Category Archives: children

Things you wished you knew about ADHD treatment

adhdAttention Deficit Hyperactivity Disorder (ADHD) has three types: “inattentive” type, when focus and distractibility are an issue, but there is no hyperactivity, “hyperactive” type, when restlessness and impulsivity are an issue and focus is not as much of an issue, and “combined” when inattentiveness and hyperactivity are both a challenge. ADHD is on the rise in our culture. The number of children diagnosed with ADHD has doubled in less than 10 years. Additionally, 4.2 million kids are on prescription psychostimulants.

Some experts, myself included, believe the single biggest factor is lack of proper nutrition. Yet this is not usually addressed, at least not by doctors. Nutrition and sleep are the two pillars of a child’s brain health. These two foundational areas impact everything. They are so fundamental and need to be optimized so that a child’s brain can function at its best.

I want to make one thing clear: I am not anti-medication. Medication can be a very good treatment option for a child with ADHD. But medication alone or medication as the first or only treatment is a tragic missed opportunity. When we optimize a child’s health so his brain can work at it’s best, other secondary treatments, like meds, will have better success. Without addressing nutrition, no one’s brain or body can operate optimally.

For a complicated diagnosis such as ADHD, a comprehensive set of treatments is needed. Below I have outlined many areas of consideration and treatment for a child with ADHD. This is a long post because there are so many considerations. I have tried to be thorough yet brief (the vast amount of this info could easily fill a book, and has!).

Diet:

Overall healthy diet

  • Nutrition is so crucial for the body and brain to develop and function. A child needs to get adequate protein, healthy fats, and plenty of fruits and vegetables. Sugars and processed foods need to be limited.

Breakfast

  • In addition to maintaining overall healthy nutrition for functioning, there are specific diet choices that can be made to help improve daily symptoms. Sugar and simple starches, like those in cereals, breads and other typical breakfast foods, get digested and absorbed very quickly. This raises a child’s blood sugar and the body’s response is to process and get rid of that blood sugar, leaving a child with LOW blood sugar by mid-morning. As we all know, a person with low blood sugar can become irritable, inattentive and tired, so you can imagine how this affects someone who is already prone to impulsivity or inattentiveness. A good breakfast with plenty of protein is essential. The carbs should be in the form of fruit or dairy or, if need be, whole grains. Looking for breakfast ideas? Click here.

Snacking

  • Small frequent snacks are good for both keeping a child’s blood sugar stable and providing ongoing nutrition throughout the day. A snack should not be junk food, candy, cookies, or other nutrition-less foods. A snack should reflect the same standards as a meal: protein, healthy carbs, fruits, vegetables, and healthy fats. Click here for my kid’s snack list.

Water

  • Make sure your child has enough water. Dehydration can negatively affect every aspect of the body, especially the brain.

Food sensitivities

  • About half of all kids with ADHD suffer from food sensitivities. Food sensitivities are NOT the same as food allergies. An allergy causes an immediate immune system reaction (like those requiring an epi-pen). Sensitivities cause a slow inflammatory response and chronic symptoms. Food sensitivities can be the culprit for symptoms such as skin rashes, fatigue, digestive symptoms, respiratory symptoms, as well as mood and behavior disturbances.
  • Cutting out any foods your child is reactive to can improve ADHD.
  • An elimination diet, (when you eliminate a specific food in all its forms for one to three months, and then reintroduce it) is the gold standard for figuring out food sensitivities. This elimination can be done for one food at a time, or you can eliminate all the foods that are potential triggers, really calm things down, and then reintroduce one food at a time. This can be complicated, so it is wise to seek professional help.
  • The most common food sensitivities are to: gluten, dairy, tree nuts, peanuts, seafood, corn, eggs, and soy.
  • There are tests, such as IgG and MRT, for food sensitivities. They are both controversial, but have yielded some amazing results in some cases.

Gut health

  • Gut health and behavioral/brain health are linked. The gut-brain axis is a two way street, and the health of one affects the health of the other. If there are unhealthy bacteria or yeast in your child’s gut, those can be causing or worsening their ADHD symptoms.
  • If their gut lining isn’t healthy, toxins and waste products from the gut can leak into the body and dramatically affect the brain.

