Children and adolescents with avoidant restrictive food intake disorder (ARFID) are more likely to have comorbid neurodevelopmental and psychiatric disorders like autism, ADHD, and anxiety, according to a new study¹ published in The Journal of Child Psychology and Psychiatry.

Among the 30,795 children included in the large-scale study, those with ARFID (n=616) were 14 times more likely to have autism and nine times more likely to have ADHD than were children without ARFID. They also demonstrated an increased risk for OCD, separation anxiety, generalized anxiety disorder (GAD), depression, learning disorders, conduct disorder, and more.

These results stand out amid the relatively scarce research data on ARFID, an eating disorder added to the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5) in 2013.

“This study is one of the few large-scale epidemiological investigations of ARFID comorbidities in a general population sample,” the researchers wrote. “The findings emphasize the importance of incorporating routine screening for neurodevelopmental disorders, anxiety, and depression into ARFID assessments.”

Individuals with ARFID avoid foods based on sensory characteristics, a lack of interest in eating, and/or fear-related concerns over adverse eating experiences — not due to the body image concerns that compel other eating disorders like anorexia nervosa. ARFID is characterized by a “failure to meet appropriate nutritional and/or energy needs.”

Despite affecting 1-2% of children and adolescents², ARFID is often excluded from eating disorder discourse and clinical examinations. ARFID’s high comorbidity can complicate symptom identification, according to researchers.

“It’s important to really think about those with ADHD being at risk for a variety of eating disorder thoughts and behaviors, not just binge eating,” said Christine Peat, Ph.D., in a 2024 ADDitude webinar, “Eating Disorders Comorbid with ADHD: What You Need to Know About ARFID, Anorexia, and Others.” “In clinical contexts, ARFID and atypical anorexia nervosa may be overlooked, even in very routine eating disorder screenings.”

The study’s results emphasize the importance of identifying ARFID, the diagnosis of which may shed light on comorbidities.

“Early identification of these comorbidities can facilitate timely, targeted interventions and improve treatment outcomes,” the researchers wrote.

One ADDitude reader, Tiffany Bird, suffered decades of poor health before being diagnosed with ARFID in her late 20s. “For the first time, a doctor fully examined me and determined that I’ve been severely malnourished my entire life, no matter what ‘the numbers’ might have said. It made complete sense,” wrote Bird in an ADDitude guest blog post, “I went Over 25 Years Without Consuming a Vegetable.”

ARFID and Neurodevelopment Disorders

The study examined parent reports for 30,795 children born between 1992 and 2008, at 9 or 12 years old (depending on their cohort), from the Child and Adolescent Twin Study in Sweden. The parents rated their child using three measures of neurodevelopmental and psychiatric disorders: the A-TAC inventory, the Screen for Child Anxiety Related Emotional Disorders (SCARED), and the Short Mood and Feelings Questionnaire (SMFQ). The researchers examined the relationship between having ARFID and showing symptoms of other disorders using linear and logistic regressions.

The link between ADHD and ARFID found in the study reflects preliminary research in this area. According to Peat, one study found that 25% of adults with ARFID also had ADHD, and another reported that 10% of children and adolescents with ARFID had been diagnosed with ADHD at some point in their lives.

“We are so far from having causal explanations for this overlap,” Peat said. “But maybe kids and adults with ADHD are just sort of more biologically predisposed to have difficulty with sensory characteristics with food, so maybe that makes them more vulnerable to going on to develop something like ARFID.”

The study’s results regarding autism and ARFID also mirror prior research. One meta-analysis reported that autism was present in 16% of individuals with ARFID³.

People with ARFID are more likely to have autism than those without, and vice versa, possibly due to heightened sensory issues and inflexibility due to anxiety around change, both symptoms of autism, according to an article in ARFID Awareness UK.

ARFID and Psychiatric Disorders

According to the study, children with ARFID were four to six times more likely to have a psychiatric disorder, with OCD and anxiety presenting the greatest risks.

The most common type of anxiety found in the study was separation anxiety, which contrasts previous research that found GAD to be more common. This could be because of the younger age of onset characteristic of separation anxiety or younger age of the sample, the researchers wrote. However, they also hypothesize another reason their results differed.

“One hypothesis worth exploring is that separation anxiety is increased in ARFID because children fear separation from caregivers due to the potential for unanticipated exposure to feared foods or feeding-related situations,” the researchers wrote.

The study also found a higher rate of oppositional defiant disorder (ODD) (19.4%) than reported in previous studies, suggesting a possible overlap of symptoms between the two disorders.

“Our findings suggest that food-related conflicts may underlie the observed risk of ODD in ARFID, but further research is needed to confirm this association,” the researchers wrote.

Children with ARFID were found to face a higher risk for anxiety than depression. Depression is common among children with other eating disorders, according to the researchers. This discrepancy in comorbidities highlights the differences between ARFID and other eating disorders.

“The defining feature [of ARFID] is a persistent and pervasive eating or feeding disturbance in which someone is simply not meeting all of their nutritional needs,” Peat said. “In ARFID, these people don’t necessarily have that fear of fat or fear of weight gain.”

Gender and ARFID

Prior research may suggest that ARFID is more common in young males. However, this study found no gender-based differences in comorbidity rates associated with ARFID, meaning that the likelihood of having symptoms of another disorder in conjunction with ARFID did not significantly differ based on sex.

The results did indicate that, overall, boys had higher odds of developing a neurodevelopmental disorder, depression, and sleep problems; girls had higher rates of anxiety disorders (except for panic disorder).

“Unlike other eating disorders, the distribution of males and females with ARFID has been reported to be approximately equal,” the researchers wrote. “Given the sex differences observed in the prevalence of (neurodevelopmental disorders) and psychiatric conditions, it is important to investigate whether these sex differences are also present in individuals with ARFID.”

The study’s sample did not include transgender and nonbinary youth, a major limitation considering that transgender, nonbinary, and gender-expansive kids are at higher risk for eating disorders compared with their cisgender peers.

“There remains an urgent need to develop integrated treatment approaches that address both ARFID and its co-occurring conditions,” the researchers wrote.

Sources

¹ Nyholmer, M., Wronski, M.-L., Hog, L., Kuja-Halkola, R., Lichtenstein, P., Lundström, S., Larsson, H., Taylor, M.J., Bulik, C.M. and Dinkler, L. (2025), Neurodevelopmental and psychiatric conditions in 600 Swedish children with the avoidant/restrictive food intake disorder phenotype. J Child Psychol Psychiatr. https://doi.org/10.1111/jcpp.14134

² D’Adamo, L., Smolar, L., Balantekin, K.N., Taylor, C.B., Wilfley, D.E., & Fitzsimmons-Craft, E.E. (2023). Prevalence, characteristics, and correlates of probable avoidant/restrictive food intake disorder among adult respondents to the National Eating Disorders Association online screen: A cross-sectional study. Journal of Eating Disorders, 11, 214. https://doi.org/10.1186/s40337-023-00939-0

³ Sader M, Weston A, Buchan K, Kerr-Gaffney J, Gillespie-Smith K, Sharpe H, Duffy F. (2025) The Co-Occurrence of Autism and Avoidant/Restrictive Food Intake Disorder (ARFID): A Prevalence-Based Meta-Analysis. Int J Eat Disord. 58(3):473-488. https://doi.org/10.1002/eat.24369

Teens may succumb to the temptation of cannabis because it promises to alleviate anxiety and stress, and to quiet racing brains quickly. However, cannabis can negatively affect ADHD brains by slowing the brain’s signaling processes, affecting motivation and memory.

Still, teenagers may deny that their cannabis use is a problem or even dangerous, leaving their parents exasperated and worried.

“Parents should work deliberately not to shame their child and instead focus on understanding their child’s experience on cannabis,” wrote Roberto Olivardia, Ph.D., in the ADDitude article “The Damaging Effects of Cannabis on the ADHD Brain.” “They should also set boundaries and consequences for substance use to remind their child it is not acceptable.”

We asked 198 ADDitude caregivers whether they are concerned about their teen or tween possibly or habitually using cannabis and how marijuana use impacts their child’s ADHD symptoms.  Many parents expressed apprehension about the long-term effects of cannabis use and shared their strategies for monitoring and managing their child’s usage.

[Read: The ADHD and Addiction Link]

Are you concerned about your ADHD teenager using cannabis? Share your thoughts in the Comments link above.

