ADHD + Nutrition: What the Research Actually Says

I’m so glad you’re here today for this important conversation about ADHD and nutrition. We’re gonna actually be looking at what the research says. If you’re new to the Connected and Capable podcast, welcome. My name is  Alisha  Grogan, and I’m a pediatric OT, and I’m a mom of three kids, one of whom has ADHD. 

And so as a mom, this is something that I have thought about a lot, and to be quite honest, have felt the weight and the confusion around does nutrition matter a lot? Does it matter a little? And, and really what I should say is we’re really talking about a larger conversation here of, first, diet and nutrition, but secondly, are there supplements and vitamins that kids with ADHD, quote-unquote, should be taking? 

And we’re gonna look at three of those vitamins or supplements today, and specifically, what is the research showing? Now, I just want you to know that as I’m referencing research throughout this podcast, I promise it’s gonna be super parent-friendly. I’m not gonna get into the nitty-gritty details on this study because I think that starts to just get confusing and overwhelming, but they will all be linked up on our website. 

So you’ll see a link to get to the full transcript, episode, all of that stuff. If you’re looking for the links to that or any of the supplements that I may reference, you can find all of the links there. So we are gonna get started by first acknowledging that this conversation can be very polarizing. I think that many of us see claims that nutrition is the only factor, and if we pull that lever, it is going to, quote-unquote, “cure” ADHD. 

At the same time, I think we see the full other end of the spectrum with lots of people saying, “Nutrition matters not at all.” Okay? “This is about brain chemistry. This is about wiring in the brain. We cannot, we cannot boil this down to something as simple as nutrition.” And so we see these two completely opposite perspectives often really pushing at us. And I think on, as an added layer on top of that, I think many of us in general are like, “Yes, I want my kid to eat healthy. Yes, I wanna make good food choices for them.” But they have all of these sensory needs as an ADHD kiddo. 

They may have very extreme picky eating. So the thought of improving their nutrition is already something that is on your, that is- on your heart and on the w- like, just you feel the weight of as a parent. And so please know that everything that we’re talking about today, and I will continue to come back to that, is very much top of mind for me. And I will, I would just say spoiler alert right now, I think that there is no one-size-fits-all solution for any family. 

I think that a conversation about nutrition and supplements is very personalized for a variety of factors, and that we need to work towards generally being less judgmental and talking about what the options are. I will also say as a spoiler alert right now that there is no research out there that is saying this helps significantly improve ADHD symptoms for 100% of ADHD kids or adults, for that matter. 

Okay? So that does not mean that there are not benefits, that there are not maybe considerations that you want to know for your family, but here’s the goal. The goal is not for you to walk away from this episode with a laundry list of nutrition changes and supplements that your child needs to be taking, but instead, it’s for you to feel clarity around what the research is actually saying so that you can make an informed choice about the s- next steps that you want to take at this point right now. 

Now, I know we also have a lot of fellow therapists like myself that are listening, and I’m so glad that you’re here for this conversation as well, because many times parents are appropriately looking to us to ask, “Hey, I just saw this article about vitamin D and links to ADHD. Does my kid need to be taking vitamin D?” It can feel really overwhelming as a therapist to just kind of stay on top of this. So this conversation is all about setting a strong foundation on where the research is actually lying. 

All right, are you with me? Are you ready to get into this? I’m, I’m super excited to talk about this today. So let’s start off by just, we got, we gotta name nutrition, okay? And there have been multiple studies done that look at ADHD kids having moderate changes to their diets, minimal changes to their diets, and significant changes to their diets. So let’s talk about what those tend to look like. 

Minimal changes are usually making healthier choices, adding more fruits and vegetables in. There may be some times where they’re avoiding certain additives, like food coloring in particular, as obviously there’s been a lot of studies- And some also that, that dispute that, but that show that artificial food coloring can have a really negative effect on attention and hyperactivity. So at a minimal level, we have studies looking at that. 

We have a moderate level where it’s more of an emphasis, so maybe we’re pulling out preservatives, maybe we’re pulling out a lot of processed foods, but a child is still eating a lot of different types of foods, but there’s an emphasis on getting more fruits and vegetables into their diet. And then there are studies that are really looking at intensive anti-inflammatory diets that may eliminate gluten, dairy, eggs, soy, all artificial colors and flavorings, as well as all types of processed food. 