Additives

  • There are twenty-four types of food additives found in the food that we eat. There is a lot of controversy about the effect of these artificial chemicals that we consume with every bite of processed food. We don’t know for sure the impact of these chemicals on the growing brain and nervous system but there is some evidence that it is harmful. Most countries (besides the US) do not allow some of these additives in their food supply. Some examples:
    • Preservatives
    • Artificial colors (Red No. 40 for example) There is research that shows these additives cause hyperactivity. They are stimulating for the brain.
    • Artificial sweeteners
    • Artificial flavors

Picky eaters:

Picky eating, food aversion, sensory issues, and other eating-related behavioral problems are often present in ADHD. These need to be addressed. They all have the potential to negatively affect growth and development. Seek help from a dietitian and/or sensory specialist.

Vitamin and Mineral Deficiencies:

Almost all children with ADHD have nutrient deficiencies, sometimes more than one. The following are common deficiencies and/or nutrients that have been shown in research to help with ADHD symptoms.

  • Magnesium
  • Iron
  • Zinc
  • Vitamin D
  • B6 (should be in the form P5P-see below)
  • All B vitamins (should be given in their activated form-which are impossible to find in the store, even Whole Foods. The best place to get these is from a health care practitioner who has an account with a high-grade supplement company)
  • Focus supplement: I have developed a formula that contains most of these nutrients and more, in the right proportions. And I recommend it to all my clients with ADHD.

Other nutrients and supplements:

  • Omega-3 fatty acids, commonly known as fish oil. EPA and DHA are two fatty acids that are scarce in our diet and essential for brain health. There is tons of research on these, suggesting that they can aid in managing Fish oil pills, liquids or chewables can be found in many stores. Fish oil is better than flax seed, which contains ALA and isn’t as readily used by the body as EPA and DHA
  • This and other phospholipids are essential for cell membranes and might have a place in the treatment of ADHD. A new product, Vayarin, has phosphatidylserine attached to Omega 3s and has been shown to improve ADHD.
  • Gingko Biloba has been shown in research studies to improve focus in kids with ADHD.
  • Anti-oxidants naturally occur in fruits and vegetables, or they can be found in supplements. They are crucial for reducing the oxidative stress that is present in people with brain challenges.
  • Amino acid precursors to neurotransmitters. Neurotransmitters are the chemicals that the brain uses to communicate. Neurotransmitters are required for thinking and focusing. Many people with ADHD are deficient in the neurotransmitter dopamine. This makes sense as dopamine is needed for focus, attention, and executive functioning. L-tyrosine is an amino acid (single molecule protein) that is the precursor to dopamine in the body. This is a safe, non-medicinal way to balance the brain.

**Both nutrient supplementation and herbal or neurotransmitter supplementation should be done under the supervision of a qualified health care professional.

Tests:

There are several tests that I offer in my practice, which can reveal important information about what’s going on inside the body and therefore aid in targeted individualized treatment.

  • Micronutrient test. By doing this test, we can determine which vitamin, mineral, or anti-oxidant deficiencies a child has and therefore need to be supplemented.
  • Neurotransmitter Test. This test measures the levels of serotonin, dopamine, norepinephrine, epinephrine, GABA, and glutamate. By discovering which neurotransmitters are higher or lower than expected, we know exactly how much of which amino acids to provide in order to restore balance.
  • Genetics Testing can be very illuminating about the genetic factors relating to someone’s health. There are ways to combat or get around genetic roadblocks.
  • Heavy Metal Testing to see if a toxicity exists and needs to be treated.
  • Food sensitivity testing to determine if someone is reacting to certain

Other lifestyle factors:

  • Heavy metal toxicity
    • Lead, mercury, and other metals contaminate our soil, seafood, and sometimes our water. These can cause brain issues in susceptible people. Children are naturally susceptible, as their brains are still developing. Furthermore, genetics dictates that some people are worse at detoxifying than others, and may need extra help.
  • Exercise:
    • Physical activity-we know that exercise is good for the brain, and is very beneficial in helping with ADHD symptoms.
    • Yoga has been shown to be beneficial in this population too.
    • Martial arts can help with self-control and focus.
  • Meditation and mindfulness can be very calming and helpful to improve one’s control over their attention.
  • Biofeedback and neurofeedback: this takes another expert and his machinery, but can very helpful to reinforce when a child is focusing.
  • Screens
    • Limit all screens such as TV viewing, video games and iPad to 30 minutes a day (ideally).
  • SLEEP
    • Last but not least. Sleep is as foundational as diet. Without the proper amount and quality of sleep, a child simply cannot function optimally. 8-10 hours is usually optimal. Going to bed at the same time every night is a good idea too.