Teen Cannabis Use Worries Parents

“I am very concerned about my teen son, who has ADHD and smokes cannabis. I don’t want to see him become a ‘stoner’ and lose interest in life’s possibilities.” — Lynne, Australia

“My son first used cannabis at university. He has since stopped but went on to cigarettes and now vapes. My thought is that the cannabis may have initiated the ADHD behavior.” —  Jill, United Kingdom

“My young adult children went through a heavy weed phase as teens, which I could not stop. Thankfully, they have decided to stop by themselves. Weed made things more overwhelming for my daughter with inattentive ADHD. Neither of my children could get anything done.” — Jess, Spain

“I am very concerned. He seems to be very attracted to cannabis use despite knowing it’s illegal and not good for the growing brain. I’m afraid it’s going to become a problem, but I don’t know if I’m being paranoid or a helicopter mom.” — Casey, North Carolina

[Read: Substance Use Disorders and ADHD: 5 Key Facts and Additional Resources]

“The mind racing, the sleep issues, the overall overwhelm of the ADHD mind at times — cannabis use is very concerning.” — Anonymous

“Cannabis has been glorified as a ‘magic’ cure-all, when in reality it exacerbates or hides many ADHD symptoms like anxiety. It does not cure it.” — Anonymous

“We know he’s smoked some already, but I also know that with ADHD comes a lot of anxiety and stress, and cannabis offers quick short-term relief. I worry that it can become a habit, not to mention the effects on his developing brain.” — Anonymous

“It calms their anxiety but lessens their motivation to get things done.” — Sallie, Michigan

Strategies for Navigating Teen Cannabis Use

“We regularly speak about self-medicating and substance abuse in neurodivergent people. I think the worst thing that we can do as parents is not educate our children on the topic.” — Courtney, Tennessee

“I stress that they already use medication and already have a predisposition to a system that is more delicate. They need to be smart and informed about what they put in/on/around their bodies. I stress that I am there to support them and to do their research.” — Amber, Wisconsin

“It can be scary for me. All I can do is teach him healthy ways to cope with issues and hope he makes the right choices when no one’s watching.” — Chery, Colorado

“I know he smokes cannabis regularly. I monitor him closely to help him manage himself and his difficulties in such a way that he’ll not be tempted to use cannabis to escape his problems, but only as an enhancement.” — Inge, Netherlands

“Decision-making skills begin very early by allowing failures. We talk and discuss each failure, keep the communication and respect channels open, spend time together, and keep our children involved in healthy activities of their choice.” — Anonymous

“It’s all about openly discussing the risks and reasons for use, along with offering support so that teens do not turn to drugs to remediate or cover their problems.” — Cynthia, New Jersey

ADHD and Cannabis: Next Steps

• Read: When Your Teen Says Weed Is the Only Thing That “Helps”
• Self-Test: Could You Have a Substance Use Disorder?
• Read: “Will Cannabis Ease My ADHD Symptoms?” ADDitude Readers Weigh In

Sources

¹ 1. Lee, S. et. al. (2011). Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: a meta-analytic review. Clinical psychology review, 31(3), 328–341. https://doi.org/10.1016/j.cpr.2011.01.006

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Conflicting and paltry research on caffeine and ADHD leaves many parents with mixed messages and unclear recommendations. For example, a 2013 study¹ suggesting that caffeine may normalize dopamine and attention levels in people with ADHD, was essentially rendered obsolete by a 2024 study² published in the journal Public Health that associated energy drink consumption with an elevated risk for physical and mental health conditions such as ADHD, depression, anxiety, and suicidal ideation among children and adolescents.

This study also tied energy drink consumption to increased ADHD inattention, conduct disorder, and depressive and panic symptoms. It showed startling rates of suicidal ideation and attempts among those who drank more than one energy drink a day compared to non-drinkers.

Caffeine is not the only reason these drinks may pose concerns for those with ADHD. A recent meta-analysis³ found that sugary beverage consumption was associated with a 25% increase in ADHD symptoms.

[Get This Free Download: A Parent’s Guide to ADHD Medications]

And still other research has suggested that consuming caffeine with another stimulant can be dangerous, exacerbating side effects like heart rate and blood pressure elevation. Still, no formal contradiction warnings exist, and many parents are left wondering, How much caffeine is too much for a teenager with ADHD?

We asked ADDitude readers if they have a teenager who regularly consumes caffeine and, if so, what observations or concerns they have. We received 189 responses. Many shared their strategies for embracing the benefits of caffeine, moderating it, or eliminating it altogether for their teenagers both with and without ADHD.

How do you manage caffeine consumption by your teen? Share your thoughts in the Comments section.

Negative Effects of Caffeine Consumption

“Caffeine gives some spike of energy but then makes her down and interrupts her sleep. Since she does a lot of sports, she knows coffee will distract her routines.” — Inna, Massachusetts

[Read: Your Guide to ADHD Symptoms in Teens]

“Energy drinks are part of his consuming habits. His crash can be quite volatile, however. Since he has anxiety issues, I’m very concerned when he says he feels his heart pounding. I feel it may be a result of these drinks, but he won’t listen to us.” — Anonymous

“It’s a spiral effect that impacts forgetting to eat, poor nutrition, energy surges and crashes, and intestinal issues.” — Anonymous

“With caffeine, the mind becomes overactive, to the point where my child can’t stop to take a breath.” — Stacey, Canada

“Our youngest followed his friends in consuming energy drinks. This was a huge contributor to the nightmare side of ADHD symptomatic behavior.” — Craig, England

“My son drank energy drinks routinely. That’s when he began giving into naps and sleeping late.” — Mindy, Connecticut

Teaching Caffeine Moderation

“I didn’t allow caffeine until age 16. Then, we discussed the consequences of overdoing it, watched some videos, and talked about the healthy use of caffeine.” — Eva, Arizona

“The energy drinks are limited to one, with 150 milligrams of caffeine a day. It has to be consumed before 3 p.m.” — Anonymous

“We treat caffeine as another over-the-counter drug — to be used with great thought. We actually recommend caffeine on days when the prescription stimulants are not taken to make it a bit easier to focus. Stimulant use and caffeine may have a reaction, and that should be considered.” — Amy, Michigan

“I see a high usage of energy drinks among my son and his friends. I regularly discuss this, and see it influences him from time to time to lessen his intake.” — Inge, Netherlands

“Soda is limited to one can a day. An energy drink is okay with friends, but we limit to one.” — Becky, Pennsylvania

“We try hard to limit caffeine — energy drinks is where we draw the line.” — Kathy, New Hampshire

“I know from personal experience that caffeine can exacerbate ADHD symptoms, so I just try to keep a watch on what he drinks. It’s a very fine line between just enough and too much.” — Casey, North Carolina

Eliminating Caffeine Entirely

“We have educated our children on the dangers of mixing caffeine and stimulant medication.” — Donna, California

“I do not allow it. She already has some trouble falling asleep, so she is happy to avoid it.” — Anonymous

“We do not allow caffeine consumption before college because it is habit forming.” — Kaycee, California

“We have been very upset at not being able to give our daughter what other children get every day, and see it is a missed part of her ebbing childhood.” — Larry, Indonesia

“We hide caffeinated sodas in our house because he will drink them. Due to the stimulant he takes for ADHD, we have concerns about the amount of caffeine he consumes and its impact on his behavior, sleep, and activity level. We’ve allowed him to drink carbonated and flavored waters, and non-caffeinated, low-sugar sodas.” — Anonymous

Embracing Caffeine

“He makes homemade coffee drinks. It calms him, he says, and helps him gain energy at the same time.” — Theresa, Minnesota

“My 14-year-old daughter with ADHD is unmediated and has just started drinking cappuccinos. When she has one, I’ve noticed that she becomes quite engaged and focused on her love of drawing.” — Lucy, England

“They use caffeine daily as their only stimulant. I don’t think they could function without it.” — Sallie, Michigan

“Caffeine seems to help him regulate.” — Anonymous

How Much Caffeine Is Too Much For a Teenager: Next Steps

• Free Download: Free Guide to ADHD Brain Food – What to Eat, What to Avoid
• Read: The Truth About Lion’s Mane, Psychedelics & Caffeine
• Read: Why My Kids Drink… (Wait For It)… COFFEE

Sources

¹Pandolfo, P., Machado, N. J., Köfalvi, A., Takahashi, R. N., & Cunha, R. A. (2013). Caffeine regulates frontocorticostriatal dopamine transporter density and improves attention and cognitive deficits in an animal model of attention deficit hyperactivity disorder. European Neuropsychopharmacology, 23(4). https://doi.org/10.1016/j.euroneuro.2012.04.011

²Ajibo, C., Van Griethuysen, A., Visram, S., & Lake, A. A. (2024). Consumption of energy drinks by children and young people: A systematic review examining evidence of physical effects and consumer attitudes. Public Health, 227, 274–281. https://doi.org/10.1016/j.puhe.2023.08.024

³Khazdouz, M., Reza Safarzadeh, Bahram Hejrani, Hasani, M., Fatemeh Sadat Mahdavi, Hanieh-Sadat Ejtahed, & Mostafa Qorbani. (2024). The association between junk foods consumption and attention deficit hyperactivity disorder in children and adolescents: a systematic review and meta-analysis of observational studies. European Child & Adolescent Psychiatry. https://https://doi.org/10.1007/s00787-024-02521-8

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Caffeine may be the world’s most common stimulant, almost universally seen as nature’s antidote to memory, fatigue, and focus problems. But caffeine’s common side effects, including higher heart rate, irritability and sleep problems, may outweigh the benefits for adolescents and adults with ADHD. What should adults with ADHD, and caregivers of children and teens with ADHD, know as they weigh caffeine’s role in improving certain symptoms?