Now, I wanna just share here on a personal note, and, uh, this is not something I’ve talked too much about publicly, but I have been mostly on an anti-inflammatory, very strict diet for six, going on seven years. In the last year and a half, I have started to take steps back to reintroduce foods into my diet because living a strictly anti-inflammatory diet, which for me was most of those foods that I just listed being eliminated, not all of them, uh, but most of them, is challenging in ways, uh, socially, culturally, and can also take a significant toll in our fast-paced, busy world that we live in today on our mental health and keeping up with such a structured, intensive diet. Now, please hear me. 

I know some of you are like, “Oh my gosh, my kid is on an intense diet. They’re on anti-inflammatory, and they are doing so well. We have seen so many significant changes.” I love that, and I believe it because a lot of the challenges that we see, and I, I’m speaking extremely broadly right now. I’m s- I’m talking about every challenge every child or adult can experience too. Chronic headaches or digestion problems, attention issues, executive functioning challenges, anxiety and depression, skin rashes. All of this stuff is often at a root level linked back to inflammation in our body And many of these foods, because they have been changed so much, uh, genetically modified over the last 100 years, are now being broken down and digested in our body in just a totally different way. 

The food is just not the same. And so there is a base level of inflammation that happens, uh, for a lot of people. And so eliminating some of these foods can feel very life-changing, as it did for me. Why do you think I’ve done it for so long? I’m at a point in my life now where I really have to, I really have to be aware of what the larger consequence is. 

Because for me, as a recovering type A personality, I know that this is a thing that I can get really hyper-focused on. This is a thing that can become anxiety-ridden and control-based for me. It’s a thing that, uh, I can sometimes just feel some exclusion from in a social setting when my diet is so restricted. And so I think that there are wonderful, wonderful benefits to an elimination diet, but f- I think we have to be careful as practitioners to recommend these blindly to families because it takes a lot of planning. 

It’s certainly an increase in, in cost, significantly so in some cases, to eat anti-inflammatory, which is sad and so unfortunate, but is true. And so when parents are already feeling completely burnt out, if they’re already over the edge, if that’s you listening to this and you’re like, “Oh my gosh, how could I, how could I even begin to think about eliminating dairy, gluten, eggs, soy, making every single thing from gra- scratch?” That can feel like just completely unaccessible and undoable. 

Now, that does not mean that there are not small steps to take there. That does not mean that it’s not something that’s worth considering. That does not mean that if you are doing an anti-inflammatory diet that you shouldn’t be. I just want to say that I think that there’s a lot of gray area, and I think that we have to really consider our individual situations and what is worthwhile. 

So what does the research say? Well, I want to look at one 2021 study, and this study, again, is going to be linked up. You’ll see it in our, the article on our website, looked at kids that were kind of doing a general healthy diet for ADHD compared to kids that were doing a strict eliminated diet. Now, across a variety of these studies, what we see is the very strict intensive diets that around 50 to 60%, again, this varies per study, really see- a significant improvement in ADHD symptoms. 

So please hear me, that’s significant improvement. That’s not complete elimination of any symptoms ever, but there are significant improvements in 50 to 60%. That is a high number for research standards. But we also have to consider that there were half of those kids that did not see an improvement. So this does seem to show us that ADHD itself may be rooted in various underlying causes that we don’t fully understand yet, and that some kids may be displaying ADHD, which is really deeply a food sensitivity that they have. Okay? So I think for families that have the bandwidth, that are wanting to do a trial, I think the research is strong enough certainly to support doing that. 

But I also think that we need to be very cautious in thinking that this is going to be a cure-all that absolutely fixes everything, and it needs careful consideration and guidance for how to begin to rule that out in your family. Most families, I have found, that have decided to do an anti-inflammatory diet, and of course, there’s research related to this around autism as well, and again, just about every other type of challenge that, that kids have, and adults for that matter. 

