Indian Nutrition Protocol for ADHD Management.

Table Of Content

Have you ever been around or with someone who has an overwhelming tendency to be hyperactive, absent-minded and seemingly unable to constantly regulate their emotions?

Then there is a high probability that they are suffering from a condition known Attention Deficit Hyperactivity Disorder or ADHD/ ADD. You may have heard the term being used quite a bit these days, especially with regards to children and young adults.

While more and more movies are now exploring mental disorders, talking about them may still be a tabboo in the Indian culture.

It is also very true that ADHD can be over diagnosed in our society, thus, as caregivers or patients, we need to have access to the right information about the topic.

In this article, lets get clarity on understanding:

• what ADHD actually is,
• what causes it,
• how it is often misdiagnosed,
• can nutrition help resolve symptoms,
• what are some of our hidden food triggers, and,
• the rise of ADHD in India.

Further, we will look into the side effects of taking ADHD medication and alternative treatment options for the same.

Finally, let’s uncover how transitioning to eating healthier can greatly improve dealing with ADHD symptoms.

I will interchange the words ADHD and ADD through this article as both teh conditions are similar.

What Really Is ADHD/ ADD?

Imagine watching a movie projecting on a big screen. You can see the actors, the sets, you can hear the dialogues and take everything in. Now image two movies being projected on the same screen. There is instant confusion. But now imagine 50 different movie being projected onto the same screen. Suddenly, all you see is chaos.

An ADHD mind works in a similar fashion. An individual might have trouble focusing on one specific task due to various projectors (thoughts) simultaneously playing in the persons head.

It’s a complex neurodevelopmental disorder that affects the individual’s mental functioning, manifesting in their clear struggle to manage their thoughts, emotions, words and actions appropriately.

The most obvious signs of ADHD are:

• Being extremely distracted, unable to focus on doing one thing at a time
• Absent-mindedness, having trouble remembering things and inability to finish even simple tasks efficiently
• Hyperactivity, unable to stay still in one point for even a short time, constantly fidgeting
• A tendency to talk non-stop, rambling on without being considerate or even aware of the situation and cannot focus or listen to what anyone else is saying, often interrupting

Any medical expert working in the mental health field including a psychiatrist, psychologist, internist, family physician, neurologist etc can help diagnose ADHD.

The DSM (Diagnostic and Statistical Manual of Mental Disorders), follows the 12-6-6 approach when diagnosing for ADHD.

The 12-6-6 approach states that:

1. The person should have been 12 years or younger when the first symptoms surfaced.
2. The person must have portrayed 6+ symptoms in multiple settings.
3. The person must have demonstrated the symptoms for at least 6 months.

Wondering what would classify as a "symptom"? Here is a list.

According to the Center For Disease Control & Prevention, ADHD affect between 2-7% of children globally!

While ADHD is usually associated with growing children, it can last well in adulthood as well. Many adults may actually have ADHD, but, sadly, have never been diagnosed for it.

While the symptoms may appear different at older ages, for example, hyperactivity observed during childhood can lead to being as intense restlessness for a person struggling to cope with the demands of adulthood.

The Rise of ADHD in India.

Closer to home, in India, the numbers tell a far more troubling story regarding the rise of ADHD.

A study titled, ‘Prevalence of ADHD in Primary School Children’ was conducted in Coimbatore in 2013.

Their research uncovered an alarming statistic. The prevalence of ADHD amongst children in India was much higher than the global estimate, at higher than 11%!

It was estimated that 10 million children in India are diagnosed with ADHD every year. Many of those children aren’t properly diagnosed/treated and carry this condition into their adult lives. There, it manifests as larger, self-destructive tendencies. This is only exaggerated by the instant gratification they get from an over-dependence on technology.

However, heightened screen time has been confirmed as catalyst to boost ADHD symptoms. The endless and everchanging stimulating content that is freely accessible on our phones is highly additive and rewarding to an ADHD brain.

Is ADHD Genetic? Can it be reversed?

The exact causes of ADHD are ambiguous. While genetics can play a role, there are various different types of genes that can cause ADHD. But besides genetics, lifestyle factors, chemical intake, nutritional intervention etc can all play a role in ADHD.