In this webinar, you will learn:

• About the neurobiology of the ADHD brain and why caffeine may be considered by some scientists as a supplemental therapy
• What the latest studies say about caffeine, ADHD, and cognitive enhancement
• How caffeine affects memory, focus, and other ADHD symptoms
• About the risks and benefits of consuming caffeine, including its impact on sleep, a known problem for people with ADHD
• Whether caffeine should be used with stimulant medications or in place of stimulants
• How caffeine and exercise can work together to address ADHD symptoms

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

Download or Stream the Podcast Audio

Click the play button below to listen to this episode directly in your browser, click the symbol to download to listen later, or open in your podcasts app: Apple Podcasts; Audacy; Spotify; Amazon Music; iHeartRADIO

Additional Resources

• Read: 10 Supplements and Vitamins for Brain Health
• Read: The Truth About Lion’s Mane, Psychedelics & Caffeine
• Read: The Truth About Caffeine and ADHD

Obtain a Certificate of Attendance

If you attended the live webinar on February 19, 2025, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Dr. Cheyette graduated cum laude in Cognitive Neuroscience from Princeton University and received her medical degree from the UCLA David Geffen School of Medicine. Following specialty training in pediatrics at Cedars-Sinai Medical Center in Los Angeles and in pediatric neurology at Seattle Children’s Hospital, she is now in private practice.

Webinar Sponsor

The sponsor of this webinar is

Accentrate® delivers personalized Brain Ready Nutrition designed to support focus, emotional balance, and overall brain health through a combination of omega-3s, vitamins, and minerals. Featuring LYSOVETA® LPC, Accentrate® Omega products offer 6x higher absorption than traditional fish oil, ensuring faster, longer-lasting benefits to help you perform at your best every day. | fenixhealthscience.com

Follow ADDitude’s full ADHD Experts Podcast in your podcasts app:
Apple Podcasts | Spotify | Google Play | Amazon Music | RadioPublic | Pocket Casts | iHeartRADIO | Audacy

Children with ADHD are more likely to be obese, despite lower-than-average birth weights, according to a new study that found a correlation between elevated ADHD symptoms and higher body mass index (BMI) scores for both females and males. ¹The study, published in the Journal of the American Academy of Child & Adolescent Psychiatry, complements additional research tying ADHD impulsivity to unhealthy food consumption and overeating.

In analyzing data from the Millennium Cohort Study (MCS) of more than 19,000 families with children born between 2000 and 2002, researchers found that children with ADHD had significantly lower birth weights than did children in the control group. Both groups maintained similar obesity rates until age 5, when the ADHD group experienced a rise in obesity that continued throughout adolescence.

“As children with ADHD are typically lighter in weight at birth than children without ADHD, the results suggest there may be a sensitive time period between the ages of 3 and 5 years during which this association reverses, and higher ADHD symptoms become associated with obesity,” the researchers wrote.

Researchers collected data when the 442 ADHD cohort members reached 9 months and 3, 5, 7, 11, 14, and 17 years. (The study excluded cohort members taking ADHD medications.) They found that weight gain began earlier for girls with ADHD (age 7) compared to boys with ADHD (age 11). “The weight changes in girls additionally seemed to be more long-lasting, whereas the observed changes in boys seemed to be transitory,” the researchers wrote. It is unclear whether these associations continue into adulthood.

Further analysis revealed that elevated ADHD symptoms in females at ages 7, 11, and 14 predicted higher body mass index (BMI) scores at ages 11, 14, and 17, respectively. The same association occurred in males at ages 11 and 14. These results suggest that ADHD symptoms are not entirely responsible for the uptick in weight children experience between the ages of 3 and 5 years.

Genetics, Prenatal Factors Impact BMI

Hormones and puberty contribute to weight gain. “Sometimes pre-teens can gain weight as the body prepares for a growth spurt in height,” says Roberto Olivardia, Ph.D., clinical psychologist at Harvard Medical School. “Therefore, BMI normalizes as they gain height.”

Prenatal factors, including the mother’s pre-pregnancy BMI, prenatal blood pressure, smoking during pregnancy, and poor nutrition, predicted a higher BMI at 5 years. Genetics may also increase the risk of obesity.

“It is possible that there is a common genetic background to both ADHD and [being] overweight or, as parents with ADHD are more likely to have children with ADHD, this may have an impact on executive function skills involved in parenting, such as planning healthy meals, which in turn may influence weight status,” the researchers wrote. “Parents with an increased genetic risk may be influencing their child’s home environment in ways that compound inherited risk.” ², ³

Impulsivity Linked to Poor Dietary Decisions

Another recent observational study found a strong link between impulsivity, a common ADHD trait, and unhealthy food consumption and overeating, specifically in the form of snacking. ⁴

The study, published in the Journal of Attention Disorders, analyzed data from the KOALA Birth Cohort Study of 810 adolescents aged 16 to 20 years. The researchers identified five dietary patterns

• Snack — high intakes of regular (non-diet) soft drinks, fruit juice/drinks, fried snacks, chips, nuts or snacks, and energy drinks
• Healthy — high intakes of lettuce, raw vegetables, fruit, eggs, and tea
• Animal-based — high intakes of animal dairy products, meat and chicken, and fish
• Sweet — high intakes of pastry, chocolate bars, candy bars, cake or biscuits, and sweets
• Beverage — high intakes of diet soft drinks, light fruit juice/drinks, sports drinks, and energy drinks

Among the five dietary patterns, adolescents with an ADHD diagnosis scored higher on the Snacking dietary pattern than did those without ADHD. Higher Snack scores were associated with difficulties with cognition, inattention, and impulsiveness. Impulsivity was inversely related to Sweet dietary patterns and positively related to Beverage dietary patterns.

Interestingly, adolescents with ADHD appeared no less likely than their neurotypical peers to engage in Healthy dietary patterns. “The lack of a reverse association between ADHD symptoms, especially impulsivity, and the healthy pattern is unexpected and raises questions,” the researchers wrote.

Though the study does not prove causality, the findings suggest that eating habits may differ based on the specific ADHD symptoms each individual experiences.

“When studying how ADHD impacts an adolescent’s diet, looking beyond a simple diagnosis and considering the specific dimensions of their ADHD symptoms, like inattention, hyperactivity, and impulsivity, provides a more nuanced understanding of their dietary behaviors, as these individual dimensions can differentially influence food choices and eating patterns, even among individuals with the same ADHD diagnosis,” the researchers wrote.

Both ADHD and high BMI are associated with poor health outcomes, including asthma, diabetes, and cardiovascular disorders, so it’s vital that children understand the potential consequences of their dietary decisions. ⁵,⁶

Adolescents have more independent access to food, which can also result in unhealthy choices when impulsivity collides with puberty. “Parents have less control over what teenagers eat since they are not always with them,” Olivardia says, “and this most likely plays a bigger role in weight gain.”

Preventing Childhood Obesity

Educating children about their food choices can help curb unhealthy food cravings. For example, instead of banishing carbs from your kitchen, Olivardia says, explain them in a way children can understand. “Say, ‘Simple carbs, like potato chips, taste good, but basically break down in the body as sugar. There is no nutritional value in simple carbs, and they get in the way of healthy weight, high energy, and other things that matter, like your complexion.’”

