September 1, 2011

ADHD From Allergy? Study Shows Benefit From Diet Changes

The kids in this study were basically fed white meat, rice, & some veggies. For those of you who have a child with ADHD you may want to try this diet to see if it helps. If you go back and read our story this is basically what we did and we saw improvements in 3 days!! I'd love to hear from you if you decide to give it a try.

ABC News Medical Unit
Feb. 4, 2011
Many parents will acknowledge that too much soda and candy makes their kids bounce off the walls on a sugar high, but what if a child's persistent hyperactivity was caused by tomatoes, eggs, gluten or some other seemingly innocuous food?

That is what a Dutch study published Thursday found: In kids with ADHD, researchers found that putting them on a restrictive diet to eliminate possible, previously unknown food allergies or sensitivities decreased hyperactivity for 64 percent of kids.

It isn't the first time researchers have tried to link ADHD to things kids eat, such as sugar, food dyes or other preservatives, but even with this recent study, pediatricians remain skeptical of a true connection between diet and hyperactivity disorders.

For Lynne Edris, 45, of Mechanicsburg, Pa., an elimination diet was one of a series of non-pharmacological interventions that she tried with her son, Bobby, in hopes of keeping him off prescription meds.

"He was about three at the time and his hyperactivity symptoms were pronounced. I tried food elimination, [which] basically takes you back to white meat chicken and few other things that they can eat," she said.

Edris spent three months trying the diet and slowly reintroducing other foods, but never saw any effect on her son's symptoms.

Now Edris is a ADHD coach working with parents of children with ADHD and said that while every once and a while a parent will have a lot of success with food elimination, for the most part, hopeful parents are disappointed when it fails, especially because of the amount of effort that has to go into keeping a young child on such a strict regimen.

Bobby, now 15, currently is being treated with ADHD medication and behavioral interventions.

Proof in the Pudding or Placebo Effect?
Similar to Edris' experience, past studies on food elimination diets for ADHD have had mixed results, with elimination of specific "trigger" foods working partially or completely for some children but failing in others.

"There is a longstanding, somewhat inconsistent story about diet and ADHD," said Jan Buitelaar, the lead author of the Dutch study and a psychiatrist at the Radboud University Nijmegen Medical Centre. "On the one hand, people think it's sugar that's the trigger, others think that food coloring could be causing ADHD. Our approach was quite different. We went [with] the idea that food may give some kind of allergic or hyperactivity reaction to the brain" because of an allergy or sensitivity the child may have.

The past studies have been limited, Buitelaar noted, and many pediatricians are skeptical of the connection between diet and ADHD.

"This has long been viewed as a kind of a controversial approach," Buitelaar said. "When we started the research, I was skeptical, but the results convinced me."

In the study, of the 41 kids who completed the elimination diet, 32 saw decreased symptoms. When certain foods thought to be "triggers" for each child were reintroduced, most of the children relapsed. The eliminated diets, which lasted five weeks, consisted predominantly of rice, white meat and some vegetables.

Among 50 kids given a "control" diet that was just a standard, healthy diet for children, significant changes were not noted. Given these findings, Buitelaar recommended that the elimination diet become part of standard of care for children with ADHD.

Though pediatricians acknowledge the limited effectiveness that some patients see with diet changes, most were against including the elimination diet, which can be a harrowing experience for parents and children, as standard of care.

"People seem to think that dietary modification is essentially 'free,' but it is difficult, socially disruptive, and presents the risk for nutritional deficiency," said Dr. Michael Daines, a pediatric allergist-immunologist at the University of Arizona.

Currently, food elimination diets are not standard of care in the U.S. or in the Netherlands, where the study was performed. They are used limitedly when parents specifically request to attempt this alternative treatment for the hyperactivity disorder.

No Jujubes for Junior

Though Daines is willing to work with families who want to try an elimination diet for treating ADHD, he feels it will only have an effect if the child is having a true food allergy or intolerance.

Edris felt similarly: Because ADHD can only be diagnosed by a cluster of symptoms (and not something biological such as a blood test), she thought that it was more likely that some children had allergy-related ADHD and it was only such children who would see a benefit from the diet.

This could be the case for some children, agreed Dr. Anne Francis, a pediatrician in the Elmwood Pediatric Group in Rochester, N.Y.

There is "no question that allergic children show symptoms very similar to ADHD in terms of behavior," she said.

Edris was drawn to try the elimination diet because she was hoping to be able to avoid giving her young son prescription medication for his ADHD. While dietary changes are seemingly a non-invasive treatment option to explore, pediatricians, even those who support the diet as a type of ADHD treatment, warn against parents trying it alone.

