It must have been mid-October 2017 that Oliver (8 years of age) and his family were referred to us by one of our co-workers. “Parents would like to know more about a dietary intervention for Oliver’s ADHD as opposed to medication. Oliver is falling behind at school due to attention difficulties and impulsivity. In addition to that, he has difficulty maintaining friendships and gets into fights every other day.” After screening Oliver’s behavioural problems both at home and at school, we concluded that Oliver fulfilled all inclusion criteria and none of the exclusion criteria: he and his family were most welcome to participate in our dietary intervention at New Brain Nutrition.

Oliver’s family consists of his mother, father and younger sister Liz (6 years of age). In addition to that, his grandmother and grandfather are closely involved in raising Oliver and Liz: they take care of their grandchildren two days a week (after school). One of the major difficulties that parents had to deal with in implementing the diet was that the grandparents were somewhat sceptical about the intervention. While grandfather had this ‘Well, boys will be boys’ kind of view on Oliver’s behaviour, his grandmother was more into a ‘The way to a man’s heart is through his stomach’ perspective, which led to pampering Oliver and Liz with candy on a daily basis. This called for some extra support from our researchers (who are also clinicians) in explaining the treatment to the grandparents. Eventually, all were on the same page and well-instructed before the start of the dietary intervention.

chocolate gooey browniesAt the start, parents filled out a baseline questionnaire on the behavioural problems (i.e. hyperactivity, impulsivity, attention deficits), physical problems (i.e. headache, stomach-ache, changes in appetite) and emotional difficulties (i.e. tantrums, mood swings) that Oliver dealt with. These measures were monitored by his parents on a daily basis (on a 5-points scale) for the following five weeks. These data were collected by our dietician on a weekly basis, while the dietician also monitored their adherence. In the first week, Oliver and his grandmother made a few dietary mistakes, but from the second week onwards, all became accustomed to the dietary protocol. Oliver’s mother encouraged all family members by setting shared goals on a weekly basis. For example, if the children earned a certain amount of stickers, they would go to the swimming pool by the end of first week, to a play-farm by the end of the second week, and so on.

After three weeks, a drop in behavioural problems was seen (from an average of 5/5 at baseline to an average of 3/5 after 3 weeks), while emotional difficulties (and the related fights with peers) were diminished after three weeks (from 5/5 on average at baseline to an average of 1/5 after 3 weeks). Physical complaints were not reported (1/5 on average at both baseline and after 3 weeks). His attentional problems however remained severe (4/5 on average at both baseline and after 3 weeks).

The decrease in problems persisted until the end of the first five weeks of the dietary intervention. Since the attentional problems kept interfering with Oliver’s school performances, school provided Oliver with a noise-cancelling headset after the fifth week.

The overall results led Oliver and his family to decide to proceed with the re-introduction of eliminated foods. This however was done after the holidays (Saint Nicholas, Christmas), which parents considered too much of a challenge to combine with a strict diet. Today (mid-February), Oliver and his family are in the midst of the re-introduction of foods. Every two weeks one new product is re-introduced in bulk. Oliver’s mother turns out to be a genius in creating attractive snacks and dishes that adhere to the dietary protocol. And Oliver? He is very proud of himself for sticking to the diet!

(Editor’s note: New Brain Nutrition is conducting numerous studies on food elimination diets and other nutrition and supplement topics through 2022.  Subscribe to our blog for updates.  We look forward to sharing a lot of information and findings with you.)

Vitamin B and ADHDThere is a well-documented relationship between dietary factors, health and human behavior. Severe malnutrition produces neurological and psychiatric symptoms. It is also assumed that dietary factors play a role in common mental disorders, such as ADHD, but this is less established and more difficult to investigate. A few studies have documented a beneficial effect of dietary interventions and vitamin supplements in ADHD in children and adults. To examine the nutritional status in ADHD, Landaas et al.(1) recently compared blood vitamin levels in 133 adult ADHD patients and 131 healthy controls. In the ADHD group there was a clear overrepresentation in the group with low levels of vitamins B2, B6 and B9.

It is yet unclear whether these vitamin levels are a) associated with ADHD symptoms, or b) whether they are the result of altered dietary intake, or c) metabolism in ADHD patients. However, it is possible that the differences reflect dietary habits that are different in a subgroup of ADHD patients and controls. Dietary habits are established early during life and may last into adulthood. It is possible that suboptimal dietary habits may precipitate, exacerbate or maintain symptoms of ADHD. More research in larger samples is obviously needed to clarify these issues. Over the next five years in our project, entitled “Effects of Nutrition and Lifestyle on Impulsive, Compulsive, and Externalizing behaviours,” we expect to gain much more insight into these connections.  We will share our findings with you.  Stay tuned!!

(1) BJPsych Open. 2016 Nov; 2(6): 377–384. Published online 2016 Dec 13. doi:  10.1192/bjpo.bp.116.003491
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5153567/