Caregivers can help children and adolescents make better dietary decisions by incorporating the following strategies:

• Set up a “food environment” that promotes healthy eating. Children with ADHD may not notice they’re hungry until they’re starving. To fend off unhealthy pantry raids, stock up on nutritious, easy-to-grab meals and snacks that require little preparation, such as peanut butter crackers, yogurt, or string cheese. Display healthy snacks and fruits in plain view in the refrigerator or pantry.
• Practice good sleep hygiene. In addition to regulating hormone levels, a good night’s sleep makes it less likely that children will turn to food for comfort in fragile moments.
• Set healthy eating rules. Create family eating rules that encourage children to eat attentively — for example, no eating while watching T.V. or eating straight out of the bag. Consider requiring children to eat only in the kitchen or dining area.
• Teach children mindful eating skills. Children are less likely to overeat when they practice mindful eating. Teach children to put down their fork in between bites. Or ask them to describe what they’re eating as though the person listening has never tasted that food.
• Set a good example. Children learn by watching others, especially their parents. Set a good example by making smart food choices, dishing appropriate portions, and not distractedly eating while engaging in another activity (like using your phone).
• Treat ADHD. Make sure children adhere to their ADHD treatment plan. ADHD stimulant medications help children better observe and regulate their behaviors and avoid impulsive eating. They also make it easier to follow through with healthy eating and exercise plans.

Sources

¹ Reed, C., Cortese, S., Golm, D., Brandt, V., et al. (2024). Longitudinal Associations Between Physical Health Conditions in Childhood and Attention-Deficit/Hyperactivity Disorder Symptoms at Age 17 Years. Journal of the American Academy of Child & Adolescent Psychiatry https://doi.org/10.1016/j.jaac.2024.09.009
² Barker, E.D., Ing, A., Biondo, F., Jia, T., et al. (2021). Do ADHD-Impulsivity and BMI Have Shared Polygenic and Neural Correlates? Mol Psychiatry;26(3):1019-1028. https://doi.org/10.1038/s41380-019-0444-y
³ Faraone, S.V., Larsson, H. (2019). Genetics of Attention Deficit Hyperactivity Disorder. Mol Psychiatry; 24(4):562-575. https://doi.org/10.1038/s41380-018-0070-0
⁴ Dalnoki, L., Hurks, P. P. M., Gubbels, J. S., Eussen, S. J. P. M., Mommers, M., & Thijs, C. (2024). Exploring the Relationship of Dietary Intake With Inattention, Hyperactivity, and Impulsivity, Beyond ADHD. Journal of Attention Disorders https://doi.org/10.1177/10870547241293946/a>
⁵ Arrondo, G., Solmi, M., Dragioti, E., et al. (2022).Associations Between Mental and Physical Conditions in Children and Adolescents: An Umbrella Review. Neurosci Biobehav Rev. https://doi.org/10.1016/j.neubiorev.2022.104662
⁶ Horesh, A., Tsur, A.M., Bardugo, A., et al. (2021). Adolescent and Childhood Obesity and Excess Morbidity and Mortality in Young Adulthood—a Systematic Review. Curr Obes Rep; 10, 301–310. https://doi.org/10.1007/s13679-021-00439-9

That study, published in the Journal of the American Medical Association, did not show a causal relationship. Patients in that study may have had conditions like diabetes or obesity, in addition to ADHD, that raised their risk of cardiovascular disease.

This is what I say to parents of my patients: ADHD causes all kinds of problems if it’s untreated. School failure, substance use, and, as an adult, poor job performance or getting fired, breakups in marriages — these are known risks when ADHD is not well managed.

In older populations, the risk for cardiovascular disease generally increases, but even then, I say to patients, “How are your diet, exercise, sleep, and other health habits?” These are the predictors of cardiovascular disease as best as we know. The study didn’t look at these factors.

Q: Does research show that nutrition plays a role in ADHD symptoms or symptom management?

We have every reason to think that healthy diets may lead to general benefits in mood and behavior. Large population-based studies suggest that food additives may have a relatively small negative effect on behavior. However, many parents report that children have hyperactive responses to sugar.

[Free Guide to ADHD Brain Food: What to Eat, What to Avoid]

New research is beginning to teach us more about the importance of a healthy diet and healthy gut biome. We know that too much processed food leads to the generation of unhealthy bacteria in the gut, which can create chemicals that pass through the blood-brain barrier and lead to problems, such as depression, anxiety, and possibly even ADHD. So, a healthy diet (along with adequate sleep and regular exercise) is likely to benefit people with ADHD.

Q: Does screen addiction over a period of several years affect a young adult’s brain development?

Very good studies have shown that screen time can lead to brain changes. A number of neuroimaging studies have proven this even in randomized controlled trials. Specifically, violent video games, such as first-person shooter games, have been found to lead to decreased empathy and social connections, increased negative and hostile thoughts, and possibly harmful actions.

ADHD Symptom Management: Next Steps

• Download: Lifestyle Changes for Adults with ADHD
• Read: 5 Smart Screen Rules for Teens with ADHD
• Read: Your ADHD Treatment Options — Medication, Diet, Therapy & More
• Find: ADHD Specialists and Clinics Near You

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Help your child stay hydrated and healthy this summer (and year-round) with these strategies.

1. Follow a Hydration Routine

Develop a fluid-intake routine to train your child to better tune in to their senses.

Challenge your child to drink a minimum of eight cups of fluids — even better if it’s mostly water — spaced out every few hours throughout the day (e.g., after waking up, mid-morning, before lunch, mid-afternoon, and before dinner). Your child may need more fluids depending on activity level and the weather. Fluids can be paired with snacks and meals.

Monitor your child’s fluid intake — including time, amount, and types of fluids (water, juice, milk, etc.) they drink. Maintaining a log can help ensure they’re sticking to the routine and help you spot any unhealthy drinking patterns, like not drinking enough in one sitting, going for long hours without fluid intake, or hydrating too close to bedtime, which can disrupt sleep. Be sure to ask teachers, babysitters, and other caregivers to record your child’s fluid intake, too.

[Read: A How-To Guide to Summer Safety]

If your child struggles to tell when they’re thirsty, chances are that they also struggle to tell when they’re hungry and/or need to use the bathroom. A benefit of a hydration routine is that it can regulate all these bodily processes. Download my free chart here to track your child’s eating, drinking, and bathroom habits.

2. Set Reminders

• Set alarms using your watch, smartphone, and/or a device such as an Alexa to prompt your child and family to drink water and other fluids.
• Use pictures and other visual cues. Hang up an illustration of a child eating and drinking in sequence to remind your child what to do. Store cups next to plates and pack a carton of juice with your child’s lunchbox to visually connect eating with drinking.

3. Make Hydrating Fun

Encourage your child to choose a special cup or bottle, like one decorated with their favorite characters or animals, to motivate them to refill and stay hydrated. Novelty or musical reusable straws are also fun. Make water more interesting and palatable by adding natural flavors such as chopped mango, blueberries, or any fruit of your child’s choice, introduced at different times of the day.

[Read: How I Reduce the Summer Stress]

4. Incorporate Hydrating, Water-Rich Foods

Hydrating is not just about consuming cups of fluids. Water-rich foods – gelatin, popsicles, yogurts, and fruits – can also help your child stay hydrated. Though not a substitute for drinking fluids overall, these foods are a great compromise if your child resists drinking fluids.

5. Get Help from a Medical Professional

If keeping your child hydrated with the above strategies is a daily battle, you may be thinking, “Can’t I just let my child drink when they want to?”

Our bodies need to stay hydrated for many health reasons, from keeping the bladder clear of bacteria to carrying nutrients and oxygen to cells. Indigestion, constipation, and dysregulation are all results of dehydration.

But forcing your child to take in more fluid isn’t the answer. A medical professional can help you implement healthy strategies for your unique child.

Be mindful of the following symptoms, as they could indicate that your child is dehydrated. If symptoms are severe, call 911.