A condition such as ADHD requires a comprehensive and integrated treatment plan. There are many, many areas to work on before, instead, or in addition to treating with medication.

Please use those ‘share’ buttons to share this article on social media-chances are someone you know needs this info!

“I don’t like it”

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When you put a new food or combination of foods in front of a small child (or a big child!), it is not uncommon to hear “I don’t like it” And what do you, the parent, usually say? If you are like me or a lot of parents, you say, “how can you know, you haven’t tried it”. And then proceed to persuade the child to take one bite.

I am a big believer in no pressure at meal times. Pressure leads to power struggles. A child will only get more stubborn in the face of your pressure. And that makes sense if you think about it. Here is a child, who has resistance to this food and no one is honoring his or her feelings. In general, I follow the no pressure rule. I am in charge of making the food and he is in charge of eating it (or not). Period. But the argument of ‘I don’t like it’ when they have never tasted it, sparks an urge in me. I counter a child’s illogical statement with a logical one, ie: you haven’t tried it. But what does a child really mean when he says he doesn’t like something he has never tried.

I read an article written by Maryann Jacobsen recently and it changed my understanding of what is actually going on with a child when they say “I don’t like it”.

A child probably means that he is not ready to eat it, that he is unfamiliar with this food and that makes him uncomfortable or even scared.

So at this point we should either

  • honor our child’s feelings and leave them alone. This doesn’t mean we can’t still offer the food at future meals. We have known for a long time that it takes a child 10-15 exposures to a food before they try it. Maybe now we can understand why.
  • try to give them the support they need.
    • Ketchup, ranch dressing or cheese can make an unfamiliar food familiar again
    • Ask your child, what could be done to the food to make it yummier or more appealing?
    • Have them help you prepare the food, so they see what it is, where it comes from, etc.

Most of all: be patient. As always, don’t make a big deal out of this. That only leads to power struggles and more resistance.

Image courtesy of rakratchada torsap at FreeDigitalPhotos.net

Best Books on Food for Kids

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As a nutritionist and a mom, I have always been interested in good food-related books for my kids. Anytime I came across a book that teaches about food, healthy eating, or healthy body image, I bought it (even before I was a parent).

Here are just a few of my favorites (for young children):

“Eating the Alphabet: Fruits and Vegetables from A to Z” by Lois Ehlert is good for babies on up. Great pictures give exposure to all kinds of fruits and vegetables. As children get older and verbal they can pick out something at the market after seeing it in the book.

“Blueberries for Sal” by Robert McCloskey is a classic that was read to me when I was a child. It’s about a mother and child who go blueberry picking on the same hill as a bear and her cub.

“Bread and Jam for Frances” by Russell Hoban. Poor Frances only wants to eat the same thing meal after meal until she gets bored and learns that variety is a good thing.

“Berenstein Bears and Too much Junk Food” Besides the use of the word “chubby” that I don’t like, this book has great lessons about food and exercise.

“Cat in the Hat: Oh the Things you can do that are good for you” Great book with rhymes and information about healthy eating, exercise and other healthy habits.

“Shapesville” by Andy Mills and Becky Osborn. This book is all about loving the body you have and celebrating that we are all different shapes and sizes.

 

Do your kids watch TV while they eat?

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Two-thirds of kids watch TV during mealtimes. On average, kids spend 53 hours a week looking at a screen (sometimes more than one at a time!).

The problem? This affects their health, today and tomorrow.

First of all, just that much screen time makes me cringe. Watching TV means kids are sedentary instead of moving their bodies. Exercise is important for people of all ages. Also, if they are watching TV they aren’t playing or socializing, both of which are needed for healthy brain and personality development.

But back to the mealtime issue. If they are watching TV, they are missing out on the family meal. Family meals are extremely important for emotional development and for kids to adopt healthy eating habits. For more on the family meal, read this post.  Additionally, kids who watch TV the most have higher intakes of calories, fat, and sugar, and lower intakes of fruits and vegetables. This leads to poor brain and body development now while they need optimal nutrition. And it also is associated with obesity, Diabetes and heart disease later.

