Can what you eat worsen your ADHD? [PODCAST]

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes

“Suzy was a bright and hardworking student. However, even though she was conscientious and generally cheery, her grades began to fall during her senior year, and she started to feel depressed. She also constantly had an upset stomach, which she had just accepted as a way of life. She’d had an ADHD diagnosis since she was younger, but while Ritalin had helped her focus on her work in the past, the effect seemed to be dwindling as she built up a tolerance.

I noted that her diet seemed to have shifted toward more comfort food. Her meals were cereal with milk, a sandwich, pizza, or pasta. She was eating a lot of dairy and gluten, and it’s no coincidence that both of these dietary components can exacerbate the symptoms of ADHD.”

Uma Naidoo is a nutritional psychiatrist and author of This Is Your Brain on Food: An Indispensable Guide to the Surprising Foods that Fight Depression, Anxiety, PTSD, OCD, ADHD, and More.

She shares her story and discusses her KevinMD article, “Can what you eat worsen your ADHD?”

Did you enjoy today’s episode?

Please click here to leave a review for The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out!

Do you know someone who might enjoy this episode? Share this episode to anyone who wants to hear health care stories filled with information, insight, and inspiration.

Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Uma Naidoo. She’s a nutritional psychiatrist, and she wrote the book This Is Your Brain on Food: An Indispensable Guide to the Surprising Foods that Fight Depression, Anxiety, PTSD, OCD, ADHD, and More, and she wrote the KevinMD article “Can what you eat worsen your ADHD?” Uma, welcome to the show.

Uma Naidoo: Thanks so much, Kevin. I really am so excited to be here and talk with you.

Kevin Pho: So we’ll get into your article and book in a little bit, but first off, can you share your story and your journey to where you are today?

Uma Naidoo: Thanks, Kevin. I’d be happy to. You know, I wish, Kevin, that I could say I had a grand plan and all these goals, but I really didn’t. I followed things that I loved to do. I knew early on that I really enjoyed working with people, and psychiatry seemed like a natural fit. And I came from a very large South Asian family, so food and nutrition was always a big part of it, because there are many physicians in the family. And so my love for food and cooking, I carried with me when I started training.

But here’s the fun part: I really didn’t know how to cook, because there were always too many cooks in the kitchen, mothers, grandmothers, and aunts. So I really learned to cook when I was in residency, and it became a real part of mindful practice for me, something I enjoyed, and a creative space. So I decided that I wanted to incorporate just learning more about nutrition and working on that with patients.

My trip to culinary school was really about honoring my food hero, Julia Child, because when I heard that she did this as a second career and later in life, I thought, “Why not me?” Once I learned to start cooking, I really began to enjoy it, and I wanted to learn more. And in a very wonderful way for me, these elements of what I studied came together in the work that I do and the evaluations that I was doing for patients, really trying to have more of a holistic and integrated functional approach to mental health, and not just relying only on medications. I do prescribe medications and still do, but really looking at an out-of-the-box way to offer people more solutions. And that’s how I came to do my work.

Kevin Pho: Excellent. And you are a nutritional psychiatrist, and that sounds like a perfect combination of your passions. So tell me a little bit more: How does one become a nutritional psychiatrist?

Uma Naidoo: You know, it’s a very nascent field, Kevin. For decades, mentors of mine at Mass General have studied folate, and without folate, and omega-3 fatty acids. But when we think about how we eat, we never just eat one ingredient, and any ingredient that you eat has so many nutrients, minerals, vitamins, fiber, and tons of things in it. So in the last decade or so, nutrition and mental health has been more formalized as a field of nutritional psychiatry. There are research groups all over the world.

And so there isn’t yet a formal fellowship training, although I do feel that people are so interested and want to learn more about how to incorporate this into their practice that we’re currently working on, of course, for clinicians, as well as considering one just to help with people asking about how they can learn more, should they not be able to see such a doctor. So I incorporated this into my practice, incorporated the things that I had studied, and really designed my own evaluation that I do with individuals, based on the research that I’ve done for my book, which I had been doing for a while, you know, looking at the nutrients and the foods to either embrace for a certain condition or foods to avoid for a certain condition.

Kevin Pho: So one of the conditions that you talk about is ADHD, and let’s talk about that KevinMD article, “Can what you eat worsen your ADHD?” Now, for those who haven’t read your article, can you walk my audience through it and share the story of why you decided to focus on this?

Uma Naidoo: Absolutely. You know, I was thinking, Kevin, about what would be appropriate for this time of year, with the pandemic ongoing and schools being uncertain and whether we’re returning or not. I felt that parents were struggling or maybe facing difficulties around taking care of their children at home, and if a child were to have symptoms of ADHD, just to make them aware of certain things in our diets that could drive certain symptoms. Because studies have shown that categories of foods with gluten, or certain types of dairy, A1 dairy from cow’s milk, could worsen symptoms. Added sugars, I know that with sugar, many parents will attest to this if they’ve taken their kids to a birthday party, or, you know, at Halloween, for example. So I thought that there were two things that seemed to make this article timely. One was the return to school, and the other was the Halloween holiday coming up.

