folate level was associated with greater head circumference at birth and lower levels of hyperactivity/inattention and peer problems in children.  Authors of the study note that the associations were small but “our data provide preliminary support for the hypothesis that lower folate status in early pregnancy might impair fetal brain development and affect hyperactivity/inattention and peer problems in childhood”.  The study only shows an association and it might be that mothers with a good folate level have overall better diets which impact brain development in foetus.

Previously written about ADHD and the importance of omega 3 fats in particular.  A balanced, healthy diet in pregnancy is vital for many reasons and may prevent a number of conditions.  Eating well and considering a pregnancy-safe multi-nutrient supplement is certainly worth discussing with your midwife or GP.  In a press release (2) the lead author noted:
“Our findings further support the hypothesis that maternal nutrition contributes to an individuals’ development, with potential consequences for their behavior later in life.”  The long term effects of poor maternal nutrition may even branch out to the child’s ability to interact with peers or form social bonds (1,2).  The researchers also found that children born from mothers with a low folate status had a notably smaller head circumference at birth, which may indicate a smaller rate of prenatal brain growth in children adversely affected by low folate levels. The researcher note that the findings indicate a cause for concern among populations where the nutritional health of the mother is low, and women may be less likely to take folate supplements in advance of pregnancy.

(1)Schlotz et al.  2009.  Lower maternal folate status in early pregnancy is associated with childhood hyperactivity and peer problems in offspring. Journal of Child Psychology and Psychiatry, 2009; [Epub] DOI: 10.1111/j.1469-7610.2009.02182.x
(2) Wiley-Blackwell (2009, October 28). Attention-deficit/hyperactivity Problems Associated With Low Folate Levels In Pregnant Women. ScienceDaily. Retrieved October 28, 2009, from http://www.sciencedaily.com/releases/2009/10/091028134631.htm
Written by Ani Kowal

Related posts:

1. Can essential fatty acids help children with Attention Deficit Hyperactivity Disorder (ADHD)?
2. Taking folic acid before pregnancy is associated with a reduction in premature birth
3. Folate may be related to cancer prevention in women

Children everywhere are starting to get ready to go back to school after their long summer holidays.  Nutrition and diet can impact the body and health in many ways, the most apparent concerns for parents of school aged children are immune health and brain function/behaviour.

In July I wrote about probiotics and prevention/treatment [...]]]>

Children everywhere are starting to get ready to go back to school after their long summer holidays.  Nutrition and diet can impact the body and health in many ways, the most apparent concerns for parents of school aged children are immune health and brain function/behaviour.

In July I wrote about probiotics and prevention/treatment of childhood colds and last year I wrote about boosting immune health in children going back to school.  Today I wanted to have another look at behaviour and the brain.  Previously I have written about ADHD, particularly with regards the importance of omega 3 fatty acids for brain function.  The brain is a highly complex organ.  In infancy and childhood the brain is growing rapidly and it requires a lot of energy.  There is a mounting body of evidence to suggest that diet can influence the development and functioning of the brain (1).  This influence may well start with the diet of the mother during pregnancy and then in the infant in early life, however later in childhood nutritional intervention may well make a difference to brain function and cannot be discounted.

There is increasing evidence that the missing of breakfast has negative behavioural and attention consequences later in the morning and it is also thought that meals of a low rather than high glycaemic load are beneficial with regards child behaviour.  There are also findings of an association between a tendency to develop low blood sugar (glucose) and aggression in children(2). 

Glycaemic index and glycaemic load are terms used to characterise foods and diets based on their effects on blood glucose levels.  Foods that release sugar quickly into the bloodstream have what is known as a high Glycaemic Index (GI), meals that favour a spike in blood sugar levels are said to have a high Glycaemic Load (GL).  White bread, potatoes, processed/refined carbohydrates have a high glycaemic index i.e. they tend to cause a rapid surge in blood sugar.  Vegetables, whole-grain high-fibre carbohydrates, create a more gradual change in blood sugar levels and are considered to have a low glycaemic index.  For the classification of more food examples please visit the website ‘The Glycemic Index’, there you will find a database where you can search for specific foods and find out more about GI and health.

