Bee Healthy: ADHD – managing the whole child

ADHD, or attention deficit hyperactivity disorder, is a commonly diagnosed problem among school-age children. There are several types of this disorder, ranging from the distracted, inattentive but calm child to the hyperactive and severely impulsive one, or a combination of the two. Many children with ADHD also suffer from other emotional issues, such as poor self-esteem, depression and anxiety.

It is estimated that 10percent of children ages 4 to 17 have some form of ADHD, and it is generally thought that boys are more often affected than girls. The number of children being diagnosed with ADHD has risen steadily in the past 20 years, and it is not clear if there are actually more cases, or simply that we are better at recognizing them.

Most experts agree that ADHD can be hereditary, yet there are many environmental factors that contribute to the child’s functioning. We know that babies born prematurely will have a greater risk of developing inattention and/or hyperactivity. Scientists also are finding that factors during a woman’s pregnancy, such as infections or poor nutrition, may lead to increased risk of ADHD in their child.

In pediatric practices, we see many children who may or may not have ADHD but whose behaviors are worsened by environmental factors. When children are being evaluated for ADHD, the parent and physician should consider the whole child in order to have the best possible outcome.

When considering the whole child, we need to look at diet, sleep patterns, medical history, family history and lifestyle. For example, children who are snoring at night may have allergies or enlarged adenoids leading to sleep apnea, and may be distracted or hyperactive during the daytime simply because they are overtired chronically and are having their oxygen dip repeatedly during the night, which affects their brain and attention.

Other children are staying up late at night and are not getting the 10 hours of sleep they need to function properly in school. Still others are spending many hours each week watching TV or playing video games, both of which have been shown to cause inattention even in a normal child.

Children who eat breakfast at school are unfortunately often given sweet and starchy foods such as cereal, juice, muffins and chocolate milk, when we have good evidence that sugar actually creates inattention. Children who eat a breakfast with protein and healthy fats, such as egg, cheese or nut butters, and no simple sugars, stand a much better chance of paying attention in school.

The remainder of their meals are also important, and many are getting far too much sugar in the form of Gatorade, soda, juice or simple starches such as fast food and processed snacks.

Likewise, finding out how much exercise and outdoor time a child gets is very important, as lack of exercise increases anxiety and depression, and we also know that increased time outdoors improves ADHD symptoms. Children who spend all day in school will also not get enough Vitamin D unless they are taking a vitamin supplement, as it is available only from the sun and from a few fortified foods. The lack of appropriate vitamins and nutrition makes all of the symptoms of ADHD far worse.

If you are concerned about ADHD in a child, please evaluate, with your physician’s help, the child’s lifestyle, sleep, diet and health before considering having that child take medication for ADHD. Medication can be extremely helpful, but may also cause undesirable side effects.

Our brains are only as effective as our bodies allow them to be. Good health and healthy living should always be our primary objective, and often can correct or improve emotional and attentional issues in children.

This story was originally published November 29, 2014 at 4:00 AM with the headline "Bee Healthy: ADHD – managing the whole child."