You know, I’m reading a book on perimenopause right now because, yeah, that’s where I am. And I was so thrilled to see, uh, many of you are probably familiar with Mary Claire Haver and her book on the new perimenopause. Okay, so she is a medical doctor. She is looking at this through a traditional, uh, you know, I’m expecting her to look at this through a traditional kind of like western medicine framework, and she’s completely holistic ac- actually, which was awesome to see. 

And, uh, while she talks about a variety of options, one of those was leaning into this anti-inflammatory diet because, again, the way our human body works when we’re suffering with symptoms, there is a link to inflammation. And even, like, if we’re just able to reduce that inflammation, all of our symptoms just start to go down, which is why we are probably seeing some variability in this too with ADHD kids and just about everything in our lives. 

So again, I, I think that there is valuable research that points us to this, but there are many, many factors that we need to consider. Okay? If you have more to say on this or you have questions about this, ’cause I feel like this is just such a, uh, hot topic, please hit reply to one of our emails. 

In fact, grab one of our printables below. That’s in the show notes too. We have a bunch of free printables. Head to our website, um- We’ll let you know when the new podcast episode comes out because I love to hear from you, and many times your replies or your comments, if you’re listening on Spotify or YouTube, you can drop a comment below or an Apple, a review. That helps me know what all, you all wanna be hearing more of, or I might just directly answer your question here. So keep that in mind and keep the questions coming. I love hearing from you. 

Now, of course, with this, again, I wanna make sure that we’re addressing if your primary emphasis right now is on your child just being fed, then this probably doesn’t make sense as a next step, probably. There are exceptions to that, for sure. And I think with support, there can be a way to even move forward in starting to eliminate some of these kind of high inflammatory foods. 

However, however, I think sometimes the best focus is to just be on r- getting a routine around meals so that your child is able to consistently eat, so that their fear of food decreases. And again, there is a psychological component to that, and for many of our ADHD kids, there is a sensory component that is inducing a lot of fear when something smells, looks, feels, or tastes absolutely revolting to their nervous system. That’s not a choice. That is the way that their brain is wired right now. 

And sometimes because they are already in an elevated sense of fight or flight, so the brain is more reactive, it’s more quick to judge foods, it’s m- and if there’s been past negative experiences with food, the brain is going to be extra on guard with trying to protect a child from anything else that might be a super negative experience. 

Okay? So I think it’s important if you are listening to this and you’re like, “Yeah, there is no way my kid eats three foods, and one of them are chicken nugget, uh, chicken nuggets from McDonald’s. Another one is a frozen pizza, and the third one is, uh, waffle fries.” Like, those are the three foods my kids eat. That is literally it. And then we start talking about an anti-inflammatory diet, uh, that can be super unhelpful. And so for me, the first goal is to just start stabilizing that eating. Okay? 

Now, obviously, uh, picky eating is something we haven’t talked about too much yet here on the podcast. Don’t worry, that is coming. Uh, for those of you that have followed me for any length of time, you know that, um, I have deep roots in picky eating, and I’ve had the privilege of working with thousands of families around the world. So Just know we have a lot of resources here, and we are also linking up our free picky eating workshop, which is three keys to turn around picky eating. 

This is where I start for that kid that is only eating three foods. If you have a kiddo that you’re like, “You know what? I can just– They just really won’t touch fruits and vegetables. It’s not a huge stressor, but I want them to start eating this.” These are the three key steps that I start with, and so make sure that you check that out. If you’re listening to this conversation and you’re just thinking, “There’s no way I can take any types of steps forward with, uh, changing types of food that a child is eating,” we need to start there. 

Okay? All right. Let’s move into the specific vitamins and supplements that are most often talked about and have been the most researched in regards to ADHD. Okay? The first one is iron. So some studies show that kids with ADHD have lower levels of iron. S- more specifically, a component of iron that is called ferritin. 

All right? Now, here’s the tricky part with iron. You cannot or should not give your child an iron supplement without specifically having their iron and hopefully their ferritin levels checked because sometimes kids’ iron levels will look fine and in the normal range, and it’s their ferritin that is lower. Now, if… Now, again, if a kid shows low iron levels, there’s no question doctor is gonna be like, “Yep, you need to take some iron supplements.” But there are consequences, uh, to taking too– like, if your child already has a good level of iron and you just give them iron, uh, there will be kind of a, all these health b- like, side effects for having too much iron in their body. 