The broad category of ADHD causes and risk factors, include:

• Genetic predisposition
• Being born prematurely
• Under normal weight at birth
• Impact Injuries to the brain
• Being exposure to lead during childhood
• Mothers to-be smoking and drinking

However, according to research findings from Medical News Today, a majority of risks associated with ADHD, close to 25%, have been attested to genetic & hereditary factors.

If your parents had this condition, its an almost 50% probability that you will have it too.

ADHD can be bought to remission where an individual is able to function well without symptoms of hyperactivity. Its symptoms and their impact can be effectively managed and mitigated through various, timely interventions.

With the right combination of therapies, lifestyle adjustments, and support, individuals with ADHD can experience significant improvements in their symptoms and overall functioning.

ADHD: Misdiagnosis More Than Diagnosis.

Statistics show that out of every 100 people diagnosed with ADHD, 20 are misdiagnosed.

One huge problem with ADHD is that in spite of being a neurological condition, there is no real objective way to diagnose the condition.

For instance, diabetes can be diagnosed by a simple blood test and schizophrenia can be diagnosed by a brain scan. But there is no test to diagnose ADHD. It simply is dependent on the expertise of the person diagnosing it.

It works both ways.

Sometimes, the symptoms of ADHD can often be confused or incorrectly diagnosed as anxiety, dyslexia, mood & sleep disorders, autism, depression, obsessive compulsive disorder and other similar mental illnesses.

Often, ADHD diagnosis is confirmed without deeper investigations in the root cause of the symptoms.

For example, even something as basic as being constantly dehydrated can snowball into ADHD-like tendencies and unfortunately, prematurely diagnosed as ADHD and medication is prescribed right away, without in-depth investigations.

If you have been diagnosed with ADHD, it is wise to get a second opinion before starting any medicinal protocol.

Artificial Colourings & ADHD.

Additives and preservatives are included more liberally to the generic foods we consume than you think. The only way to make your product last longer in the supermarket shelves is to add additives. Anything you pick up that is packaged and stored in market shelves will have additives.

An estimate of 15 million food dye's are used per year in the US food and cosmetic industries alone!

Think about protein bars most people eat in the name of health. They are often packaged to have a shelf life for years together. Imagine making a bar at home and eating it one year later.

Then there are those additives that are included for aesthetic and ‘colourful’ purposes. Without these artificial colouring agents,

• M&M's would not be exciting,
• ‘Cola’ wouldn’t be brown,
• red velvet cake wouldn’t be red, and,
• mint ice cream wouldn’t be green!

While these compounds are far from ‘healthy’ to be consuming, they have more serious effects for enhancing hyperactivity, especially in children, irrespective if they have ADHD or not.

A landmark research study released by Benjamin Feingold in the 1970s conclusively found that food additives caused hyperactive behaviours in children.

Since then, a plethora of peer-reviewed, scientific studies done by independent researchers have been able to confirm this. A simplistic approach, known as The Feingold Diet, proposes that ADHD symptoms can be reduced by the elimination of all foods with artificial food colouring and flavourings.

Now personally I do not propose the Feingold Diet to clients as it is too restrictive and also eliminates healthy food groups like some fruits and vegetables. But the essence of the diet is to help you build awareness to the fact that we are consuming more flavour enhancers than ever before, thus, damaging our brain function.

And it doesn’t end with foods. Synthetic dyes are used in many other common consumer goods like shampoos, toothpastes, skin lotions and even medicines!
The implantation of some concepts of the Feingold Diet, especially in the context of our modern lives has never been more important than it is now.

For our clients, we go beyond educating parents. We work with understanding what condiments, packaged foods, snacks etc the family often buys and help them make smarter choices. Starting your day with fruit loops and milk is probably not a good ides. Bakery snacks or candy bars can further aggravate your symptoms.

Also, Beware of Heavy Metal Exposure!

The smartly hidden presence of heavy metals, especially lead, in everything from paints to petrol to adulterated spices and herbal tea's, toys, artificial cookware and even cosmetics is alarming!

