Attention-Deficit/Hyperactivity Disorder (ADHD), the most common childhood neurodevelopmental condition, affects millions of US children. The number of children diagnosed with ADHD increases with age - teens are over six times as likely as younger children to be diagnosed. Boys are twice as likely as girls to have the condition.
The cause of ADHD in children is presumed to be multifactorial, with genetics, environment, and lifestyle playing roles. Scientists are researching the dietary habits of children with ADHD and are finding that nutrition and nutrient deficiencies may contribute.
ADHD presents challenges for the child and the parent. This article will help you learn more about ADHD, nutrition, and micronutrient testing in children so you can feel empowered to work with your healthcare provider to implement individualized nutrition strategies that may minimize ADHD symptoms.
What is ADHD
The most common neurodevelopmental condition in children is ADHD. The formal diagnostic criteria for ADHD are described in the DSM-5, but common behaviors are:
- Impulsivity: children may have difficulty waiting their turn, may interrupt, or blurt out answers to questions that have not been fully asked
- Inattention: children may have difficulty with listening skills, may lose items, may be forgetful, or have a reduced attention span
- Overactivity: children may squirm, fidget, or be restless, may have difficulty staying seated, may be very talkative and unable to play quietly
What is The Role of Micronutrients and ADHD in Children
Scientists have demonstrated that a large proportion of children have various micronutrient deficiencies. Since micronutrients are essential to proper brain development and neurotransmitter production, researchers have suggested that deficiencies may play a role in developing ADHD symptoms. Children with ADHD may have lower levels of specific vitamins, like vitamin D, and minerals, like iron.
Top Nutrients for ADHD Pediatric Patients
Several micronutrients have been identified as potentially important for children with ADHD.
Magnesium is involved in regulating neurotransmitters (chemicals that transmit signals in the brain) and forming new connections between nerve cells. Magnesium has a calming effect on the brain, which can help improve focus and attention. Low levels of magnesium have been found in some children with ADHD.
The Recommended Dietary Allowances (RDAs) for magnesium are:
*Adequate Intake (AI): Intake at this level is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA.
Iron is essential for crucial body processes like:
- Carrying oxygen to our tissues and brain
- Brain development in children
- Forming the fatty substance (myelin sheath) around nerve fibers
- Neurotransmitter production
Iron deficiency has been linked to ADHD in children. Ferritin (a protein that stores iron) levels are almost 50% lower in children with ADHD than in controls.
The RDAs for iron are:
Zinc is an essential mineral that plays a critical role in brain health and development. It is involved in regulating neurotransmitters and is implicated in affecting learning, memory, emotion, and mood. There is an association between zinc deficiency and ADHD in children.
The RDAs for zinc are:
Vitamin D is essential for proper brain function and development. A study of ninety children demonstrated that those with ADHD had markedly lower vitamin D levels than those without ADHD. Supplementation with vitamin D showed many improvements in ADHD symptoms.
The RDAs for vitamin D are:
Omega 3 Fatty Acids
Omega-3 fatty acids play an essential role in brain health and development.
Children with ADHD have lower levels of omega-3 fats, and a systematic review and meta-analysis found that supplementation with omega-3s improved clinical and cognitive outcomes in children and adolescents with ADHD.
The RDAs for omega-3s are:
How to Test for Micronutrients in Children
Several blood tests are available that use a small amount of blood from a finger prick, allowing easier testing for children who may have difficulty with a standard blood draw.
Nutrient tests that use a finger prick method are:
- Vitamin D
- Omega-3 index
- The Whole Blood Nutrient Profile by Vibrant Wellness tests for magnesium, zinc, iron, and vitamin D
A standard blood draw is required for a more in-depth assessment of the following:
- The total serum magnesium measurement can be inaccurate if a mild deficiency is present
- If a mild magnesium deficiency is suspected, then an RBC magnesium might be more accurate
- The total serum zinc measurement can be inaccurate if your albumin levels are low or inflammatory markers are elevated
- Ferritin, ESR, and CRP are commonly used markers of inflammation
- If you suspect a chronic zinc deficiency, then an RBC zinc may be more accurate
- A CBC with differential can evaluate for anemia
- Measure Iron and TIBC to assess iron deficiency
- Measure ferritin as a marker of iron stores.
It is important to note that even if a child does have a deficiency, it does not necessarily mean that supplementing with that nutrient will improve their symptoms. Also, excessive supplementation can lead to adverse health effects, so it's best to partner with your healthcare provider to ensure you're supplementing appropriately and safely.
There is evidence to suggest that micronutrient deficiencies are associated with pediatric ADHD. For example, low levels of iron, zinc, and omega-3 fatty acids have been found in some children with ADHD. It is also important to consider other factors that may be contributing to ADHD symptoms, such as lack of physical activity, poor sleep, and underlying health conditions. Micronutrient testing is an objective way to evaluate a child's nutrient status and work with a healthcare professional to devise an individualized plan to address any deficiencies safely. Always consult a healthcare professional or functional nutritionist before changing a child's diet or supplement regimen.