Whether your child has a diagnosed behavioural disorder (such as ADHD), or is simply going through a difficult stage, latest research has confirmed that food can be a contributing factor. Dietitian Tracy Morris reports on the three major links between food and behaviour.
Does your child display these behaviours?
Lack of organisation
Anxiety or depression
Unresponsive to others
Difficulty completing tasks
These behaviours can all be a normal part of a child’s development – however, research has shown they may be linked to diet.
1. The basics
We all know that kids need to eat breakfast, eat balanced meals and eat regularly – and research has shown that these three habits can make a big difference to children with behavioural issues.
Several studies have indicated eating breakfast helps children perform better at school. Children are more attentive, less fidgety and recall more information in the classroom when they eat a nutritious breakfast, compared to when they don’t.
Always encourage your kids to eat breakfast. Any breakfast is better than nothing, however, emerging evidence shows that lower-GI foods may be a better choice.
Great breakfast options include
A boiled egg and toast soldiers
Baked beans served on a grainy English muffin
Porridge cooked with apple and served with a dollop of yoghurt
2 weetbix with milk and sliced strawberries
A ready-made breakfast drink (e.g. Sanitarium Up&Go), with a banana
Behavioural, emotional and academic problems have been found to be more prevalent in hungry children, and both aggression and anxiety in children are strongly associated with hunger. Studies have also shown that being hungry reduces a young child’s tolerance to frustration, and can make them more prone to tantrums and behavioural issues.
Ensure your kids are offered three main meals and two snacks each day. They might not eat it all, but a regular supply of healthy foods is important to ensure stable blood glucose levels.
Great kids’ snack options include
Fresh fruit and low-fat yoghurt (e.g. strawberry Yoplait Go-Gurts are great for on the go)
Popcorn (e.g. Real McCoy Air Popped Corn Original)
Veggie sticks with low-fat cream cheese
Carman’s Deluxe Fruit Muesli Bars and Muesli Bites
Cheese (e.g. Bega Natural Cheese Fingers) and wholemeal crackers
2. Food intolerances
Covered the basics, but still suspect that your child’s behavioural issues are diet-related? Research shows that food intolerances could be to blame.
Natural food chemicals
For some children, a food intolerance to naturally occurring food chemicals (salicylates, amines and glutamate) can worsen incidences of bad behaviour or behavioural disorders. When these chemicals are removed from the diets of food-sensitive children, their behaviour may improve significantly.
Parents who suspect certain foods may be triggering behaviour symptoms may need to trial an elimination diet. But this can be an extremely tricky process and should only be attempted with medical supervision.
Natural food chemicals and where to find them
Salicylates are found in most fruit, some vegetables, herbs, spices, tea and flavour additives like mint flavouring.
Amines are found in cheese, chocolate, wines, beer, yeast extracts and fish products, and certain fruits and vegetables.
Glutamate is found in most foods, as it acts as a natural flavour enhancer, and added monosodium glutamate (MSG) is often used in soups, sauces, snack foods and Asian cooking.
For further information, visit the Royal Prince Alfred Hospital Allergy Unit website (www.sswahs.nsw.gov. au/rpa/allergy) to purchase the RPAH Elimination Diet Handbook with food and shopping guide, an easy guide that can be used in conjunction with seeing an Accredited Practising Dietitian. You could also try reading Friendly Food: An Essential Guide to Avoiding Allergies, Additives and Problem Chemicals (Murdoch Books, $29.95) by Drs. Anne Swain, Velencia Soutter and Robert Loblay.
For a small minority of the population, artificial food additives (colours, preservatives and flavour enhancers) can cause adverse reactions, including behavioural issues. A preservative commonly used to prevent bread from going mouldy, called calcium propionate, can cause irritability, restlessness, inattention and sleep disturbances in children prone to food sensitivities.
Additionally, one famous study has also found food colourings (particularly red, yellow and orange), and the preservative sodium benzoate, can cause hyperactivity in some children. While findings did cause some controversy initially, due to inconsistent findings between age groups, a recent 2010 report by the US Center for Science in the Public Interest has also called for artificial colours to be replaced by natural colourings, due to health concerns.
In Australia, these food colourings are still approved for use, and unfortunately, for those affected, foods to avoid include many popular children’s treats, like confectionary, soft drink, cordial, flavoured milk, cakes and biscuits. While removing artificial additives from your child’s diet can be a challenge, there are a few ways to avoid them:
Look for their names or code numbers on food packaging (see ‘Danger additives’ below for a complete list);
Bake your own cakes and biscuits whenever possible;
Choose foods labelled as containing ‘natural colours’ made from fruit, vegetables and spices like beetroot, carrot, paprika and turmeric; and
Try our additive-free alternatives to more traditional ‘birthday party’ fare (right).
Recommended additive-free choices
Bakers Delight’s traditional and continental ranges are free from preservatives
The Natural Confectionery Co. lollies are free from artificial colours and flavours
The Natural Beverage Co. Apple Naturally Flavoured Soft Drink is free from artificial colours, flavours and preservatives
Whole Kids Organic Popcorn is free from artificial colours, flavours and preservatives
Hart & Soul Natural Lemon Squash Cordial – free from artificial colours, flavours and preservatives
Hullabaloo Food – a range of foods free from artificial colours, flavours and preservatives, available online at www.hullabaloofood.com
Look for these names and/or numbers in the ingredient lists on food product packaging.
Glutamates including MSG
627, 631, 635
Hydrolysed Vegetable Protein
Textured Vegetable Protein
3. Nutrition deficiencies
While balanced, regular meals can help alleviate some behavioural issues, and removing foods that your child is sensitive to can also make a difference, studies have shown that boosting levels of particular minerals and nutrients may, for some children, be essential for improving behaviour.
