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Bianca Garilli, N.D.

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The Role of Lifestyle Medicine in ADHD Management

Posted: 05/07/2013 2:15 pm

Sales of stimulant medication in the treatment of attention deficit hyperactivity disorder (ADHD) have more than doubled in the past five years, according to the health care information company IMS Health, jumping from $4 billion in 2007 to $9 billion in 2012. [1] The most common of these medications include: Adderall, Ritalin, Concerta and Vyvanse.

For some, medication is a breakthrough with results improving their focus and concentration and an accompanying reduction in impulsivity and hyperactivity. Unfortunately, however, this method of treatment may not be all positive: Fears for potential abuse and dependency are on the rise. Concerns not only focus on the children who have been prescribed the medications, but also their friends and peers, as sharing and selling these stimulant pharmaceuticals has become a major concern as early as junior high school. Moreover, these central nervous system stimulants have come under scrutiny regarding their potential side effects including anxiety, insomnia, cardiovascular effects, gastrointestinal upset, and interference with metabolism which can lead to problems with inadequate weight gain during important growth phases of childhood and adolescence. [2]

Because of uncertainty about the pros and cons of using these medications in such a large number of our youth, many families are seeking a different approach to the condition. Increasingly, parents are demanding a more integrative, natural approach to the management of ADHD. According to a recent article in the journal Focus on Alternative and Complementary Therapy, many families are now asking for information on the impact of lifestyle such as diet, exercise, stress management and sleep and how these aspects of daily living might reduce their child's symptoms. [3]

It's clear there is a need to know more about treatments with the potential to impact the causative factors of ADHD, and numerous well-studied and researched lifestyle modifications have this possibility. Focusing on lifestyle factors that are within a family's control enables them to be more involved in their child's health care and encourages personal and family responsibility. The result can not only lead to better functioning for the child but may also improve multiple dimensions of health and well-being for the entire family.

The most robust, research-backed lifestyle changes for ADHD include dietary considerations and interventions as well as appropriate nutritional supplementation. For example, "elimination diets," which remove potential food intolerances and then reintroduce the foods to determine which foods may be impacting the child's symptoms, have shown encouraging results in several studies. [4] [5] Other families have found either the full-scope or a modified version of the Feingold diet to be effective. The Feingold diet eliminates artificial food coloring, flavorings, aspartame, and preservatives and, during certain stages of the diet, salicylates from foods and medications are also discontinued. Other families are successful in improving symptoms and troublesome behaviors through the implementation of a whole-foods, low-glycemic nutritional program. [6] [7]

In addition to food-related treatment options, a lifestyle medicine approach investigates how nutritional deficiencies might be affecting a child's symptoms. Low levels of certain minerals such as zinc, iron, magnesium and iodine have been associated with ADHD behaviors in some children; these levels can be tested and supplemented if found to be low. There also has been considerable recent research on the positive effect of dietary long-chain polyunsaturated fatty acid (PUFA) supplementation, the most common being omega-3 fatty acids. Surprisingly, reports indicate that the addition of these particular fatty acids not only improved ADHD behavior, but also improved reading and spelling abilities. [8] Medical literature has also reported on the therapeutic outcomes of exercise programs, stress modification and sleep optimization.

Because there is no evidence for a single causative factor for ADHD, a common sense approach is to treat each child individually. A lifestyle medicine program for the child and their family should be considered as first line therapy when given a diagnosis of ADHD. It's crucial to involve the entire family, as making changes in a child's diet, exercise, sleep, and stress levels requires the participation of a majority, if not all, family members. With the support and encouragement from members of the household, the possibility of changing ADHD behavior and creating positive long-term outcomes through lifestyle medicine is a real possibility.

Every parent wants the best for his or her child. As new information emerges regarding the positive impact of lifestyle modifications on ADHD symptoms, more families and health care providers will continue to find a lifestyle approach to be helpful and effective in managing this condition.

References:

[1] Schwarz, A. ADHD Seen in 11% of US Children as Diagnoses Rise. New York Times. March 2013. www.nytimes.com/2013/04/01/health/more-diagnoses-of-hyperactivity-causing-concern.html?pagewanted=all&_r=0

[2] Drugs.com webpage. www.drugs.com

[3] Wake Forest Baptist Medical Center. Children with ADHD benefit from healthy lifestyle options as first-line treatment. January 24, 2012.

[4] Pelsser LM, et al. Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial. 2011 Feb 5;377(9764):494-503.

[5] Pelsser LM, Buitelaar JK. Favourable effect of a standard elimination diet on the behavior of young children with attention deficit hyperactivity disorder (ADHD): a pilot study. Ned Tijdschr Geneeskd. 2002 Dec 28;146(52):2543-7.

[6] Konikowska K, Regulska-IlowB, Rozanska D. The influence of components of diet on the symptoms of ADHD in children. Rocz Panstw Zakl Hig. 2012;63(2):127-34.

[7] Millichap JG, Yee MM. The diet factor in attention deficit/hyperactivity disorder. Pediatrics. 2012 Feb;129(2):330-7.

[8] Konikowska K, Regulska-IlowB, Rozanska D. The influence of components of diet on the symptoms of ADHD in children. Rocz Panstw Zakl Hig. 2012;63(2):127-34.

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