• dry mouth, lips, tongue, eyes, and skin
• tiredness and irritability
• headaches and dizziness
• dark, concentrated, strong-smelling urine
• urinating less frequently
• muscle cramps or spasms (may be noticeable during play)
• rapid heartbeat

Hydration Tips for Neurodivergent Kids: Next Steps

• Get This Free Download: 20 Secrets to a Smarter Summer
• Read: Engineer Better Environments Kids with Sensory Processing Disorder and ADHD
• Read: More Than Picky Eating — Conditions Linked to Feeding Difficulties in Children

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Energy drink consumption is associated with an elevated risk for physical and mental health conditions such as ADHD, depression, anxiety, and suicidal ideation among children and adolescents, according to a new study published in the journal Public Health.¹

The study’s U.K. research team linked energy drink consumption with a higher-than-average risk of poor academic performance, sleep problems, unhealthy dietary habits, and risky behaviors. Children and teens who consumed energy drinks were more likely than non-drinkers to engage in unsafe sex and vehicle use, binge drinking, vaping, violent behaviors, and alcohol and substance use.

Energy drink consumption was also tied to increased ADHD inattention, conduct disorder, and depressive and panic symptoms. The rates of suicidal ideation and attempts increased among those who drank more than one energy drink a day compared to non-drinkers.¹

The systematic review examined 57 studies about the effects of energy drinks on children and young people up to age 21 from January 2016 to July 2022. The data came from more than 20 countries and involved more than 1.2 million children and young adults. (The review did not include the brands of energy drinks consumed.) The report confirmed findings from a similar review in 2016 conducted by the same research team.²

What Are Energy Drinks?

The Centers for Disease Control and Prevention (CDC) defines an energy drink as “a beverage that typically contains large amounts of caffeine, added sugars, other additives, and legal stimulants such as guarana, taurine, and L-carnitine. Energy drinks are marketed as providing mental and physical stimulation; they contain no nutritional value.

The amount of caffeine in energy drinks typically exceeds adults’ daily recommended doses. Data from the Center for Science in the Public Interest shows that energy drinks may contain as little as 75mg of caffeine — slightly less than one average cup of coffee — or up to 316mg per 8 ounces, the equivalent of more than three cups.

Energy drinks have exploded in popularity in recent years, particularly among teens. A 2013 study of 37,500 children and adolescents in 16 European countries found that 18% of children (3–10 years) and 68% of adolescents (10–18 years) consumed energy drinks in the previous year.8 Between 12% and 35% of children and young adults consume them at least once per week.³

The U.K. study found that male teens consume more energy drinks than do females. Taste and energy-seeking were the main drivers of energy drink use. The study also reported that children and teens may turn to energy drinks as a coping mechanism, out of social acceptance, or to enhance performance on tests and in sports.

Energy Drink Consumption Among Kids with ADHD

Nearly 5% of ADDitude Reader Panel members say their children consume energy drinks every day or regularly, according to a recent survey.

“My children like to drink Prime because they think it’s cool, and they like the taste,” one reader said.

“My daughter tries out the latest fads with energy drinks,” said another reader. “I worry about her caffeine consumption. I keep teaching her to watch the caffeine content and to be careful about how much she drinks. I don’t see her drink them — I just see empty containers in her car — so I can’t say what the effect is on her ADHD symptoms.”

Another reader shared that her daughter (now 21) “has used Red Bull daily since high school. She is currently unmedicated (Her choice, not mine.) I believe it helps her focus a little.”

An additional 12% of ADDitude Reader Panelists said their children occasionally consume energy drinks.

“My teen kids will have an energy drink (Yerba Mate or Celsius) now and then for sports or athletic activities like between soccer games on tournament weekends or when skiing,” a reader said. “It adds to their energy, which is fine when engaging in physically demanding activities. I would not allow it before school as it likely would create jitteriness if they had to sit for hours.”

“My child occasionally swipes a sip of his dad’s Red Bull,” said another reader. “Other than that, he doesn’t drink them. We mostly avoid energy drinks because of the additional additives in them.”

Less than half (44%) of reader panelists said their children are prohibited from consuming energy drinks.

“I am fearful of the jittery anxiety it seems to produce,” one reader said. “The [energy drink] crash has caused my son to melt down and become horribly embarrassed when in public.”

“I do not want myself or my children to have energy drinks because they are high in sugar and caffeine,” another reader said. “We have diabetes and heart disease in our family, and we do not need to add on to that.”

Other readers offer energy drink alternatives. “We don’t allow our kids to have energy drinks as they contain harmful ingredients,” the reader said. “We have allowed our kids to try coffee. They don’t care for the taste, but it did help my son to be less crabby in the morning.”

“There’s too much empty sugar and caffeine in them,” another reader said. “As a special treat, my teens with ADHD buy themselves sweet drinks at Starbucks. I encourage caffeine-free drinks. The body is hard enough to understand and regulate without all the added effects of sugar and caffeine.”

Energy Drinks: Next Steps

The observational study could not prove causality between energy drink consumption and poor health outcomes; the drinks could, for example, be more popular among adolescents with naturally low levels of dopamine and/or those facing higher risks of mental and physical health issues. However, the researchers said their findings were strong enough to suggest policymakers consider banning the sales of these products to children.

“We have raised concerns about the health impacts of these drinks for the best part of a decade after finding that they were sold to children as young as 10 years old [for less] than bottled water,” lead author Amelia Lake, Ph.D., a professor of public health nutrition from Fuse, the Centre for Translational Research in Public Health at Teesside University in England, said in a press release. “The evidence is clear that energy drinks are harmful to the mental and physical health of children and young people as well as their behavior and education. We need to act now to protect them from these risks.”

The American Academy of Pediatrics states that caffeine and other stimulant substances contained in energy drinks have no place in the diet of children and adolescents.⁴

Keeping Energy Drinks Out of Children’s Hands — and Mouths

The Centers for Disease Control and Prevention (CDC) offered the following tips for caregivers and educators:

• Teachers and other school staff can educate students about the danger of consuming too much caffeine, including energy drinks.
• Coaches can educate athletes about the difference between energy and sports drinks and the potential dangers of consuming highly caffeinated beverages.
• School nutrition staff can provide only healthy beverages such as fat-free/low-fat milk, water, and 100% juice in the cafeteria.
• Parents, school staff, and community members can join the school or district wellness committee that sets the policies for health and wellness and establish or revise nutrition standards to address the sale and marketing of energy drinks in school settings.
• Adults can model good behavior by not consuming energy drinks in front of kids.

Sources

¹Ajibo, C., Van Griethuysen, A., Visram, S., Lake, A. A. (2024). Consumption of Energy Drinks by Children and Young People: A Systematic Review Examining Evidence of Physical Effects and Consumer Attitudes. Public Health doi: 10.1016/j.puhe.2023.08.024
²Visram, S., Cheetham, M., Riby, D.M., Crossley, S.J., Lake, A.A. (2016). Consumption of Energy Drinks by Children and Young People: A Rapid Review Examining Evidence of Physical Effects and Consumer Attitudes. BMJ Open. doi: 10.1136/bmjopen-2015-010380
³Zucconi, S., Volpato, C., Adinolfi, F., Gandini, E., Gentile, E., Loi, A., and Fioriti, L. (2013) Gathering Consumption Data on Specific Consumer Groups of Energy Drinks. The European Food Safety Authority Supporting Publications. doi: 10.2903/sp.efsa.2013.EN-394
⁴Heckman, M.A., Weil, J., Gonzalez De Mejia, E. (2010). Caffeine (1, 3, 7-Trimethylxanthine) in Foods: A Comprehensive Review on Consumption, Functionality, Safety, and Regulatory Matters. Journal of Food Science. 75(3):R77–87. doi: 10.1111/j.1750-3841.2010.01561

If you answered yes to any of the above, then you share a lot in common with our ADDitude readers, many of whom experience strong sensory reactions to food based on taste, texture, smell, and/or temperature. Sensory sensitivities, after all, commonly occur with ADHD, autism, and other forms of neurodivergence.

Aversions to certain foods can create minor inconveniences around eating, but in extreme cases — as is the case for some of our readers — food aversions and selective eating are due to avoidant/restrictive food intake disorder (ARFID), a condition wherein food avoidance or restriction is based on sensory characteristics and qualities of food, concern about aversive consequences of eating, and/or a lack of interest in food. ARFID, especially if untreated, is often accompanied by nutritional deficiencies and quality-of-life problems.

