What the research tells us about gluten-free diets and ADHD Symptoms
Parents of kids with ADHD are constantly faced with an array of treatment options including medication, various behavioral interventions, and dietary recommendations. In recent years there has been a lot of buzz about the use of a gluten-free diet to treat a wide range of physical and cognitive problems, including ADHD. In posts and comments online, some parents describe huge improvements in their child's ADHD symptoms after eliminating gluten from their diet. And some pediatricians and nutritionists recommend a gluten free diet as part of a child’s ADHD treatment plan. For a chronic condition like ADHD, the thought that a dietary change could eliminate symptoms altogether is highly appealing. However, removing gluten from a child’s diet is a substantial undertaking, and one that can be stressful and exhausting for both parents and kids. Before making any major changes to your child’s diet, it's important to know what research findings tell us about the likelihood that a gluten-free diet will be an effective ADHD treatment option.
What is Gluten?
Gluten is a protein found in wheat, rye, and barley and is present in bread and pasta, as well as many rice products and processed foods present in the typical American diet. For individuals with celiac disease (about 1% of American's1) eating gluten causes severe health problems including malnutrition, gastro-intestinal symptoms, and abdominal pain.
Where did the idea of a Gluten – ADHD connection come from?
In addition to malnutrition, abdominal pain, and gastro-intestinal symptoms, untreated Celiac disease is also associated with attention problems and behavioral issues. So, children with either undiagnosed or poorly managed Celiac disease may display ADHD-like symptoms. Some may even initially receive an incorrect diagnosis of ADHD. For these children, once the underlying problem is appropriately treated, and gluten is completely removed from a child's diet, attention and behavior problems improve dramatically and may even remit completely.
In recent years, some doctors and nutritionists have suggested that a substantial minority of the population experiences non-celiac gluten sensitivity. It is thought that people in this group don't experience the severe gluten reaction found in celiac disease, but experience a milder reaction that contributes to weight gain, fatigue, difficulty concentrating, and memory problems (among other symptoms). Most often, when doctors, nutritionists, and parents of kids with ADHD talk about gluten, they are usually focused on underlying gluten sensitivity rather than Celiac disease.
What does the research say?
A number of research studies have examined the impact of a gluten-free diet on ADHD symptoms in individuals who had confirmed ADHD diagnoses. Across the board, removing gluten from a child's diet had no clinically significant impact on ADHD symptoms. In other studies of children with gluten sensitivity or celiac disease, attention and behavior issues did improve when gluten was eliminated from the child’s diet. However, these children did not have ADHD, they had attention and behavior problems secondary to their medical condition.
The Bottom Line:
Many parents are willing to go through the very difficult process of systematically eliminating gluten from their child's diet in the hope that it will lead to big improvements in the child's ADHD symptoms. If a child has celiac disease or a gluten sensitivity (which is typically associated with some physical discomfort such as bloating, stomach pain, headaches, excessive fatigue, etc.), then the ADHD symptoms may be caused by the medical condition and eliminating gluten from the child’s diet will have a significant impact. If a child does not have celiac disease or gluten sensitivity, then switching to a gluten-free diet will not lead to a significant improvement in ADHD symptoms. If you would like to try a gluten-free diet with your child, talk to your child’s pediatrician and/or a nutritionist about strategies for making the dietary changes as simple and stress-free as possible.
1Fasano et. al. (2003). A multi-center study on the sero-prevalence of celiac disease in the United States among both at risk and not at-risk groups. Archives of Internal Medicine, 163, 283-92.
Mary Rooney, Ph.D., is a licensed clinical psychologist in the Department of Psychiatry at the University of California San Francisco. Dr Rooney is a researcher and clinician specializing in the evaluation and treatment of ADHD and co-occurring behavioral, anxiety, and mood disorders. A strong advocate for those with attention and behavior problems, Dr. Rooney is committed to developing and providing comprehensive, cutting edge treatments tailored to meet the unique needs of each child and adolescent. Dr. Rooney's clinical interventions and research avenues emphasize working closely with parents and teachers to create supportive, structured home and school environments that enable children and adolescents to reach their full potential. In addition, Dr. Rooney serves as a consultant and ADHD expert to Huntington Learning Centers.
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