ADHD Treatment: Diet, Sleep, and Exercise

I have previously written on how to diagnose ADHD in children and adults, as well as treatment methods including medication and executive function support.

But I am often asked:  Are there other treatment options for ADHD?  Possibly ones that do not involve medication or costly therapy sessions? 

While medication and behavior modification are the most widely used treatment methods for ADHD, both in children and adults, I am a big proponent of what I call the Holy Triumvirate:

  • Diet

  • Sleep

  • Exercise

Today I want to examine the efficacy of these modalities and how you or your child may benefit from a renewed emphasis in these areas.

Diet

It is natural for many of us to assume that a diet full of fruits, vegetables, and healthy fats allows us to function at a higher cognitive level than an unhealthy diet.  After all, our parents always told us to eat a good breakfast before school, right?  Well, what does the research say?

Interestingly, research on diet’s impact on ADHD is murky.  For one, it is very difficult to isolate diet alone when considering ADHD symptoms.  However, in a 2022 study, researchers examined numerous studies in an attempt to determine the effects of diet on ADHD.  In their conclusion, they state:

In ADHD, dietary patterns appear to play a significant role in the risk of developing or aggravating disease symptoms. . . . Therefore, diet has emerged as a treatment option for ADHD.

So what does a diet for ADHD symptoms include?  In another study in 2019, researchers determined that a “healthy” diet comprised of vegetables, fruits, legumes, and fish decreased the odds of ADHD up to 37%.  Additionally, they noted “adherence to ‘junk food’ pattern containing sweetened beverages and desserts as well as ‘Western’ dietary patterns including read meat, refined grains, processed meats, and hydrogenated fat increased it.”  So, it appears a safe conclusion that if you want to decrease your ADHD symptoms, you should consume a diet heavy in:

  • Fruits

  • Vegetables

  • Legumes (beans, peas, lentils, etc..)

  • Fish

And minimize the amount of refined sugar.

But what about food dyes?

In an extensive 2021 study conducted by the State of California, it was determined “that the consumption of synthetic food dyes is associated with adverse neurobehavioral outcomes in children.” 

And, as many of us are now aware, even the Food and Drug Administration is taking action by phasing out all petroleum-based synthetic dyes from the nation’s food supply, calling them “toxic dyes.” 

Sleep

One of the most frustrating symptoms of ADHD can be difficulty falling and/or staying asleep.  Many of the children and adults I work with report ongoing challenges with sleep.  And a lack of sleep seems to make their ADHD symptoms worse during the day. 

In a 2019 study, it was found that “adolescents with ADHD were more likely than adolescents without ADHD to obtain insufficient sleep on school days and weekends.”

Another study in 2019 found that “for ADHD children, poor sleep worsens their predisposed attentional deficit.” 

So how much sleep should I get?

According to the National Sleep Foundation, the younger the individual, the more sleep he or she typically needs:

  • 6 – 13 years old:  9 to 11 hours

  • 14 – 17 years old:  8 to 10 hours

  • 18 – 64 years old:  7 to 9 hours

Despite these guidelines, it is estimated that 70-80% of high school students get less than 8 hours of sleep a night. And when we don’t get enough sleep, we suffer, including:

  1. Decreased grades

  2. Elevated anxiety

  3. Obesity and cardiovascular complications

Exercise

Many of the younger children I work who are diagnosed with ADHD present as somewhat hyperactive.  For these kids, movement is usually not a problem.  In fact, many of them seek out physical activity simply as a means to get their energy out.

But can exercise really help decrease ADHD symptoms?

In a 2023 study, researchers examined the effects of acute exercise on adults diagnosed with ADHD.  Their findings demonstrated that as little at 10 minutes (yes, 10 minutes!) of bicycling or yoga can have a positive impact on impulsivity.  Interestingly, however, their research did not find much evidence for effects on attention and focus. 

However, in another study of children with ADHD, researchers determined that both single-bout exercise (e.g., impromptu basketball game with friends) and long-term exercise (e.g., swim team practice) can:

  • Improve blood flow to the brain

  • Enhance information processing capability

  • Enhance attention

  • Decrease impulsivity

  • Strengthen interpersonal relationships

Perhaps most importantly, they concluded that regular exercise can “increase self-confidence and improve communication and social interaction skills,” traits that children with ADHD often struggle with.

While diet, sleep, and exercise are important on their own, a synergetic approach that emphasizes all three will likely work best at managing ADHD symptoms.  If you or your child struggle with ADHD, you may consider your diet, sleep hygiene, and overall activity level.  Managing ADHD is possible for most with these lifestyle changes.

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