Vital micronutrients – iron and zinc
Iron and zinc deficiencies have both been implicated in children’s behaviour. Under two years of age, a period of rapid brain development, iron deficiency appears the most serious and can result in longterm problems with attention and mood. Emerging research also shows that many children with ADHD have lower levels of zinc in their blood, compared to healthy children. Improving zinc levels in children with ADHD has been shown to reduce symptoms of hyperactivity, impulsivity and impaired socialisation.
If you are concerned, get your child’s iron and zinc blood levels tested. Low levels can be improved by including rich sources of both minerals in your child’s diet. Supplementation should only take place under the guidance of a health professional, as iron and zinc are toxic in large doses.
Sources of iron and zinc include
Iron-fortified rice cereal with puréed fruit (from six months of age onwards)
Iron-fortified breakfast cereal (e.g. Weet-bix Kids) with fruit
Baked beans on soy & linseed bread
Green vegetables – seaweed (try baby sushi), peas or spinach
Dairy foods – cheese, yoghurt (source of zinc only, not iron)
Milo or Ovaltine for older children
Essential fats – omega-3s
Low levels of omega-3 fats have been found in kids with ADHD and autism. In these children, studies have shown improvements in disruptive behaviours, such as inattention, hyperactivity and impulsivity, following omega-3 supplementation. Even in ‘healthy’ children, increasing omega-3 intake appears to improve concentration and enhance the function of brain regions involved in attention.
The National Heart Foundation of Australia recommends children consume about 500mg per day of combined long-chain omega-3s (DHA and EPA). This can be achieved through a combination of the following:
Two to three serves of oily fish per week (e.g. salmon or mackerel)
Food and drink enriched with marine omega-3s
F ish oil capsules or liquids (aim for a maximum of 500mg/day of DHA and EPA)
Sources of omega-3 include
Best source: oily fish (e.g. Atlantic salmon or canned pink/red salmon)
Excellent source: white fish, other seafood and omega-3-enriched eggs (e.g. Farm Pride Omega-3 enriched eggs)
Good source: tuna snacks (e.g. John West Kids tuna), frozen fish fillets and omega-3-enriched yoghurt (e.g. Vaalia Kids yoghurt pouches)
Source: regular eggs, lean red meat or other omega-3-enriched foods (e.g. Tip Top Up bread and Vaalia for toddlers)
Food and autism
Diet can’t ‘cure’ autism, but unpublished research from the University of Sydney and the Royal Prince Alfred Hospital Allergy Unit has shown a clear link between the two. When researchers removed certain foods and food additives from children’s diets, their ‘inner feelings of irritability’ vanished, according to participant and parent responses. Other dietary and complementary therapies include:
Gluten and casein-free diet: Anecdotally, there is some support for a diet that eliminates gluten and casein (a protein found in dairy products), however, this remains controversial. But, new Danish research has found significant improvements in autistic behaviours in some kids following the diet. Diet-sensitive autistic children, who show improvement on a gluten and/or casein-free diet, often react to artificial additives, too. As this diet can be highly restrictive, and may only be beneficial to kids who have an intolerance to gluten and casein, parents should only introduce this diet with the help of an Accredited Practising Dietitian.
Vitamin and mineral supplements: Vitamins and minerals thought to improve autistic behaviour include vitamin B6, vitamin C and magnesium. However, at this stage there is not enough scientific proof to justify supplementation for children with autism. Take caution as high doses of vitamin B6 can be dangerous.
The link to ADHD
Diet doesn’t actually cause ADHD, but research has shown that the three major factors we’ve discussed on the previous pages can all trigger, or worsen, symptoms. In addition to this, research has shown that:
Following the ‘Feingold’ diet may help reduce the symptoms of ADHD in children who also have food intolerances. The Feingold diet involves eliminating nearly all processed foods, as well as fruit and vegetables high in salicylates (see ‘Food intolerances’ for more information, p32). It’s important that you speak to a qualified professional (such as a dietitian specialising in food intolerances) before you try this however, as it may be a relatively drastic change to your child’s diet, and involves avoiding a large proportion of common fruits and vegetables. To find a dietitian in your area, go to www.daa.asn.au.
A lack of omega-3s has been linked to ADHD, with research now suggesting that sufferers may have an impaired ability to metabolise omega-3s. Taking omega-3 supplements however, has been shown to help improve symptoms.
Many children with ADHD appear to have lower than normal levels of zinc, so zinc supplementation may be particularly useful. It’s also been suggested that zinc deficiency may occur as a result of ingesting certain artificial food colours, so avoiding these may be of benefit, even if your child doesn’t appear to have an intolerance to artificial food colours
Despite anecdotal success, herbal supplements (such as Gingko biloba and American Ginseng) may not be beneficial in treating ADHD, with research, so far, being inconclusive. Moreover, caution should be taken when it comes to herbal supplements, as they may worsen ADHD symptoms due to their salicylate content. See ‘Food intolerances’ above for more information on salicyclates.
What about sugar?
While many parents blame sugar for an excitable and hyperactive child, several welldesigned studies have failed to prove the link. It seems more likely that the culprits are the artificial colours, flavours and preservatives packed into the sugary foods.
All children, including those with ADHD and autism, should aim to eat a balanced diet, based on minimally processed whole foods and packaged foods with a short ingredient list. If your child appears to have behavioural difficulties, research shows that altering their diet may help – but it’s important to seek help from an Accredited Practising Dietitian, to investigate possible food-related causes. It’s also worth noting that behavioural issues can stem from a variety of non-diet-related factors, so it’s a very good idea to seek assistance from a qualified health professional, such as a child psychiatrist, before doing anything else, if you’re concerned about your child’s behaviour.