ARFID, Food Aversions, and Picky Eating: Your Stories

“I suspect that I have ARFID — troublesome but not severe. If I do eat meat, it will be a small serving, and it has to be extra, extra well done, almost burnt. I don’t like mushy, runny, moist textures like flan, tapioca, and runny eggs. Hot foods have to be hot, because cold food makes me gag. Foods can’t touch on my plate. As a child, dinner time was sometimes unpleasant because I was made to eat foods I didn’t like, including foods that had been mixed all on one plate. ” — Sara, Texas

“I had never heard of ARFID before reading about it in ADDitude. My daughter, who is in her 30s, definitely has this and has had it since she was a toddler! Life would have been so much easier for us if a diagnosis had been made. The problem we have now is finding someone who knows about this and can treat it. My daughter thinks she’s a ‘freak.’ My heart breaks for her. She NEVER eats anything except for pizza late at night. I fear for her mental and physical health.” —  Wendy, Canada

[Take This Self-Test: Signs of ARFID in Adults]

“I don’t eat any fruits or vegetables. I don’t like the smell of any dark-green vegetables. I eat lots of pasta and pizza, but the tomato sauce must be smooth. I drink juice only without pulp. I eat grape jelly only, no other kinds. I eat meat without fat or it has to be cooked medium-well or fried hard. Fish must be white and dry. I do take supplements and vitamins. I am 54 years old, and I didn’t know this was a thing with a name (ARFID) until very recently. I grew up in a clean-your-plate household, so it taught me to be sneaky about getting rid of vegetables and other things I didn’t want to eat. As a child, my uncle taught me how to order food in restaurants (ask for plain pasta, rice, or potatoes, and request meat or chicken to be grilled or sautéed). He was sick of my parents making such a big deal about my eating when he just wanted to go out to dinner.” — Julie, Georgia

“My son has been extremely picky since he was a baby. His diet is restricted to hamburgers with ketchup only, chicken nuggets with ranch, PB&J, macaroni and cheese, some fruit, and carrots (which are a new thing for him, but they need ranch). Every time I give him a new food that I think he will love, he gags and runs to the bathroom to throw it up.” — Angela

“I cannot stand anything that is gelatinous or wiggly (jelly, Jell-O, custard, boba, etc.). I am also disgusted by any meat/fish/poultry that contains visible fat, gristle, tendons, skin, bones, and/or is processed into a gelatinous cube. One bite of gristle and I’ll gag and toss out the rest of the meal. When I was younger, I had issues with hypoglycemia because of my imbalanced diet. Now, I eat meat/fish/poultry that is lean, boneless, and skinless, and I make sure each meal contains adequate protein. But you’ll never catch me at a steakhouse or BBQ joint — yuck!” — Jennifer, California

“At 43, I still cannot eat a majority of green vegetables. My diet is very limited, which limits where we can go to dinner as a family. It affects social gatherings, where I may have to bring my own food. I react to a combination of taste, smell, texture, and sight of different foods. My sense of smell is very strong — once I don’t like the smell of something, I refuse to try it. It has affected my health, as I have to take vitamins every day to make up for the lack of nutrition.” — Kelly, New York

[Get This Free Download: The Eating Disorders Associated with ADHD]

“My husband has a texture reaction to onions and other vegetables in food; he eats like an 8-year-old. This does affect his health, and I no longer cook healthy things I like because he complains of the smell. My health has plummeted since I now eat mostly what he eats; fried food, potatoes, red meats. I have considered buying prepared meals to get my missing veggies but have not found the right ones.” — An ADDitude Reader

“Mint and cilantro are absolute no-gos for me. I avoid any foods, even at restaurants, that may have hidden cilantro. I use unflavored toothpaste (literal godsend for me!) and I water down my mouthwash. Going to the dentist is traumatic only because of the intense mint flavors seemingly in everything they use. I have to ask them to water everything down or use polish with limited flavor (or a kids flavor) to avoid throwing up.” — An ADDitude Reader

“I cannot STAND foods that are solid but turn mushy while chewing, like bananas, beans, and avocado. I gag after the first bite. I love foods that are homogeneous in texture all the way through, like pudding and yogurt, or foods with varied textures all the way through, like mashed beans with tortilla chips and guacamole.” — Etti

“My favorite foods are typically plain or salty comfort foods that I liked eating as a kid and that have little to no nutritional value. I avoid fruit unless it’s cold, most vegetables unless they’re cooked, water unless it’s cold and filled with ice, and so many other things. I struggle to eat a balanced diet, if I remember to eat at all.” — An ADDitude Reader

“I have aversions to certain smells and textures, and executive dysfunction creates challenges around preparing and eating food. Take chicken: I don’t like the texture or taste of chicken on its own. But shred it and mix it with quinoa or into a stew, and it’s no problem! I also like fruits, but I’m much better at eating them if they’re cut up, or else they’ll remain on my desk, untouched. Pre-peeling, cutting, and packing fruits transforms them from an EF stumbling block to a healthy snack. If you have a food aversion, I highly recommend digging around to pinpoint the exact problem, because a solution may be easier than you think. Sometimes it requires letting go of expectations or shame. I only eat crustless sandwiches, which is something I get teased for, but I don’t care!” — Natalia, Pennsylvania

Food Aversions, ARFID, and Picky Eating: Next Steps

• Read: Got a Picky Eater on Your Hands? Here’s How to Cope
• Take This Self-Test: ARFID in Children
• Read: ADHD and Eating Disorders
• Read: More Than Picky Eating — Feeding Difficulties in Children

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

One trademark of ADHD is low levels of dopamine, a neurotransmitter released by the brain that makes kids feel good and helps them focus. Increasing dopamine in the brain through medication is an effective treatment for ADHD. However, more than a year into a nationwide stimulant shortage, parents still struggle to fill prescriptions for their kids.

As the shortage stretches on, many caregivers are working to implement ADHD treatment tactics without medication. Here are some gut health strategies to consider.

Don’t Skip Meals

The way your child’s brain works is influenced by what they eat, and good nutrition is essential. Eating unhealthy, non-nutritious foods may contribute to inattention and problematic behaviors, while a diet with a variety of healthy foods nourishes the brain to pay attention and function optimally.

[Free Download: 5 Rules for an ADHD-Friendly Diet]

A study in Cell Metabolism found that dopamine release in the brain can occur at two different times: when food is swallowed and once the food reaches the stomach.¹ Skipping a meal robs the body of two potential releases of dopamine. If your child is not hungry, try to keep them on a regular meal schedule to help regulate opportunities for dopamine release. Healthy snacks help, too. A protein-rich diet, including fish, poultry, eggs, and legumes (e.g., beans, lentils, peas, etc.), can help increase dopamine levels.

Introduce Variety

Many kids with ADHD want to eat the same things every day, but doing so may mean they miss out on producing more of that feel-good hormone. Research has also found a strong connection between gut health and mental health. ² A healthy gut is best described as having a diverse microbiome, consisting of different types of microorganisms (bacteria, fungi, viruses, etc.) that coexist harmoniously in the digestive tract. Increasing the diversity of your child’s gut microbiome with a protein-rich diet, including fish, poultry, eggs, and legumes (e.g., beans, lentils, peas, etc.), ensures that dopamine can be adequately synthesized.

Introduce new foods slowly and in a variety of ways. For example, pick a vegetable your child usually eats and connect it to another vegetable or legume. So if your child eats raw carrots, pair them with a dip made of puréed red peppers or smooth refried beans. If your child prefers crunchy foods, make crunchy cooked veggies in the oven or air fryer. Experiment with spices, too. Offering your child small tastes (repeatedly) will build their acceptance of new foods. Kids are more likely to expand their taste and preference for new foods when given multiple chances to learn about and experience new food.

[Free Download: Meal-Planning Guide for ADHD Families]

Mindful Eating

Young children, especially those with ADHD, may be easily distracted during mealtimes. Make it a point to give your child a heads-up on what’s for dinner and when it will be served. Kids with ADHD do best when they know what to expect and follow a schedule. Then, turn off all electronic devices, including the TV, while eating to limit distractions. If possible, sit and eat together at the table. This lets your child know that during meals, it’s time to pause (even for a minute) and focus on eating. This is also a great time to share a moment with your child.

Gut Health Strategies for Treating ADHD: Next Steps

• Read: The ADHD Diet Plan: Healthy Foods and Supplements for Kids & Adults 
• Read: Food Therapy: The Right Nutrition for ADHD Symptoms
• Download: ADHD Brain Food: What to Eat, What to Avoid
• Watch: “What to Eat, What to Avoid: The ADHD Guide to Food and Nutrition for Children”

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

The opinions expressed in ADDitude Guest Blogs are solely those of the User, who may or may not have medical or scientific training. These opinions do not represent the opinions of ADDitude. Blogs are not reviewed by an ADDitude physician or any member of the ADDitude editorial staff for accuracy, balance, objectivity, or any other reason except for compliance with our Terms and Conditions. Some of these opinions may contain information about treatments or uses of drug products that have not been approved by the U.S. Food and Drug Administration. ADDitude does not endorse any specific product, service or treatment.

