Nutrition and ADHD: How diet can really make a difference

Despite what you may read or hear, no diet, no matter how “natural” or “anti-inflammatory” it may be, can cure ADHD [1]. It is a complex neurodevelopmental disorder, involving a combination of factors, in part genetic, but also related to brain structure and neurotransmitter chemistry. We are not talking about a child with a lack of willingness or an adult who should “just make an effort”. We are talking about a brain that functions differently.

That said, although diet does not cause ADHD (nor does it cure it), it can sometimes play a role [1]. Not always. Not on its own. But for some people, in certain contexts, well-targeted nutritional interventions can simplify daily life, modulate symptoms and support other approaches. It’s not a magic wand, but it is another tool in the toolbox. And that is what we are going to explore here.

One of the most common realities of treating ADHD with medication, is a loss of appetite [2]. It is often referred to as a common, temporary or inevitable side effect. But sometimes, for many children, adolescents and even adults, the impact is very real. For 30% to 60% of people, their appetite decreases shortly after taking the medication. Breakfast goes by, lunch is delayed, and by supper time, their appetite comes back… sometimes too late to really compensate. Little by little, their weight stagnates, their growth slows down (not all the time), and meals become a source of conflict or concern.

It is not a matter of unwillingness. Nor is it merely a whim. It is a documented pharmacological effect. Stimulants such as methylphenidate (Ritalin, Concerta, Biphentin) or amphetamines (Adderall, Vyvanse) affect the dopamine and noradrenaline circuits. By modulating attention, impulsivity and hyperactivity, they also affect the body’s hunger signals. Even the best food in the world cannot cancel out this effect, but it can help reduce the effects.

In this context, the most important nutritional strategy has nothing to do with foods to ban or a diet to adopt. It focuses on something more fundamental – helping the person maintain sufficient energy levels to support their growth, concentration and daily life. It is not about forcing someone to eat, but identifying the right times, food, and ways to achieve this, without pressure.

Sometimes the typical fixed schedule of three meals a day needs to be changed. It is preferable to eat filling meals before the medication takes effect. Eating nutritious snacks during the day and evening, when your appetite returns, can also be beneficial. Foods dense in energy, flavour and comfort can make up for the absence of traditional meals eaten at fixed times. Textures, temperatures and presentations that stimulate the appetite can make eating more pleasurable. These different strategies will not always be easy to adopt but are often highly effective.

This type of approach may not be unanimous, but it changes lives. It promotes adherence to treatment, while putting food back where it belongs, as a source of energy support, not a magic solution.

When ADHD medications decrease your appetite, the conventional meal schedule (breakfast, lunch, supper) no longer suffices. We often have to take a different approach, dividing up our food intake and including opportunities to eat wherever possible. This is not a fixed plan, but a starting point that can be adapted to age, context and appetite at any given time. What is important is to eat enough during the day and not necessarily at the ideal time or in large quantities all at once.

Morning (before taking medication)

This is often the best window of opportunity to provide a truly nourishing meal, even if it doesn’t resemble a traditional breakfast. A protein-rich smoothie with toast, leftovers from supper (yes, it’s allowed), a sandwich, a bowl of yogurt with fruit and nuts… anything is good, as long as it is dense and filling.

Morning (if possible)

A small snack, even if we are not very hungry: apple sauce, mini-muffin, a few pieces of cheese or a hard-boiled egg. It’s not the quantity that counts, but the frequency. If we can include two small snacks, all the better.

Noon

This is when our appetite is often at its lowest. We don’t skip the meal but adjust it: a smaller version of lunch, divided into two small dishes that we can finish later; cold foods, bite-sized pieces, nicely presented. The objective is to maintain our connection with lunchtime even if it is symbolic.

Late afternoon

When the effect of the medication starts to wear off, our appetite returns. This is the perfect time to enjoy a heartier snack or finish your lunch without worrying about spoiling your supper: smoothie, sandwich (e.g., wrap), bowl of cereal, dried fruit, whatever appeals to you.

Supper

This meal can be more substantial again and be eaten a little later. Variety doesn’t need to be a priority. A favourite dish, even if repeated, is often more beneficial than a “balanced” meal that no one wants to eat. A warm friendly atmosphere together with a non-judgmental attitude can really make a difference.