Lead toxicity, particularly, in India is a pressing public health concern, with significant ramifications for the population.

According to the World Health Organisation, lead exposure is responsible for approximately 1.06% of the global burden of disease. In India, the prevalence of lead toxicity is notably high, primarily due to various environmental sources, such as lead-based paints, contaminated water, and traditional medicines.

Statistically, it's estimated that around 275 million Indians, or roughly 21% of the population, are exposed to unsafe levels of lead. This exposure can lead to a range of health problems, particularly among children, including:

• developmental delays,
• cognitive impairments, and,
• behavioural issues.

The most damaging, dysfunctional health effects of continued exposure to heavy metals is on the brain and nervous system. Recent studies suggest that heavy metal exposure can amplify ADHD symptoms.

Modes of heavy metal detoxification include the use of chelating agents that work by binding to specific heavy metal molecules in the body. This allows for them to be dissolved and eventually be excreted. Other forms of heavy metal detox are through using supplements, herbs and dietary inclusions.

Incorporating flax, chia seeds, Vit C foods, green leafy veggies can aid the body’s ability to detox. As will drinking more water!

Side Effects of ADHD medication.

For understanding ADHD medication, it is essential to understand what causes ADHD. One theory states that people with ADHD do not make as much dopamine in their brains as other people.

Dopamine, a neurotransmitter, is a brain chemical that gives us pleasure. It also makes you feel motivated and focused. Without dopamine, it can become harder to focus and stay motivated to complete a task.

• The common type of medication prescribed for ADHD are stimulants. The way these simulants work is complex. They boost the production of certain neurotransmitters in the brain, such as serotonin and dopamine. This leads to periods of increased focus and helps to regulate focus and behaviour.
• Another type of medication that is prescribed for ADHD is classified as a non-stimultant. As the name suggests, the compound in these medications cause the release of a brain chemical known as norepinephrine, that has a calming down effect.

Functional Medicine Doctors have also proposed gut microbiome and environmental toxins to be the root- cause of ADHD. Wondering who a functional medicine doctor is, here you go:

When it comes to medication, as is the case with a majority of pharmaceutical medication, there are side effects you should be aware of.

Firstly, as the effects of the meds wear off or as the body starts to develop a tolerance for the stimulants, the patient can be a ‘rebound’ effect. Leading to intense mood swings and erratic behaviors.

Non-stimulant medication can cause tiredness, drowsiness, reduced blood pressure, stomach pains, nausea.

ADHD medication has also been observed to lead to:

• Irregular heart rate
• Decreased appetite
• Unhealthy weight-loss
• Seizures
• Skin problems
• sleep issues
• Addiction
• Even leading to feeling of isolation and social withdrawal

For children, ADHD medication can even cause an adverse affect on their mind & body’s natural growth patterns.

Alternative Therapies for ADHD.

There is growing hope in the effectiveness of several alternative treatments for ADHD. These can be used in addition to or instead of medication.

Such treatments can definitely help to minimize some of the common ADHD symptoms, including hyperactivity, impulsive behaviors, lack of focus, difficulty paying attention, absent-mindedness etc.

Behavioral therapy:

When you see the word therapy, you may imagine sitting in a therapist office, or via online, discussing your problems and emotions. Behavioral Therapy is different.

Greater emphasis is centered around your actions/ behaviors/ habit patterns. The goal is to integrate constructive, positive habits into one’s lifestyle. Hereby, replacing the not-so positive behaviors.

For example, if ADHD is affecting your ability to focus on completing one task at a time, a behavioral therapist will work on creating a system of rewards. This acts as a great incentive and motivation for you to complete said task.

As is brilliantly described in Charles Duhigg’s bestselling book, The Power of Habit, it is important to create a Cue- Routine- Reward loop.

The "cue-routine-reward loop" is a concept often linked to how habits are formed and maintained. It helps explain the process of habit creation. Let's break down each part:

1. Cue: The cue is the initial trigger or signal that sets off a habit or behavior. Cues can be internal, like stress or hunger, or external, such as seeing a specific object or being in a certain place.