"Restricted diets should be undertaken with caution and under close medical supervision to assure appropriate nutrition," said Dr. Karen Warman, an associate professor of Clinical Pediatrics at Children's Hospital at Montefiore.

Given the difficulty most parents may have with getting their kids to eat such a bland, restricted diet, many pediatricians feared that even trying the diet would prove impractical for many parents.

While Dr. Michael Manos, head of the center for Pediatric Behavioral Health at Cleveland Clinic Children's Hospital, said the new study was well done, it didn't dismiss the fact that pharmaceutical and behavioral interventions are much more effective than even the benefit noted by some in the study.

"I would not go so far as to say this ... should be 'standard of care'," added Dr. Kathi Kemper, director of program in complementary and integrative medicine at Wake Forest University Baptist Medical Center.

"What is standard of care is to take the entire child, including lifestyle, family values and culture, into consideration when helping them meet the challenge of ADHD so they can have better attention, focus, self-discipline and patience to help them succeed in school and in life," she said.


  1. So what changes have you seen behavior-wise in your son? Did he have problems with executive function that have since resolved with this diet?

  2. The behavior changes we’ve seen all around are very good. First off, he sleeps all night now (6 to 8 hours) before he hardly slept at all. I think this is huge and greatly impacts all other behavior. His impulsiveness and hyperactivity (which was out of control before the diet) is in what we (me and his doctor) consider the normal rage (meaning he’s your average boy).
    In regards to executive function (for those of you who don’t know what executive function is I’ve given a brief description below—there’s more to it so research further if you’re interested), yes he had problems with his executive function. Changing his diet vastly improved things in these areas. He’s more focused so he’s able to concentrate longer, control his emotions better, and also slow down and “think” about what he’s doing. I think it’s worth mentioning that he’s in 9th grade and takes a full load at the local college as well as he high school classes (FYI he is homeschooled for highschool.) Most ADHD children are above average in their studies— I’ve found when Johnny is challenged and his attention is held he thrives; hence he had flourished at the college level. Also, he enjoys his professors because they don’t talk down to him and they treat him respectfully (his words not mine). He feels his high school teachers don’t always do this (though he’s homeschooled he does take local classes through the public high school).
    It’s hard to drop wheat, dairy, & soy completely out of the diet but if you do I think you may see results very quickly (also we limit, tv, internet, and video games, because if he gets “engrossed” in them he has a tendency to get very short or terse with people. I’m going to post a study which shows what I believe is happening to his brain when he “zones out” and becomes over stimulated on these devices).
    I hope I’ve answer some of your questions. If not PLEASE feel free to ask more.

    Components of Executive Function
    1.Working memory and recall (holding facts in mind while manipulating information; accessing facts stored in long-term memory.)

    2.Activation, arousal, and effort (getting started; paying attention; finishing work)

    3.Controlling emotions (ability to tolerate frustration; thinking before acting or speaking)

    4.Internalizing language (using "self-talk" to control one's behavior and direct future actions)

    5.Taking an issue apart, analyzing the pieces, reconstituting and organizing it into new ideas (complex problem solving).

  3. Thanks for answering my question. How long did it take to start to see a change?

    I'm considering this, but I'm not sure. My son does occasionally complain about stomach pains and what sounds like reflux. But no rash, normal bowel movements. My son hates meat in all forms, so I worry about him getting enough protein if we eliminate dairy. He lives on pasta and pb&j sandwiches.

    Does your son eat oats?

  4. You are welcome!

    It honestly took us about three days to see some results… here’s a link to what we noticed first.
    Here’s a link to what we noticed 2 weeks in.

    I completely understand about your concern about getting enough protein if you eliminate dairy. Does he like eggs? This morning John scrambled 2 eggs, fried 3 links of sausage which he cut up and added to his eggs and then divided up the eggs/sausage mixture between 3 organic corn tortillas (a little breakfast burrito). That with some cantaloupe wedges filled him up. Eggs are really big in our house and they are packed with protein. I make deviled eggs (with no mayo of course), fried eggs, hard boiled (keep the in the frig for snacks), and lots of omelets with veggies and meat.

    My son loves oatmeal. And he actually eats the little instant oak meal packets (we get them from Trader Joe’s) as snacks. We have a least 5 boxes at all times because there are days he’ll eat 3 or 4 of them. I know that sounds excessive but there’s not much to snack on when he wants something fast. And he’s a teenage boy so he’s eating a lot right now!