Do not consider ADDitude Blogs as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare provider because of something you have read on ADDitude. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. ADDitude understands that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified health care provider. If you think you may have a medical emergency, call your doctor or dial 911 immediately.

Sources

¹Thanarajah, S.E., Backes, H., DiFeliceantonio, A.G., Albus, K., Cremer, A.L., Hanssen, R., Lippert, R.N., Cornely, O.A., Small, D.M., Brüning, J.C., Tittgemeyer, M. (2018) Food Intake Recruits Orosensory and Post-ingestive Dopaminergic Circuits to Affect Eating Desire in Humans. Cell Metabolism. https://doi.org/10.1016/j.cmet.2018.12.006

²Chen, Y., Xu, J., Chen, Y. (2021). Regulation of Neurotransmitters by the Gut Microbiota and Effects on Cognition in Neurological Disorders. Nutrients. https://doi.org/10.3390/nu13062099

October 19, 2023

Red Dye 3 is one of four food additives now banned by the landmark California Food Safety Act, the first law of its kind in the United States. The ban, which was signed on October 7 by Governor Gavin Newsom, cites research linking the additives to serious health risks but has drawn ire from some trade associations that accuse it of sidestepping the Food and Drug Administration (FDA).¹ , ² According to Food Safety magazine, the targeted chemicals are already banned in the European Union, in part, because studies have linked them to cancer, reproductive issues, and childhood behavioral and developmental problems.³

Known as the “Skittles ban,” the California law will take effect in 2027 and prohibit the manufacturing, selling, or distributing of food products containing potassium bromate, brominated vegetable oil, propylparaben, and Red Dye No. 3, a synthetic dye made from petroleum that is found in foods, drinks, and medications.⁴

Joel Nigg, Ph.D., director of the ADHD Research Program at Oregon Health and Science University, called food dyes a “public health concern” that affects children with and without ADHD.

“There is enough evidence that food dyes affect behavior in some sensitive children with ADHD (and other children without the condition) to justify warning labels on foods containing synthetic dyes,” Nigg told ADDitude.

Concerns about increasing rates of ADHD and other behavioral disorders prompted the California Legislature to ask the Office of Environmental Health Hazard Assessment (OEHHA) to conduct a food dye assessment in 2021. Its report, titled Health Effects Assessment: Potential Neurobehavioral Effects of Synthetic Food Dyes in Children, found links between several dyes and hyperactivity in children. The report argues that current federal levels for safe intake of synthetic food dyes may not sufficiently protect children’s behavioral health.

According to the OEHHA report, the FDA’s Acceptable Daily Intake levels (ADIs) for synthetic food dyes are based on 35- to 70-year-old studies that were not designed to detect the types of behavioral effects observed in children today. Comparisons with newer studies indicate that the current ADIs may not adequately protect children from the behavioral effects of some dyes, and suggest they should be lowered.²

Is Red Dye No. 3 a Health Risk?

Red Dye No. 3 was approved for use in food in 1907 but was banned in cosmetics in 1990 after studies found it caused cancer in lab animals. Food safety advocates, scientists, and doctors have urged the FDA to issue a nationwide ban on synthetic food dyes for years. (Red No. 3 is already banned in The European Union, Canada, Australia, New Zealand, China, and Japan.)

“The FDA considered the issue in 2011 and again briefly in 2019 but opted not to take action,” Nigg said. “Since 2011, several new literature reviews have converged supporting the conclusion that food dyes increase the risk of ADHD symptoms.”

The California law may exert new pressure on the FDA to act.

“The primary purpose of this bill was to protect kids and families and consumers in the state of California,” State Assemblyman Jesse Gabriel told The New York Times. “But a secondary purpose here was to send a message to Washington that the FDA process is broken, and hopefully to spur momentum in Washington D.C., for real, significant change.”

“We’re stuck in this regulatory quandary where you’re not allowed to apply it [Red No. 3] to your skin, but you can ingest it in food — so it’s completely illogical,” Brian Ronholm, director of food policy for Consumer Reports said in the same article.

In October 2022, the Center for Science in the Public Interest (CSPI), a consumer advocacy group, and 23 other organizations, filed a petition formally asking the FDA to ban Red No. 3 in foods.

An FDA spokesperson told NPR the agency is “actively reviewing” the petition and will assess whether there’s “sufficient data” to revoke its use. The FDA spokesperson added that the agency “evaluates and regulates ingredients added to food to ensure that the authorized use of these ingredients is safe. This includes the four ingredients included in the California bill.”

How to Avoid Red Dye No. 3

In the meantime, Nigg advises children with ADHD to avoid foods containing food dyes — an admittedly difficult task. According to the Environmental Working Group’s Eat Well Guide, Red Dye No. 3 is used in nearly 3,000 products, including sodas, juices, yogurts, snacks, candy, frostings, instant rice and potato products, cereals, and boxed cake mixes. It is also used in medications including Vyvanse. ⁵

“Parents are well-advised to remove food dyes from their child’s diet if they can,” Nigg said. “It is on the list of things to try to do — along with other health actions like a healthy diet, exercise, and lower stress. I encourage parents to do what they can knowing it’s hard to do it all. Every bit can help.”

To start, Nigg suggests steering clear of most processed and packaged foods.

“Eat whole foods found on the perimeter of the grocery store — eggs, milk, cottage cheese, meat and poultry, nuts and seeds, fresh fruits, vegetables, and legumes,” he said. “Families should also be cautious when buying seemingly ‘healthy’ foods, some of which contain synthetic dyes: pickles, flavored oatmeal, salad dressing, peanut butter, and microwave popcorn, for example. Synthetic dyes are also in toothpaste, medication, and cosmetics. Parents should read all product labels closely.”

To check for the presence of Red Dye No. 3, look at a product’s ingredient lists for “FD&C Red #3” and look for dyes in the “inactive ingredients” section for medications.

The American Academy of Pediatrics has also advised parents to limit foods that often contain synthetic dyes, such as sugary drinks, juices, and candy, that may affect children’s behavior and attention.

Sources

¹ McCann, D., Barrett, A., Cooper, A., Crumpler, D., Dalen, L., Grimshaw, K., Kitchin, E., Lok, K., Porteous, L., Prince, E., Sonuga-Barke, E., Warner, J.O., Stevenson, J. (2007) Food Additives and Hyperactive Behaviour in 3-Year-Old and 8/9-Year-Old Children in the Community: A Randomised, Double-Blinded, Placebo-Controlled Trial. Lancet. doi: 10.1016/S0140-6736(07)61306-3.

² California Office of Environmental Health Hazard Assessment. (2021) Health Effects Assessment: Potential Neurobehavioral Effects of Synthetic Food Dyes in Children. https://oehha.ca.gov/media/downloads/risk-assessment/report/healthefftsassess041621.pdf

³ Henderson, Bailee. (2023, October 9) California Food Safety Act Signed Into Law, Officially Banning Four Toxic Additives by 2027. Food Safety. https://www.food-safety.com/articles/8939-california-food-safety-act-signed-into-law-officially-banning-four-toxic-additives-by-2027

⁴  Osborne, Margaret. (2023, October 17). What to Know About California’s New Law Banning Food Additives, Including Red Dye No. 3. Smithsonian. https://www.smithsonianmag.com/smart-news/california-bans-food-additives-including-red-dye-no-3-180983082/

⁵ FD&C Red No. 3. drugs.com. https://www.drugs.com/inactive/fd-c-red-no-3-247.html

The appeal of subscription boxes — for meals, pet supplies, household essentials, toys, and beyond — is obvious. For ADHD households, these services are a game changer. Most notably, they reduce the executive-function stress of planning meals, remembering every ingredient or detail, and running errands endlessly.

Subscriptions Boxes for ADHD Families

ADDitude readers told us that subscriptions boxes help them manage time, reduce impulsivity, smooth family dynamics, and simplify shopping. Nearly half of respondents from an ADDitude survey said they had tried or currently receive a subscription box service. Here are the ones they recommended most, plus tips to stay in charge of your spending.