So you don’t wanna just go do that. So this is what I’m recommending. If your kiddo is struggling with other signs of potentially low iron, it’s worth a conversation with your doctor. So some of those are restless sleep, a lot of issues with sleep and iron, falling asleep, staying asleep, uh, waking up a lot. Now, I know so many of our ADHD kids struggle with sleep, and I am not saying that every sleep issue is related to low iron levels. But it is a clue that, oh, maybe iron is involved here. Maybe that is a factor. 

Okay? Also, if your child excessively sweats or they love to chew on ice. Now, again, I wanna just point out here that a lot of kids are huge sensory seekers. Like, if your kid loves crunchy foods, if they love to jump and climb and hop- Chewing ice could be happening from a purely sensory standpoint. So we really wanna start to look at, are there multiple things going on here? Wow, they really struggle with their sleep. They are super sweaty all the time. They do chew on ice. They kind of have an oral fixation. 

Again, there can be other explanations for all of these things. However, when we see this pattern, that is what will justify your doctor doing the blood work to check their ferritin levels. Now, of course, I cannot remember what the age is, but they do start doing blood work, uh, you know, I wanna say later elementary years routinely on kids. So sometimes doctors will give a little pushback. If you say, “Hey, I would like to have their i- ferritin levels checked. You know, she has ADHD, and I just wanna check in on that because there’s been some studies to show that.” A lot of doctors will be like, “Yeah, you’re right. That’s a good call. I’m gonna add ferritin check to their blood pl- panel.” 

Other doctors are gonna say, “Yeah, but I’m not really seeing that.” So you will need to back it up by saying, “Look, they struggle with sleep. They’re struggling with, uh… They chew on ice all the time.” That is a huge sign for doctors. So even if it is something else, they can then justify to the insurance company. Basically, that’s what they’re looking for. When they add something else onto these blood panels, they have to often say why they’re ordering that. So you may have to give the answer as to why you are asking for that specific item to be checked in their blood panel. Okay? So we wanna consider iron, but I don’t think it’s something that you have to go off the deep end about. 

Now, here is what the research says, though. Does iron make a significant difference? The research is mixed. More of the research tends to show that it’s helpful and may have some moderate improvements for some kids. So again, highly individualized, it could be a factor and is something to consider. 

All right. Let’s move on to our next vitamin, which is zinc. Zinc is talked about a lot with ADHD. There have been numerous studies that have shown that individuals with ADHD have a higher likelihood of having lower zinc levels. Zinc is ideally a supplement that you want to have checked in the blood. While not as serious as iron and potentially taking too much iron, zinc, uh, can interrupt copper absorption, which is also important, and so we don’t wanna do that if your kid has too much zinc in their system. Uh, sometimes doctors with a look of their symptoms will start off with a really low dose, uh, which for my kid was 15 milligrams. 

So this was actually not checked in his blood, but But again, a conversation for you to have with your doctor based on their age, height, size, all of that stuff kinda is taken into consideration with the doctor. But again, what we want to look at here is what are the other signs that zinc may be low? Okay, now zinc and iron, of course, because we’re talking about them, both can influence attention, emotional regulation, and hyperactivity. Okay? That’s why they’ve been researched so much in relation to ADHD, right? That makes sense. 

But there are all of these other symptoms like we just talked about with iron. Zinc also is, guess what, related to? Poor appetite. Only eating a certain amount of food, not wanting to eat often is linked to zinc. Now, again, I want to be cautious here because not all kids that are choosing not to eat well have zinc deficiencies. 

Again, I see so many kids that are eating such little foods, I would be almost willing to bet, although I haven’t seen their blood panels, that zinc is not the underlying cause. In fact, when we do the work and they are using the strategies like addressing the underlying sensory, they’re putting in the no pressure environment, they’re adding in routine, we start to see kids starting to eat. They start to add more and more foods to their diet, and zinc wasn’t even a factor. That’s a, that’s a pretty big clue to me, uh, that it wasn’t because of zinc that they were having struggles with their appetite. 

