Can Keto Improve ADHD?
When you’re easily distracted and your mind is fluttering here, there, and everywhere, it can be challenging to get through the day-to-day. You might wish you could feel more rested and focused. Dealing with ADHD or having a child or loved one with ADHD presents plenty of challenges, and many who face these hurdles are looking for ways to improve ADHD symptoms.
Because the ketogenic diet is beneficial for a range of neurodevelopmental and neurological conditions, from Alzheimer’s and Parkinson’s to epilepsy, it’s fair to wonder if this way of eating could also be advantageous for ADHD. So, what does the science tell us about whether a ketogenic diet can improve ADHD?
What Is ADHD?
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with identifying traits, including:
- Difficulty paying attention
- Hyperactivity
- Behavioral problems
- Difficulty regulating impulses and emotions
- Trouble staying focused
- Fidgeting, especially while seated
- Inability to remain quiet
- Trouble listening and following directions
- Poor time management
- Impatience
The disorder affects adults and children and commonly shows up before age twelve.
What Causes ADHD?
The exact cause of ADHD isn’t clear despite being among the most commonly studied and diagnosed mental disorders affecting young people. Complex environmental and genetic factors are at play. You’re two-to-eight times more likely to be diagnosed with ADHD if you have a family member or parent with the condition. [1] [2]
Studies have revealed differences in neurotransmitter levels or brain structure when comparing those with and without ADHD.
However, these psychiatric disorders are diagnosed using a questionnaire to uncover symptoms rather than blood tests or brain scans. [3]
Some of the identified risk factors for developing ADHD symptoms include:
- Exposure to toxins, such as lead and other heavy metals
- Nutritional deficiencies, such as copper, iron, magnesium, or zinc
- Psychological or physical childhood trauma
- Epilepsy
- Smoking during pregnancy [4] [5] [6]
Some researchers believe chemical, physical, or biological threats during development cause metabolic changes and imbalances in neurotransmitters, namely dopamine. Inflammation and autoimmune processes may also be involved.
Excessive amounts of junk food, video games, and television have also been examined as possible exacerbators of the condition. [7] [8]
What Diet Is Recommended for ADHD?
Research into ADHD treatment is largely centered around pharmaceutical medication rather than nutrition and diet; however, substantial evidence shows the food you eat affects both ADHD risk and symptom severity.
Mineral Deficiencies
Studies show deficiencies in omega-3 fatty acids and minerals occur more often in those with ADHD.
Insulin Resistance and Sugar
Studies indicate that obese or overweight children are more likely to develop ADHD. Symptom severity seems to correlate with body mass index (BMI). [9]
Sugary foods don’t just increase the waistline; they also boost your risk of ADHD by causing dopamine imbalances. On a ketogenic diet, you’re only allowed up to 50 grams of net carbs or fewer daily, which greatly reduces (or eliminates) the amount of sugar you’re able to consume. [10]
Children with ADHD may have insulin resistance. Some kids have fewer symptoms when consuming lower glycemic index (GI) foods, which are mainstays on a ketogenic diet.
Artificial Foods and Additives
Avoiding or limiting artificial food additives, processed foods, dyes, and preservatives could also be helpful for ADHD, according to research.
Food Allergies
Food allergies to gluten and the casein protein in dairy may trigger flares for some people. A randomized controlled trial in The Lancet concluded that a strict elimination diet reduced symptoms in the majority of children with ADHD. [11]
Gut Bacteria (Microbiome)
People with ADHD could have different gut bacteria compared to those without the disorder. [12]
Can a Ketogenic Diet Improve ADHD?
Scientific studies on keto and ADHD are still relatively few, though promising. However, you can find plenty of anecdotal evidence and inspiring stories online and around town that support the idea that a ketogenic diet is useful in improving ADHD symptoms.
ADHD often occurs alongside other neurodevelopmental disorders, such as OCD and Tourette’s. Countless parents have reported their child’s Tourette’s, OCD, ADHD, and other coexisting conditions improved following a ketogenic diet. Children frequently lose unwanted weight and gain focus going keto!
Some families had spent thousands of dollars on everything from medications and behavior therapy to homeopathy with little or no results before they stumbled across the ketogenic diet. Giving up potatoes, flour, rice, grains, as well as sugary juices, cakes, and cereal was life-changing for these families.
Given the connections researchers have found between diet and ADHD symptoms, it’s easy to see how a ketogenic diet could be useful for ADHD. Still, larger and longer-term studies would be necessary to draw clear conclusions.
When studying how a ketogenic diet improves epilepsy, scientists also unveiled the following mechanisms that are potentially relevant to other neurological conditions, including ADHD:
Ketones Are Brain Fuel
Ketones give your brain an alternative fuel to its usual fuel of glucose.
Ketones Improve Brain Function and Cell Communication
Ketogenic diets may protect the brain and improve how cells function and communicate in the nervous system (calming overactive brain cells).
Ketogenic Diets Lower Inflammation
A ketogenic diet lowers inflammation, which is a risk factor for seizures as well as a surprising range of chronic diseases.
Epigenetic Impact
The ketogenic diet has an epigenetic impact that may impede the expression of some genes that are linked to neurologic problems.