Certain nutrients have greater effects on brain development than do others and hence may have more of an impact on childhood behaviour and brain function. The important nutrients include protein (which is so important for proper growth in childhood), certain fats (especially omega 3 fats), iron, zinc, copper, iodine, selenium, vitamin A, choline, and folate (3).  There is evidence that sub-clinical deficiencies of vitamins and minerals may influence anti-social behaviour and intelligence but the evidence is still controversial(4).The B vitamins, Folate and B12 (cobalamin), are vital for the brain.  Deficiencies have negative consequences on the developing brain, and behaviour, during infancy; and deficits of both vitamins are associated with a greater risk of depression during adulthood (5).  Recently vitamin D has also received attention with regards brain functioning.  As you can see a myriad of nutrients are important for the brain and they probably work and act synergistically, this makes clinical trials difficult to carry out.  However, there have been three well-designed studies which have reported that vitamin/mineral supplementation in children can reduce anti-social behaviour (2).

It is difficult to conclusively say which vitamins/minerals are most important and whether or not supplementation can help children – this is because behaviour is difficult to standardise and measure in a trial-setting.  Also psychological and environmental influences will be having an effect.  Needless to say our bodies are complex, we require various nutrients in correct proportions in order to stay optimally healthy.  Many children in the UK fall short of achieving recommended 5 portions of fruit and vegetable daily which is worrying for health and many children do not eat oily fish (the best source of omega 3 fatty acids) at all.  If you are concerned that your child is not eating a consistently healthy diet you may wish to consider a food-state multivitamin and mineral supplement that has been formulated specifically for children together with an omega 3 fatty acid supplement – easy to take liquid fish oils are now available for children which are naturally flavoured (usually lemon or orange).  Flaxseed oil and omega 3 supplements produced from algae are available for vegetarian/vegan children.

A UK based study concludes: “Whilst the importance of diet in educational attainment remains under investigation, the evidence for promotion of lower-fat, -salt and -sugar diets, high in fruits, vegetables and complex carbohydrates, as well as promotion of physical activity remains unequivocal in terms of health outcomes for all schoolchildren”(6)

(1)Benton D.  2008.  Eur J Nutr.  The influence of children’s diet on their cognition and behavior. Eur J Nutr.  47 Suppl 3:25-37.
(2) Benton D.  2007.  The impact of diet on anti-social, violent and criminal behaviour. Neurosci Biobehav Rev. 31(5):752-74.
(3)Georgieff MK.  2007.  Nutrition and the developing brain: nutrient priorities and measurement.  Am J Clin Nutr.  85(2):614S-620S.
(4)Benton D.  2008.  Micronutrient status, cognition and behavioral problems in childhood.  Eur J Nutr. 47 Suppl 3:38-50.
(5)Black MM.  2008.  Effects of vitamin B12 and folate deficiency on brain development in children.  Food Nutr Bull.  29(2 Suppl):S126-31.
(6)Ells LJ et al.  2008.  A systematic review of the effect of dietary exposure that could be achieved through normal dietary intake on learning and performance of school-aged children of relevance to UK schools. Br J Nutr.  100(5):927-36.

Written by Ani Kowal

Related posts:

1. Unhealthy ‘Western’ style diet linked to ADHD
2. Can essential fatty acids help children with Attention Deficit Hyperactivity Disorder (ADHD)?
3. Omega 3 fats during pregnancy are important for memory function of children

The long summer holidays have ended and children are heading back into their classrooms.  Over the last few years the press have been giving increasing coverage to a condition known as ADHD (attention deficit hyperactivity disorder).  Today I would like to write about essential fatty acids, one of the many nutritional aspects associated with the [...]]]>

The long summer holidays have ended and children are heading back into their classrooms.  Over the last few years the press have been giving increasing coverage to a condition known as ADHD (attention deficit hyperactivity disorder).  Today I would like to write about essential fatty acids, one of the many nutritional aspects associated with the condition. 