2. Routine: The routine is the actual action or behavior that follows the cue. It's the habitual activity that a person performs in response to the cue. This could be a simple action or a more complex sequence of actions.

3. Reward: The reward is the positive outcome or satisfaction that comes after the routine. It's what reinforces the habit and encourages a person to repeat the behavior when they encounter the same cue in the future. Rewards can be concrete, like a treat, or intangible, like a sense of accomplishment or reduced stress.

Understanding the cue-routine-reward loop is fundamental to comprehending how habits form. As this loop repeats over time, the habit becomes more automatic and ingrained. People often engage in habits without conscious thought because they anticipate the reward associated with the routine.

Behavioral Therapy assists you in developing an action plan for your life. By addressing the specific areas where you may be struggling to focus and arming you with healthy coping mechanisms.

Supplements:

Various supplements can be suggested based on specific symptoms you are facing. Our team works closely with a functional medicine doctor to understand each client case and suggest specific supplements necessary. We do not suggest anyone takes supplements without expert consultation first.

Taking supplements containing amino acids, zinc, omega-3s, melatonin, magnesium and 5-HTP can help to improve ADHD symptoms. Once again, you

Exercise & Outdoor Exposure:

Just as stimulant and non-stimulant medication boosts the production of brain chemicals like dopamine and norepinephrine, exercise has the very same impact, without the damaging side effects.

As little as 30 minutes a day of light-medium intensity exercise can have amazing results on our health and well-being and significantly reduce ADHD symptoms.

Still in two minds regarding exercise?

Check out my blog where I share why Exercise is a Must-Do!

You know that park, nearby to where you live? Head on out for a leisurely walk today!

There is strong evidence to suggest that just 20 mins of time spent outdoors, in a natural setting, can boost focus and concentration levels!

Mindfulness meditation:

Mindfulness meditation is literally re training your mind to adopt a new personality trait. While it mind be hard for people with ADHD to indulge in static meditation techniques, dynamic meditation can greatly help them.

Dynamic meditation is a specific type of meditation practice that involves physical movements, active breathing, and sometimes even emotional expression.

This practice encourages individuals to be in the present moment and tune into their bodies. For people with ADHD, who often struggle with focus and impulsivity, developing a stronger mind-body connection can be beneficial.

How Can Nutrition Help with ADHD.

Various research studies have tried to formulate a link between ADHD and food consumption. One very interesting Randomized Control Trial (the gold standard when it comes to research studies) for a direct link between fruit and vegetable consumption and reduction symptoms of ADHD.

Kids who ate more plants simply did not have as many symptoms as kids who did not eat enough plants.

One of the most significant, long lasting and wholistic path to improved health is developing healthy eating habits. Disruption in gut- microbiome is strongly related to various mental disorders including ADHD. Guess what determines the health of your gut microbiome- the food you eat! Your biological habits can literally impact your psychological health.

The two most inflammatory foods you could be eating right now that are leading to ADHD symptoms are dairy and sugar! Unfortunately, thanks to our new- age fast- food addiction, these items are commonly added to everything we eat. But dairy, including ghee, might not be as good as you think it is. Watch this to understand more:

Plant forward nutrition plays a crucial component in the management of ADHD symptoms. After all, only plants contain fiber, anti- oxidants and polyphenols that aid in reducing inflammation.

Here’s how a balanced, well-planned diet with a greater intake of fruit, nuts, seeds, whole grains and vegetables and low in processed foods, sugar and salt can help:

• Improves brain function as it low in saturated and trans fats.
• Regulate gut health and immune system that can influence mood and behavior.
• Reducing exposure to environmental toxins that can disrupt hormonal balance.
• Enhancing mental and physical clarity by providing antioxidants, vitamins, minerals, and fibre.

Please remember, its not about giving up what you to eat. This is about finding suitable, healthy replacements to your favourite foods that are causing damage to your mind and body.

So, you’re ready to take your steps to effectively heal your (or your child’s) ADHD symptoms by incorporating a plant-forward diet?

The journey towards holistic well-being and improved focus through smart, practical dietary choices is indeed an empowering one.