Improving the Microbiome
Following a ketogenic diet has been shown to improve the microbiome (bacteria and microorganisms) in the digestive system, which could lead to better communication between the gut and the brain in those with neurological disorders such as ADHD and epilepsy.
Balancing Neurotransmitters
Neurotransmitters are signaling molecules that allow your nervous system to work properly. Neurotransmitter imbalances occur in anxiety, epilepsy, depression, ADHD, and other conditions. One cohort of researchers believes alterations in dopamine function are responsible for ADHD. Dopamine is involved with motivation, reward, and focus, and many ADHD medications work by mimicking dopamine or increasing dopamine levels.
Going low-carb also leaves sugar in the past, which helps balance dopamine. [13] Animal studies conclude that a ketogenic diet could protect neurons that produce dopamine and boost dopamine activity. [14]
An imbalance of the neurotransmitter GABA is another possible contributor to ADHD. A ketogenic diet has been proven to improve the synthesis and regulation of GABA, which could be beneficial for ADHD and epilepsy. The differences in the microbiome of those with ADHD may be causing or worsening the imbalances in GABA and dopamine. [15]
An abundance of anecdotal evidence along with promising but limited research indicates that a ketogenic diet could positively affect ADHD. You won’t know if you or your child will respond positively to the low-carb lifestyle until you try. Make sure your ketogenic diet is balanced and nutrient-dense to avoid deficiencies. Keep in mind it’s always best to visit a qualified nutritionist, doctor, or healthcare provider to address concerns and discuss treatments surrounding your or your loved one’s ADHD.
References
Rader, R., Mccauley, L., Callen, E. C. (2009). Current strategies in the diagnosis and treatment of childhood attention-deficit/hyperactivity disorder. Ann Fam Physician, Current strategies in the diagnosis and treatment of childhood attention-deficit/hyperactivity disorder - PubMed (nih.gov)
Thapar, A., Cooper, M., Jefferies, R., & Stergiakouli, E. (2012). What causes attention deficit hyperactivity disorder? Arch Dis Child, DOI: 10.1136/archdischild-2011-300482
Gehricke, J-G., Kruggel, F., Thampipop, T., Dyan, S., Tatos, E., Fallon, J., & Muftuler, L. T. (2017). The brain anatomy of attention-deficit/hyperactivity disorder in young adults – a magnetic resonance imaging study. PLoS One, DOI: 10.1371/journal.pone.0175433
Banerjee, T. D., Middleton, F., & Faraone, S. V. (2007). Environmental risk factors for attention-deficit hyperactivity disorder. Acta Paediatr, DOI: 10.1111/j.1651-2227.2007.00430.x
Villagomez, A., & Ramtekkar, U. (2014). Iron, magnesium, vitamin D, and zinc deficiencies in children presenting with symptoms of attention-deficit/hyperactivity disorder. Children (Basel), DOI: 10.3390/children1030261
Vrijsen, J. N., Tendolkar, I., Onnink, M., Hoogman, M., Schene, A. H…Franke, B. (2017). ADHD symptoms in healthy adults are associated with stressful life events and negative memory bias. Atten Defic Hyperact Disorder, DOI: 10.1007/s12402-017-0241-x
Naviaux, R. K. (2014). Metabolic features of the cell danger response. Mitochondrion, DOI: 10.1016/j.mito.2013.08.006
Johnson, R. J., Gold, M. S., Johnson, D. R., Ishimoto, T., Lanaspa, M. A…Avena, N. M. (2011). Attention-deficit/hyperactivity disorder: Is it time to reappraise the role of sugar consumption? Postgrad Med, DOI: 10.3810/pgm.2011.09.2458
Altfas, J. R. (2002). Prevalence of attention deficit/hyperactivity disorder among adults in obesity treatment. BMC Psychiatry, DOI: 10.1186/1471-244x-2-9
Del-Ponte, B., Anselmi, L., Assuncao, M. C. F., Tovo-Rodrigues, L., Munhoz, T. N…Santos, I. S. (2019). Sugar consumption and attention-deficit/hyperactivity disorder (ADHD): A birth cohort study. J Affect Disord, DOI: 10.1016/j.jad.2018.09.051
Pelsser, L. M., Frankena, K., Toorman, J., Savelkoul, H., Dubois, A. E., & Pereira, R. R. (2011). Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): A randomized controlled trial. The Lancet, DOI:https://doi.org/10.1016/S0140-6736(10)62227-1
Ly, V., Bottelier, M., Hoekstra, P. J., Vasquez, A. A., Buitelaar, J. K., & Rommelse, N. N. (2017). Elimination diets’ efficacy and mechanisms in attention deficit hyperactivity disorder and autism spectrum disorder. Eur Child Adolesc Psychiatry, DOI: 10.1007/s00787-017-0959-1
Kim, Y. S., & Yoon, B-E. (2017). Altered GABAergic signaling in brain disease at various stages of life. Exp Neurobiol, DOI: 10.5607/en.2017.26.3.122
Church, W. H., Adams, R. E., & Wyss, L. S. (2014). Ketogenic diet alters dopaminergic activity in the mouse cortex. Neurosci Lett, DOI: 10.1016/j.neulet.2014.04.016
Bough, K. J., & Rho, J. M. (2007). Anticonvulsant mechanisms of the ketogenic diet. Epilepsia, DOI: 10.1111/j.1528-1167.2007.00915.x