However, again, when we start to stack symptoms together, you can say to your doctor, “Look, they are really struggling with attention.” Yes, they do have this diagnosis, but it, it is attention. They are struggling with hyperactivity. They are struggling with poor appetite. And the last big one, which was a really huge clue for my kid, which by the way, when he was younger, had a lot of sensory stuff with eating that we worked on and through. He is now a super foodie kid, which if you would have seen him as a toddler, would have seemed like an impossible, light years away type of situation. 

But he is now my salad-loving, smoothie-making, uh, most curious, adventurous eater. And so I don’t, I have not seen a poor appetite in him. However, this kid is chronically sick. Out of my three kids, there are numerous times Every year that he is the only one that is sick in my house, and when he is sick, he is sick. He is down and out for four or five days. 

Now, some of this is related to his executive functioning skills with perseverance and kind of m- monitoring, like, his interoception. Like, he feels sick deeply, and so it’s harder for him to kind of, like, push up and overcome even when he’s feeling somewhat okay. So I do recognize that that’s part of it, but it is a very, very clear pattern to me that he is sick more often, he is sick longer. Okay? So if you are seeing that in your child, it is also an indication that zinc might be low. It is also why we did start using a zinc supplement, which we sometimes forget to take, uh, to be fully honest. So, but I do know that that zinc is supporting everything, and when his blood work comes up the next time that he is due for blood work, we are going to check zinc. 

That is definitely something I’m going to ask for because maybe, uh, we started off on a very low conservative dose of just 15 milligrams. Now remember, he is 14 but is an adult-sized man. Uh, we are tall people, so he is, he is already adult-sized. But that dose could easily be 30 milligrams depending on his needs. Now, again, hear me. The research on zinc is moderately strong. Okay? There are not any studies showing that, like, zinc is going to just cure ADHD, nor is iron. But they could help. They could help. 

All right. And the last supplement that we are going to talk about is fish oil. Fish oil is actually one of the most studied in regards to ADHD, and there are some mixed results with ADHD. There was actually a study from the early 2000s that showed really significant improvement in memory, in attention, in hyperactivity related to ADHD, but there have been some recent studies that have showed just minimal progress. Now, fish oil has been studied quite a bit and is widely recommended. 

Again, uh, side note, one of the things that is recommended, and not, you know, when we’re looking at, like, even perimenopause, because it’s supporting brain health. So it’s very interesting to me as I’m reading about perimenopause, I’m like, “Oh my gosh, these are, like, so many of the things that are recommended for ADHD.” Uh, and you know, there’s just, there’s some o- there’s some overlaps there. So the challenge I think with fish oil is, uh, it is something that is fairly safe to give your child. 

However, any supplement, anything you’re doing, I think is good to run by your doctor and to just say, “Hey, I’d like, I’d like to try fish oil.” That can be a call to the nurse, the nurse’s line and just saying, “Is there any contraindications, any reason I shouldn’t? What dose do you recommend?” Okay, for my child at this height and size. I think the biggest challenge with fish oil is, uh, for those of you watching on YouTube, this is a fish oil pill. 

Okay, now it is in a soft gel capsule, but it is big. It is big. So I’m taking this myself. My son has not started taking this, but it’s something that I am considering trying this summer. Again, at his age, uh, we are not dealing… Well, at his age, we- he is able to swallow a pill pretty easily, something he’s very comfortable doing. So that is, that is one obvious challenge. Uh, the younger a child gets, the harder it is to swallow a pill, let alone a pill this big. 

So how the heck do you get fish oil into a kid’s diet? Because here’s the other challenge. This fish oil inside this capsule, I don’t take it, I don’t taste it one bit when I take it, and it does say, uh, the brand that I’m using, which I will link up in the show notes. Uh, well, the link will take you to our full article where all the links will be. 

Uh, but this brand that I’m using has a natural lemon flavor added to it because the taste of fish oil can be so strong. Again, I’m not tasting it. I take it with food, uh, at the same time, but for many of our kids, this is gonna be a tricky one. So there are some other ways to get fish oil in, but before I even get to that, it’s really important that we make sure that when we are looking at fish oil, there are different types of fish oil, and there are a lot of basic kind of products on the environment, but they don’t include EPA, and EPA is what is shown to be the more effective component of the fish oil. So if this is not in there, the EPA, and it should outweigh the amount of DHA. 