The following facts were provided by a fantastic charity – Food for the Brain(1) – a non-profit educational charity, created by a group of nutritionists, doctors, psychiatrists, psychologists, teachers and scientists to promote the link between nutrition and mental health.

 
-Children with ADHD often have three basic problems, they can’t pay attention, they are hyperactive and they act on impulse.
-It is estimated that up to 5% of school-age children in England and Wales have ADHD – representing around 67,000 children.
-In a class of 30 children there will be one or two children with ADHD.
-Boys seem more likely to have ADHD than girls.
-In the UK, between three and nine boys are diagnosed with ADHD for every girl diagnosed, this may be because boys and girls tend to have different symptoms of ADHD.
-Inattention is more common among girls while hyperactivity is more common among boys.  A boy who is hyperactive (shouting, running about and getting into trouble) may be more noticeable than a girl who is inattentive (daydreaming, forgetful and easily distracted).
-It is estimated that between 30% and 70% of children with ADHD continue to exhibit symptoms in the adult years.

In this blog post I am going to concentrate on the potential usefulness of long chain omega 3 fatty acids (EPA and DHA found in oily fish such as salmon, mackerel, sardines) in the management of ADHD.  These essential fatty acids are crucial to brain development and brain function and increasing evidence indicates that deficiencies or metabolic imbalances of these fatty acids might be associated with childhood developmental and psychiatric disorders including ADHD. Omega-3 are often lacking in modern diets and as I will discuss here, preliminary evidence suggests that supplementation may well be helpful in the management of ADHD and linked behavioural and learning difficulties (such as dyslexia and dysphraxia).

Children with ADHD are often found to have nutrient deficiencies, especially in essential fatty acids(2,3,4). Common symptoms of deficiency may include dry, flaky skin, frequent urination and excessive thirst.  However, symptoms vary or may be absent altogether.

Clinical trials with nutrients and behaviour problems are not easy to conduct as the diagnosis and tracking relies on behavioural criteria and trials do not allow for individual tailoring of treatments.  The data for nutritional management of ADHD is still preliminary but growing rapidly.  Personally I see the links as being exceptionally strong and I know that many other health professionals feel the same way as I do.  The brain needs optimal nutrition to function effectively.  If we are not getting enough vitamins, minerals and essential fatty acids from our diets then we are bound not to be at our best!

One of the leading researchers into learning/behavioural difficulties and nutritional supplementation in the UK is Dr Alexandra Richardson.  Dr Richardson is an inspiration and I have been privileged enough to hear her speak on a number of occasions.  In 2002 she published a paper(5) which detailed a small trial conducted with 41 children, aged 8-12, who had specific learning difficulties (mainly dyslexia) who also showed ADHD features.  The children were given essential fatty acid supplements or a placebo for 12 weeks.  After 12 weeks cognitive (learning/mental) problems and behaviour problems were significantly lower for the group treated with fatty acids.  This small pilot study paved the way for further small studies which all indicate the importance of essential fatty acids in the management of behavioural problems(6,7,8,9).  Unfortunately large scale trials are still needed but funding is notoriously difficult to find for nutritional intervention trials (compared with drug trials). 