Meal Planning

“HelloFresh meal kits helped our son, who has sensory challenges around food, become more open to trying new things. Cooking from scratch allowed him to see and smell the ingredients before being asked to try them. Once he had a few meals that he really enjoyed, he was more willing to try new ones, and has learned what ingredients he likes.” — Sue, Michigan

[Download: Free Meal-Planning Guide for ADHD Families]

“My current favorite is Home Chef, which has a nice variety of options. I usually go for the Oven Ready meals that require very little prep, but they also provide more advanced cooking options should I desire. The best part is the meals are well-sized, tasty, and nutritionally balanced without me having to expend mental energy on deciding what to eat or shop for. And the generally quick and easy cleanup keeps me from dreading cooking at home.” — Dawn, Illinois

“My teen likes to cook and follow directions for new recipes that she selects. She looks forward to it arriving in the mail.” — An ADDitude reader

“It helps with decision fatigue and having to plan every single meal.” — An ADDitude reader

Grocery Delivery

“Hungry Harvest produce boxes helped us save produce from being tossed, so I feel like I’m doing something good while also being catered to. Affordable and customized, it helps me get fresh food to my doorstep. It was especially useful during the more stringent periods of the pandemic.” — Paulette

“I have used Blue Apron meal kits in the past, but I’ve developed systems with meal prep since then that make it a lot easier. The Monday to Friday Cookbook taught me how to regularly keep things on hand in a pantry, and how to throw something together easily. I used Fresh Direct in NYC a lot for groceries and would keep certain things in standing order.” — An ADDitude reader

“Imperfect Foods allowed me to try new foods and divert waste, but I found it overwhelming to stay on top of cooking after a few weeks (even with the smallest possible box option) and canceled by the end of month three.” — Hannah, Pennsylvania

“When I get home after a long day where I barely ever sit down, the planning and advanced thinking part is already done. Otherwise, I would have to generate motivation, which would sap my remaining executive function skills and leave me cranky.” — An ADDitude reader

Fashion & Beauty

“I like to try new products with IPSY even when I like the products I am currently using. The trial sizes ensure I don’t get bored with my skincare and makeup routine.” — An ADDitude reader

“I subscribe to FabFitFun. It’s a reliable way to ensure I am receiving things that I enjoy and not only focusing on others.” — An ADDitude reader

“It’s a reliable way to ensure I am receiving things that I enjoy and not only focusing on others.” — An ADDitude reader

“If I had to remember to order it, it would happen far less often.” — An ADDitude reader

Best for Home Essentials

“With Who Gives A Crap, I don’t run out of toilet paper. I don’t have to remember to buy it at the store, figure out the cost per square inch, or determine what the best kind is. It just magically shows up at my house.” — Tamara, Idaho

“I subscribe to Amazon for products such as bathroom essentials, personal care products, and vitamins. This also reduces the need to store extra supplies in my small living space.” — Daphne, Minnesota

“Subscribing to eco-friendly cleaning products saves me from trying to find them in store.” — An ADDitude reader

Pet Supplies

“Chewy sends me dog and cat food, treats, and toys so I don’t run out or have to carry heavy bulky bags home. I never have to go and get an emergency bag of dog food anymore. I hate that. Loading kids in the car, dragging them through the pet shop, having to buy them another toy that I’ll accidentally step on and break just makes me angry.” — Tamara, Idaho

“We sure do get excited on BarkBox day! Our pets are a huge part of our family.” — An ADDitude reader

Art & Reading

“Of past subscriptions, the one I miss the most is Once Upon A Book Club. It’s perfect for people with ADHD because they package the book with three to five gifts that you open as you read. It’s a great incentive to keep going. I was introduced to books I love but that I never would have picked for myself. Currently, I have Paletteful Packs, which is an art subscription. I also use Amazon auto ship for some essentials, such as iron pills and Frontline flea treatment.” — Sherry, Texas

“Let’s Make Art is a good, constructive activity box that develops skills. However, it does have a screen component and sometimes my child will get frustrated and walk away mid-project.” — An ADDitude reader

“It gives me that little dopamine boost getting stickers in the mail… I’ve never been able to keep a calendar or planner until now. I find putting the stickers on to be a form of active meditation.” — An ADDitude reader

STEM Projects & Games

“My son gets Little Passports science kits every month. Science is a strength for him, so it feeds something positive. ADHD kids — and especially those with learning difficulties — can really get caught in negative thinking. This is something positive for him.” — Deidra, Florida

“My children were quite interested in KiwiCo and learned some neat things. But… we have found better experiences with renting library kits because they get the same experience without the cost. We also tried Epic Family reading subscription and ABCmouse. Those were interesting at times, and we see the kids reusing them… [but] we’ve had a better experience with book rentals from library apps.” — Amy, Michigan

[Read: 10 Captivating Audiobooks for Middle Grade Readers]

“Tinker Crates are engaging, non-electronic, and [help my son] learn something new. However, he is not quite at the age to be independent, so it’s a hands-on activity for both of us.” — AJ, Ohio

Sneaky Spending

Recurring subscriptions for everything from multivitamins and movies are convenient, but recurring costs automatically deducted from your bank account are easy to forget — and quick to add up.

To avoid paying for products and services you no longer need or use, use a subscription tracker like Rocket Money or Hiatus to conduct periodic reviews of your spending. Then ask yourself these questions to determine whether you should cancel a current subscription:

1. Are you continuing to watch, listen to, and/or read podcasts, cable, music, and other streaming media services?
2. Does it actually save any money to continue your recurring subscriptions to multivitamins, pet food, shampoo, and other products through delivery memberships like Amazon Prime?
3. Are you using your gym membership enough to justify the cost, or would switching to a subscription for online classes be more affordable and convenient?
4. Are you delighted by the quality of new clothes, cosmetics, craft beverages, or other products to which you subscribe?

Note renewal dates in your calendar and set a cancellation reminder before they automatically renew. Or better yet, uncheck the auto-renewal button when you sign up.

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication.

Subscription Boxes for ADHD: Next Steps

• Download: Activity Ideas for ADHD Families
• Read: Follow These 9 Healthy Food Rules
• Read: Learn How to Sharpen Executive Functions

Sources

¹Davidkhanian, S. (2021, July 30). More US consumers likely to continue shopping via ecommerce subscription models. eMarketer. https://www.insiderintelligence.com/content/more-us-consumers-ecommerce-subscription-models

Dietary Disguises

“My 6-year-old is a super smeller and taster with texture issues. I put 1/2 teaspoon of orange sherbet-flavored fish oil in orange juice. I mix a capsule of supplements in a peanut butter and honey sandwich. I sprinkle a probiotic in a sports drink.”

“Eating a popsicle before taking any medicine or supplement freezes the taste buds so the taste isn’t as strong.”

“Thick chocolate milkshakes work for us. In a blender, pour in milk, the powder or liquid supplement, and chocolate ice cream. Blend until no longer chunky.”

“Homemade waffle and pancake mix can hide protein powder and flax seeds.”

[Download: Free Guide to ADHD Brain Food]

“There are vegan alternatives to fish oil that provide omega-3 nutrients, like chia seeds and hemp. I use these in smoothies, yogurt, and oatmeal.”

“I drip the liquid from a fish oil capsule into a shot of fruit juice, then have my kids eat dinner to overshadow any lingering tastes.”

“My son loves the protein café latte shakes and they’re loaded with vitamins and minerals. They also have caffeine, which I think helps him.”

“Protein powders, spinach, and hemp, flax, and chia seeds go in smoothies with frozen fruit and non-dairy almond or coconut milk.”

[Read: ADHD and Fish Oil Supplements — What’s a Safe Dosage?]

“My child is autistic and has gut issues. He needs to take a laxative daily. I mix the powder in flavored water to make it taste better.”

“I put fish oil in smoothies and make popsicles out of the smoothies.”

“I always put powdered supplements in applesauce. For the ones that taste bad, I give a juice chaser afterward.”

“I have my own challenges with supplements and find that using yogurt with a drizzle of honey helps.”

“I sprinkle my son’s capsules into a small spoonful of pre-made cake frosting. A spoonful of sugar makes the medicine go down!”

“I put powder or liquid supplements in banana smoothies, chocolate milk, and pudding.”

“I give my kids gummies.”

“I mix liquid fish oil into tea with lemon and sugar.”

Picky Eaters with ADHD: Next Steps

• Download: Everyday Foods Filled with Omega-3s
• Read: The Parent’s Guide to Mealtime with Picky Eaters
• Read: ARFID, SPD, & Other Conditions Linked to Feeding Difficulties in Kids

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.