Okay, so these are all components of the fish oil, and it’s important that that EPA is higher. That is what the research is showing us. So if you are gonna try fish oil with your kiddo, you wanna consider making sure that the EPA is higher. And again, this is another reason why it might just be helpful to check in with your doctor. I’m going to, to show you the one that I am taking, uh, in those, in those show notes, but again, for your kid, you’re likely gonna be looking at some other option, and there are such a variety of things that are possible. 

So first of all, there are gummies- But of course, they are a lower concentration, ’cause otherwise they’re just gonna taste like fishy gummies, which kids are just not gonna wanna eat. So they’re in there in pretty small amounts. I will link up a brand that I like that has a decent amount in there, but it’s not going to be a full dose of this fish oil, okay? But it would be something. 

Uh, and at that point, we have to ask ourselves, when the research is showing anywhere from minimal to significant cha- you know, like change with ADHD symptoms, is it worth even trying to get a low dose in? Okay, so that’s one option. You can also buy bottles of the straight fish oil, so it’s not in the capsule, and you can squirt that into a smoothie. 

A lot of families keep that chilled, uh, so that it like that helps take the flavor down, making a really strong and powerful smoothie to put that in. So we have gummies, we have direct fish oil, and if your kid is able to swallow a pill, but just not a giant horse pill like this, then they do make mini capsules as an option as well. So if you’re listening to this and you’re like, “There is no way, no way my kid is doing that right now,” that’s okay. That’s okay. But it is one of the recommended, uh, supplements that sometimes comes up with ADHD, so I think it’s good for you to have an understanding on it. 

I will lastly just give two quick shout-outs to two other supplements that are sometimes talked about in ADHD, uh, research and nutrition, just to round out our conversation here, and that is vitamin D and magnesium. Now, in general, vitamin D is almost always recommended for kids to take. So if your kid isn’t taking that, that is actually a really easy one to get in. It’s a drop or two of completely tasteless oil, and if you live in the… If you live, like, not in a tropical environment where the sun is out all the time, and like me in Pittsburgh, there is a decent chance that your kiddo is needing that vitamin D. 

Now again, if they have a lot of dairy with fortified vitamin D in it, that might not be the case. Uh, but definitely something to talk to your doctor about. Generally speaking, they’re like, “Hey, you should just take vitamin D,” and there are a ton of benefits to it. So that’s one to consider. Magnesium, we are all chronically low in. Most doctors are totally cool with you just taking magnesium or giving your kids some magnesium. 

It can be very supportive of sleep in particular, and digestion issues if your kid is struggling with constipation. However, there are multiple time- types of magnesium, and it’s important to talk to your child’s doctor about what a good dose would be. And also know that there are some powdered versions that are really easy to mix into things, and even have like a citrusy taste that are very pleasant for a lot of kids. 

But again, the research, when we look at vitamin D and magnesium, what it does show is that these can help support brain health, but they’re not showing significant changes for ADHD symptoms or challenges that kids are having with attention and hyperactivity. All right, friends, I hope that makes sense. Uh, as you start to think about this, I hope it gives you just some peace of mind in what next steps you might wanna take. I hope you took some notes today on just conversations to have with your doctor, your spouse, or your partner about if you want to consider, uh, having some blood levels checked, if you want to take some steps to having, uh, making some diet changes. 

Remember that if you are thinking about any of these things and your kid is just a really picky eater, uh, there is hope for that, like a lot, a lot of hope. I have worked with so many kids with ADHD and autism and no diagnosis at all, but are just such severe picky eaters that it’s like controlling a family’s life, and I’ve seen them learn to eat and love a variety of foods. I know what that can feel like an impossible mountains, but it’s possible. And so if that’s you, make sure that you check out our free workshop in the show notes. 

All right, guys, take a deep breath. You’re doing so well. Truly, you’re doing so well. Remember, there is no perfect way, uh, to approach ADHD or any of these challenges that our kids have. It’s just about taking the next small step. I’ll see you next time.