Turn the TV off and enjoy the family meal. You are your kids’ best model of how to eat healthy.

Kids breakfast ideas

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Let’s face it, planning meals for your kids is hard. The ideas don’t come and we’re all tired.

I have compiled a list and some tips. I hope it inspires you!

  • Yogurt, fruit, and granola
  • Breakfast pizza on English muffin
  • Cottage cheese sundae with fruit and nuts and even whipped cream
  • Oatmeal with cranberries and cinnamon
  • Breakfast burrito: Whole wheat tortilla, scrambled eggs, cheese, salsa, green peppers and onions, ham, bacon, chicken sausage
  • Pancakes (made from healthy recipe not Bisquick)
    • Pancake pizza (with rasp for sauce and all kinds of toppings)

Smoothie:

  • Fruit: strawberries, banana, peach, mango, pineapple
  • Liquid: orange juice, pineapple juice, milk or milk alternative
  •  Additionals:
    • Yogurt
    • Chia or flax seeds
    • Protein powder

Toast (low calorie bread, whole grain bread, English muffin, flat rolls) with:

  • Yogurt and fruit
  • Avocado
  • Avocado and hard boiled egg
  • Peanut butter and banana
  • Peanut butter and jelly
  • Almond butter, granola and fruit
  • Fried egg
  • Laughing cow cheese and fruit
  • Cottage cheese, edamame and tomato
  • Laughing cow cheese and cucumber
  • Melted cheese and salsa
  • Melted cheese
  • Pureed beans and melted cheese
  • Mozzarella cheese and tomatoes and basil
  • Hummus
  • Tomato, hard boiled egg and cheese
  • Bacon and scrambled egg

Or serve non-breakfast food. Serve their favorite lunch or leftovers from dinner.

Does Constipation Cause Accidents?

This one is for all you parents out there.

It’s No Accident: Breakthrough Solutions To Your Child’s Wetting, Constipation, Utis, And Other Potty Problems
Steve J. Hodges

Dr. Hodges says that constipation is to blame for most accidents, whether they be nighttime or daytime, pee or poo.  He says that kids can be pooping regularly and still holding large amounts of old poop in their rectum. This causes pressure on the bladder, and loss of muscle sensitivity and control of the rectum. It’s worth considering if your child is struggling with this problem. He lays out treatment plans and schedules, and includes two bonus chapters. One on nutrition written by a dietitian and one on behavior written by a psychologist.

And even if you are sure your child isn’t constipated, there is still great info on peeing accidents and holding. Holding leads to bladder muscles becoming so strong that they spasm and overpower the ability to hold in pee. He lays out treatments for this.

Buy it on amazon

Thanksgiving Fun with Food

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Every holiday is a perfect excuse to do something creative with food. And now, those of us who aren’t overflowing with our own ideas have pinterest.

And there aren’t just sugary unhealthy options on my Thanksgiving board. Here is the pb&j sandwich my son had for lunch last year on Thanksgiving day (he had to have something to hold him over until the 4:00 feast). And there are fruit and vegetable platters that are shaped like turkeys- they are a must see! Check out my collection of Thanksgiving pins now!

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Healthy Halloween Treats

We all like candy. But let’s face it, candy isn’t good for our kids and isn’t good for us (or am I the only one who eats my kids’ candy after their bedtime?) I found a few ideas out there and thought I would compile them.

English muffin Monster Faces

Peanut butter pumpkins

Strawberry Ghosts

and there are many more healthy and not-so-healthy ideas on my pinterest “Halloween” board

Enjoy

 

 

Family Meals

It has been known for a while: the family meal provides numerous benefits to the children. Several studies over the years have been done on this.

Children who eat one meal a day with their family as a whole:

  • eat more fruits and veggies
  • are less likely to do drugs
  • are less likely to bully and be bullied
  • are less likely to be overweight and obese

A study came out recently on the last bullet. Here is a quote from the abstract:

“Family meals may be protective against obesity or overweight because coming together for meals may provide opportunities for emotional connections among family members, the food is more likely to be healthful, and adolescents may be exposed to parental modeling of healthful eating behaviors”

In our busy lives, it is easy to forgo a sit down meal with the whole family. Since family meals have so many significant benefits, it is important to make the effort and build your day around one family meal.