Evening

A final snack before bedtime (or eating the rest of our supper!) helps boost our intake: warm milk, bread, oatmeal, yogurt. Even a small amount can have a positive effect.

When providing nutritional support for ADHD, it is often helpful to ask yourself what “the right way to eat” is. This refers not only to food, but to the speed at which we eat, the context and sensory preferences [3,4]. Many people living with ADHD (children and adults alike) are hypersensitive to the texture, smell, mixture or temperature of food. They are not “being picky”, quite the contrary. It is a way of perceiving food, often amplified by noise, fatigue or anxiety.

Rather than fighting it, we should make the best of it. We can do this by offering familiar foods, adjusting textures, dividing a meal into smaller portions and avoiding overly intense sensory combinations. Eating becomes a skill to be built, not a performance to be achieved.

And most importantly, we should keep in mind that eating well with ADHD is not a question of willingness or discipline. It is a matter of adaptation. With kindness, no pressure and a good dose of creativity.

Although there is a wealth of research on the connections between nutrition and ADHD, it remains difficult to interpret. The studies are not similar, the protocols are sometimes unclear, with few individuals studied, and mixed results. Despite this diversity, certain observations regularly recur and are beginning to point us to some more solid leads.

Some studies have reported lower levels of iron, zinc and magnesium in children with ADHD [5]. These nutrients are involved in the regulation of dopamine, which points to plausible leads, but not automatic solutions. To date, there is no evidence that taking supplements improves symptoms in individuals who do not have a confirmed deficiency. Taking supplements “just in case” may also prove unnecessary or cause us to miss out on more effective interventions. Before adding anything, it would be better to analyze what actions should be taken based on sound data, not assumptions.

Food colouring and certain additives have long been suspected of exacerbating agitation and impulsivity, especially since the 1970s [6]. Recent studies show that, when these effects occur, they only affect a small subgroup of children. Although we often talk about “individual sensitivity”, we still do not know what causes these reactions. It may be a genetic interaction, or perhaps a biological factor that is as yet poorly understood. What we do know, on the other hand, is that this phenomenon is unpredictable and that treating it as a nutritional priority for everyone does more harm than good.

As for sugar, we can rest assured that it does not cause hyperactivity [7]. The idea has persisted, but it has no scientific basis. Well-controlled, double-blind studies have compared the behaviour of children after consuming sugar or placebo and no significant difference has been observed. What is often perceived as the “sugar effect” actually reflects the context in which it is consumed (celebrations, excitement, noise, parental expectations to be calm). And from a neurobiological perspective, sugar does provide energy. But it does not alter behaviour. It is the situation that stimulates, not the cake eaten at the birthday party.

Research into ADHD has focused on omega-3, particularly EPA. These fatty acids play a key role in the structure of neuronal membranes and communication between brain cells [8,9]. A number of studies have reported lower levels in children with ADHD. Overall the scientific literature tends to show that EPA-rich supplementation (around 500 mg per day or more) may modestly improve some symptoms, especially in children with an omega-3 deficiency or who do not respond well to medications. This is not a first-line treatment, but a potentially useful supplement. This said, these doses must be monitored. Just because a nutrient is “natural” does not mean that it is harmless, particularly in children.

Some families explore elimination diets in an attempt to reduce ADHD symptoms. The most documented is the Few Foods diet, which is very restrictive at first, followed by a gradual reintroduction [1,2]. One study conducted in the Netherlands showed improvement in some children, but this type of approach requires close professional supervision. Without rigorous monitoring, the risk of deficiencies, family conflicts, or potential for eating disorders becomes very real, and any positive effects, when they do exist, do not always last over time.

Gluten-free or dairy-free diets, recommended without a medical diagnosis, are not based on evidence [1]. The perceived effects may reflect an overall reduction in ultra-processed foods, a placebo effect or simply better meal management. In any case, an assessment by a dietitian-nutritionist remains the best option.

Eating better doesn’t change everything, but it can really help stabilize energy levels, support concentration, improve sleep and make everyday life easier. For some people, targeted adjustments can really make a difference. For others, the effect is more subtle. And that’s normal.

There is no miracle diet, but a varied, satisfying diet, with as few ultra-processed foods as possible, adapted to the individual’s appetite at the time can become a valuable tool. What’s important is to provide the necessary resources without making things more difficult. Supporting them without blaming them. Because in nutrition, as with ADHD, what really works, is adapting.