Dr Richardson wrote a review paper(10) detailing current thinking around essential fatty acids in childhood developmental and psychiatric disorders.  In it she details the fact that long chain omega-3 fatty acids (EPA and DHA) are often lacking in our diets and that evidence has built up to suggest that deficiencies and/or imbalances are associated with childhood developmental and psychiatric disorders including ADHD, dyslexia, dyspraxia, and autistic spectrum disorders.  The current evidence seems very supportive of dietary supplementation with these fatty acids, particularly EPA (eicosapentaenoic acid).  Dr Richardson stresses the need for large-scale studies to determine optimal treatment formulations and doses and the need to develop ways of identifying individuals most likely to benefit.  She points out “Childhood developmental and psychiatric disorders clearly reflect multifactorial influences, but the study of LC-PUFA [long chain polyunsaturated fatty acids] and their metabolism could offer important new approaches to their early identification and management”

Omega 3 fatty acid supplementation will not help all children affected by ADHD.  However, omega 3 fatty acids are beneficial to health for a number of reasons (which I frequently mention in my blog posts) and, as many of us do not consume oily fish regularly (at least twice per week as a minimum), supplementation seems prudent to make up for the dietary lack. 

A daily supplement providing around 300-500mg of EPA and 250mg of DHA may be worth trying.  The appropriate dose for the improvement of mood and cognition varies.  Some of the trials with ADHD used up to 1000mg EPA.  The quality of the supplement also needs consideration as fish oils may be contaminated with heavy metal residues e.g. mercury.  Supplements containing Vitamin E or C are worthwhile as these vitamins prevent the oil from oxidation (going rancid).  High dose fish liver oils are not recommended as these contain large amounts of vitamin D and A which can be toxic if taken in excess.   

There are many other nutritional factors (vitamins and minerals) associated with ADHD and related conditions and I hope to cover these important topics in time.  Any dietary interventions with children needs to be closely monitored and I would suggest speaking with your GP or health professional before embarking on a regimen.  Dietary interventions are to be viewed as complementary to any other management approaches.  Individual cases need individually tailored treatment. 

Please visit the Food For The Brain website for more ideas and information. 

(1)www.foodforthebrain.org
(2)Burgess JR et al.  2000.  Long-chain polyunsaturated fatty acids in children with attention deficit hyperactivity disorder.  American Journal of Clinical Nutrition.  71(1):327-330.
(3)Mitchell EA, et al.  1987.  Clinical characteristics and serum essential fatty acid levels in hyperactive children. Clin Pediatr.  26:406-411
(4)Stevens LJ et al.  1995.  Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder. Am J Clin Nutr.  62:761-768
(5)A. Richardson and B. Puri.  2002.  A randomized double-blind, placebo-controlled study of the effects of supplementation with highly unsaturated fatty acids on ADHD-related symptoms in children with specific learning difficulties.  Prog Neuropsychopharmacol Biol Psychiatry, Vol 26(2):233-9
(6)Colter AL et al.  2008.  Fatty acid status and behavioural symptoms of attention deficit hyperactivity disorder in adolescents: a case-control study. Nutr J.14;7:8.
(7)Johnson M et al.  2008.  Omega-3/Omega-6 Fatty Acids for Attention Deficit Hyperactivity Disorder: A Randomized Placebo-Controlled Trial in Children and Adolescents.  J Atten Disord.  Apr 30. [Epub ahead of print]
(8)Sinn N, Bryan J.  2007.  Effect of supplementation with polyunsaturated fatty acids and micronutrients on learning and behavior problems associated with child ADHD. J Dev Behav Pediatr.28(2):82-91.
(9)Effects of an open-label pilot study with high-dose EPA/DHA concentrates on plasma phospholipids and behavior in children with attention deficit hyperactivity disorder.
Sorgi PJ et al.  2007.  Nutr J. 13;6:16.
(10)Richardson AJ.  2004. Long-chain polyunsaturated fatty acids in childhood developmental and psychiatric disorders.  Lipids. 39(12):1215-22.

Written by Ani Kowal

Related posts:

1. Attention Deficit Hyperactivity Disorder (ADHD) may be associated with low folate levels during pregnancy
2. Unhealthy ‘Western’ style diet linked to ADHD
3. Are there alternatives to stimulant drugs for adults with ADHD?