ADHD: Risk Factors and Nutritional Considerations

ADHD: Risk Factors and Nutritional Considerations

By Dr Hazel Batten, Integrative GP at Remede Wellness Medicine

 

Understanding ADHD

ADHD (Attention Deficit Hyperactivity Disorder) is not a disease but a collection of behavioural symptoms that vary across individuals. Many with ADHD are charismatic, creative, energetic, passionate, and highly driven. However, when these traits are heightened, they may impact relationships, productivity, and emotional wellbeing.

The hallmark features of ADHD are inattention, hyperactivity, and impulsivity (APA, 2013).

 

Risk Factors for ADHD

Genetic Factors
ADHD has a strong hereditary component. Studies estimate that approximately 75–80% of ADHD cases are genetically linked, particularly to genes that affect dopamine transmission (Faraone & Larsson, 2019). This explains why stimulant medications like methylphenidate (Ritalin) are effective—they increase dopamine availability in the brain (Volkow et al., 2001).

Neurological Factors
Children with ADHD often show different brain wave activity on EEG scans. Increased theta (4–7 Hz) and reduced beta (13–30 Hz) wave activity have been observed, reflecting patterns associated with drowsiness and reduced alertness (Clarke et al., 2001).

Environmental Factors
Prenatal exposure to toxins such as lead, tobacco smoke, or endocrine disruptors like BPA has been linked to increased ADHD risk (Braun et al., 2006). Additionally, overstimulating environments, such as overcrowded classrooms with limited support, may exacerbate symptoms (DuPaul & Stoner, 2014).

Nutritional Factors
Nutritional imbalances can contribute to the severity of ADHD symptoms. Below are five nutrients that may play a significant role.

 

Nutritional Support for ADHD

Magnesium
Magnesium is critical for neurotransmitter regulation and energy production. ADHD children often have lower serum magnesium levels, and supplementation—especially when combined with vitamin B6—may improve symptoms (Starobrat-Hermelin & Kozielec, 1997). Food sources include nuts, legumes, whole grains, and leafy greens.

Iron
Iron is a cofactor for dopamine synthesis. Research has shown that children with ADHD often have lower ferritin levels (a marker of iron stores), which correlates with symptom severity (Konofal et al., 2004). Iron supplementation should only occur after appropriate testing.

Zinc and Copper
Zinc plays a role in dopamine metabolism and modulates the activity of stimulant medications. Low zinc levels, particularly in children with ADHD who are picky eaters, are common (Arnold et al., 2005). High copper-to-zinc ratios may contribute to overstimulation and aggression (Walsh et al., 2004).

EPA and DHA (Omega-3 Fatty Acids)
People with ADHD are often deficient in long-chain omega-3 fatty acids. Supplementation with EPA and DHA has shown modest but significant improvements in attention, hyperactivity, and impulsivity in several trials (Bloch & Qawasmi, 2011; Chang et al., 2018). Benefits may take 3–6 months of consistent use.

L-Theanine
L-theanine, an amino acid found in green tea, has demonstrated some benefit for improving sleep quality and cognitive performance in children with ADHD in small clinical trials (Lyon et al., 2011).

 

Other Considerations
  • Food sensitivities: Some studies have linked casein (a milk protein) and gluten to worsening of ADHD symptoms in sensitive individuals, though evidence is mixed (Pelsser et al., 2011).
  • Gut health: Emerging research suggests that the gut-brain axis and microbiome diversity may influence ADHD symptoms, though this area is still developing (Aarts et al., 2017).
  • Sugar: High sugar intake may disrupt dopamine regulation, possibly worsening hyperactivity, although findings are inconsistent (Wolraich et al., 1995).

 

References
  • Aarts, E., et al. (2017). Gut microbiome in ADHD and the gut–brain axis: current evidence and future directions. Microbiome, 5, 24.
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
  • Arnold, L. E., et al. (2005). Zinc in ADHD: The empirical evidence, mechanisms of action, and future directions. Biological Psychiatry, 57(11), 1424–1430.
  • Bloch, M. H., & Qawasmi, A. (2011). Omega-3 fatty acid supplementation for the treatment of children with ADHD symptomatology: systematic review and meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 50(10), 991–1000.
  • Braun, J. M., et al. (2006). Prenatal environmental chemical exposures and child ADHD behavior. Environmental Health Perspectives, 114(12), 1904–1909.
  • Chang, J. P. C., et al. (2018). Meta-analysis of omega-3 fatty acids in children and adolescents with ADHD. Journal of Child Psychology and Psychiatry, 59(6), 514–523.
  • Clarke, A. R., et al. (2001). EEG-defined subtypes of children with Attention-Deficit/Hyperactivity Disorder. Clinical Neurophysiology, 112(11), 2098–2105.
  • DuPaul, G. J., & Stoner, G. (2014). ADHD in the Schools: Assessment and Intervention Strategies.
  • Faraone, S. V., & Larsson, H. (2019). Genetics of attention deficit hyperactivity disorder. Molecular Psychiatry, 24(4), 562–575.
  • Konofal, E., et al. (2004). Iron deficiency in children with attention-deficit/hyperactivity disorder. Archives of Pediatrics & Adolescent Medicine, 158(12), 1113–1115.
  • Lyon, M. R., et al. (2011). Effects of L-theanine (Suntheanine®) on attention and reaction time response in healthy children: a randomized controlled trial. Alternative Medicine Review, 16(4), 348–354.
  • Pelsser, L. M., et al. (2011). Effects of a restricted elimination diet on the behaviour of children with ADHD. The Lancet, 377(9764), 494–503.
  • Starobrat-Hermelin, B., & Kozielec, T. (1997). The effects of magnesium physiological supplementation on hyperactivity in children with ADHD. Magnesium Research, 10(2), 149–156.
  • Volkow, N. D., et al. (2001). Therapeutic doses of oral methylphenidate significantly increase extracellular dopamine in the human brain. The Journal of Neuroscience, 21(2), RC121.
  • Walsh, W., et al. (2004). The role of zinc and copper in autism and ADHD: A review of research and clinical findings. Alternative Therapies in Health and Medicine, 10(6), 44–53.
  • Wolraich, M. L., et al. (1995). The effect of sugar on behavior or cognition in children. JAMA, 274(20), 1617–1621.

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