    Does your son like chili? Chili over tortillas or even potato chic’s might make a good meal. If you could put together a menu for a few days and test whether it’s working (especially if his stomach pains and reflux goes away) then you can decide to continue on longer if you see improvements.

    One thing I’ve learned is in the beginning of Johnny eating this way I was trying to find variety (I didn’t want dinner to be the same thing every night) and I was going crazy trying to do this but my husband pointed out that John was happy rotating the same foods every few days. So don’t go crazy trying to find different menu items. If your boy likes only 4 things that are wheat, soy, & dairy free, then just feed him those 4 things (lets him eat as much as he wants too) over the next few days and see if you notice any changes.

    Good Luck ! Please let me know if you give it a go. I’m interested to see how he does.

    How does he sleep?
    *Also you might want to add Vit B12 if you can’t get him to eat meat.

  5. He does eat an egg every day. My son (7) is a very choosy eater. There are plenty of fresh veggies and fruit that he'll choose from, so that is no problem. Protein sources are legumes, eggs and dairy right now. The three lunches that he will eat are: mac and cheese, pea soup and pb&j. He would also eat left over pesto pizza if we had it. Breakfast is usually a choice of: cold cereal with milk, bagel with peanut butter, waffles or pancakes, toast with butter. Dinner is either spaghetti with fresh pesto and pinenuts, pesto pizza, or eggs (hardboiled or scrambled) with plain starch (pasta, potatoes, couscous, bread, rice) and a veggie. You can see that eliminating W/D/S would substantially cut down his already limited self-imposed diet.

    It is not unusual for Sam to wake up once during the night. I would say that it happens 3-5 times a week that he will wake up and come find me. He says he has a "bad dream". It's pretty easy to get him to go back to sleep though, esp. if I climb into bed with him and snuggle for a few minutes.

    I'm just wondering if I could quietly go W/D/S free on him for a few days without him noticing. Just to see what happens.

  6. I think you CAN and SHOULD go W/D/S free for a little while--and I bet he won’t even notice. What are a few days? If it works fantastic if not you can look into other things. Maybe you can do it on a Friday, Sat, & Sun, so you can watched every little thing he eats.

    I think it is fantastic that he likes, pesto and pinenuts …for some kids they are “acquired tastes”. It does seem like he has a lot of wheat in his diet ( mac& cheese, pbj, pizza, cereal, bagel, waffles, pancakes, toast, spaghetti, couscous). If you wanted to give it a quick test maybe you could just buy a few days worth of gluten free pizza crust, pancake mix (you can make muffins, waffles, pancakes) & bread. So then he can eat some of the foods he likes.

    I think waking up once a night is totally normal. Another parent just emailed me and she said that though her son doesn’t wake up at night she feels he doesn’t sleep hard/deep so he’s never fully rested (I never thought about that so thought I’d mention it).

    Breakfast ideas: egg, fruit, veggies, wheat free muffin (my son loves banana or pumpkin), pancakes, waffles, oatmeal.

    Lunch ideas: egg (scrambled or hardboiled), potato chips, fruit, pbj on gluten free bread, a few slices of deli meat, nuts, chili. *I’m sure you know peanuts have a very high allergic rate..John doesn’t eat peanut butter or peanuts just because we don’t want to give his body any reason to have a reaction. Beside I’ve read they aren’t really that good for you. Almonds are a much better choice. I get roasted and raw almonds at Costco and we snack on them all day. John also uses Almond Butter instead of peanut better.

    Dinner: spaghetti (gluten free noodles), steamed veggies, salad (watch your dressing it’s very hard to find one that’s W/D/S free…when we started diet we just used lemon & rice wine vinegar but now I make all kinds of crazy dressings. Last night it was a little orange juice, salt, pepper, garlic, olive oil, honey, & vinegar.) potato (dairy free butter, salt, pepper, chives), rice.

    If you’re going to try this I say jump in with both feet and remove it ALL. I tried the Feingold Diet for a long time (I was a paying member and utilized their shopping lists and message boards) but we didn’t see a lot of results because it focuses on synthetic food additives and trigger foods. Remember my son was eating organic, whole wheat, natural foods when all of this came to a head and we had to go to the doctor. I think the FG diet is great and we (everyone in our family) try and eat that way. So when John was on the FG diet his body was doing “better” but it wasn’t working at it optimum. I would hate to have you do this and not see result because of one food you didn’t remove.

    Good Luck!

    The Feingold Program eliminates these additives:
    Artificial (synthetic) coloring
    Artificial (synthetic) flavoring
    Aspartame (Nutrasweet, an artificial sweetener)
    Artificial (synthetic) preservatives BHA, BHT, TBHQ