Kevin Pho: When you’re talking about dairy, sugar, and gluten, these are foods that a lot of kids eat. So how much is a dangerous amount? How much is an amount that would manifest in potential symptoms of ADHD?

Uma Naidoo: Sure. So basically, I think what a parent should watch for is, you know, the child may not have celiac disease, but they might have non-celiac gluten sensitivity. And so if they’re noticing a change in behavior, a worsening of symptoms when they’re, say, having their lunch sandwich or having a pizza, something that contains gluten, I would start paying attention to the behaviors that the parent might be noticing or the child might be reporting, and start to slowly eliminate that particular ingredient, or that food, from their diet and see if the symptoms improve.

You know, with dairy, it’s really the kind of dairy, because there are now A2 milks on supermarket shelves. So it could be that, you know, if the child is responding to, say, they’re having a milk drink in the morning or some other type of beverage that contains milk, and the parent is again noticing something different, or maybe the child is not coping with their assignment that morning for school, if they’re doing it, you know, virtually from home, then again, it might be a simple thing like replacing the type of milk and seeing if the child does better. They don’t have to give it up. I really try as much as possible, Kevin, not to have people eliminate foods unless they’re experiencing real symptoms or there’s a food allergy or food intolerance.

And when it comes to sugar, you know, not all the studies showed an association, but I also felt putting it in context was important, because not only from what parents report, but from what I’ve seen in my clinical practice, it seemed to be a no-brainer, in addition to the fact that we know added sugars are just not good for our brain in general, and studies have shown this. There’s an increased association with depression and anxiety, for example, and it was in symptoms of ADHD. So, you know, I think that it’s more about cutting back on the amounts of those foods if a parent is noticing an uptick of symptoms, and maybe slowly, you know, switching to a different form or a different snack or a healthier version of food that may help them with the symptoms, or switching out the milk, for example.

Kevin Pho: And how long would you expect any type of behavioral change that can result from this potential change in diet?

Uma Naidoo: I’ve seen these types of dietary changes take a few weeks. I’ve also seen, and this is much related to the mostly unique microbiome that we each have, adults do better within about a week of just cutting out something that was driving a symptom. And I would imagine the same, I’m not a child psychiatrist, but I would imagine the same in children as well. Certainly parents report that to me. So I would definitely give it a try and see how the child does, and maybe try to switch out some healthy alternatives of what they eat.

You know, an ice cream could be replaced with the recipe in my book, which is made from bananas, and you can make a really great chocolate-flavored ice cream by adding super dark cacao, which is natural and has tons of flavonoids for your brain. So you could make that the ice cream alternative, and, you know, the child still has a scoop of ice cream and skips the processed ice cream that is in the freezer.

Kevin Pho: So I’m a primary care internal medicine physician. I see a lot of depression and anxiety in my clinic. Now, what are some nutritional connections between those conditions?

Uma Naidoo: OK, so in depression, you know, I think there are some building blocks around, say, things like omega-3 fatty acids. So we know that there have been a good number of trials of things like salmon, if you do eat fish. But if you’re plant-based, there’s the short-chain ALA in things like chia seeds, flaxseeds, sea vegetables, and algae, so there’s a way that you can still get omega-3s that way. We also have things like prebiotic- and probiotic-rich foods, which actually help symptoms, mostly because of the fiber and the culture, the bacteria, that they bring back to the microbiome. And those are just some examples. And then, you know, there are spices that people often overlook. Turmeric and saffron hit the high notes in terms of trials in depression. So I would at least start with some of those building blocks.

And then with anxiety, I find, Kevin, that it’s really important for people to know things to stay away from. One is, and you’re not going to be surprised by it, the added sugars. But another is artificial sweeteners, and they actually worsen anxiety. A third is processed vegetable oils. So, you know, if you’re eating fast foods or you’re eating out a lot, you know, restaurants, not all restaurants, but some restaurants, tend to use these processed vegetable oils because they’re inexpensive, and that could be worsening your symptoms as well.

In terms of improving your symptoms, omega-3s are great. There are certain great polyphenols, and certainly fruit and vegetables, that are great. Magnesium and zinc are great. You can get them from food sources, or, you know, speak to your doctor about a supplement. And, you know, again, turmeric with a pinch of black pepper. You always add a pinch of black pepper to turmeric, Kevin. In fact, I keep my glass jar of turmeric, and I grind in some black pepper, because the black pepper makes the turmeric, the curcumin, more bioactive to your body and brain. So it’s just worth doing that for yourself.

Kevin Pho: We’re talking to Uma Naidoo. She’s a nutritional psychiatrist, and she wrote the KevinMD article “Can what you eat worsen your ADHD?” Uma, I have a lot of clinicians, both specialists and primary care physicians, who listen to this podcast. Now, we all don’t have the nutritional expertise like you do. Now, what are some messages and lessons that you can share with my audience?

Uma Naidoo: Sure. You know, Kevin, I often get asked this question, and even though it may seem very rudimentary or very straightforward, sometimes it’s those basic building blocks of a good and healthy diet. I think everyone is trying their best. I think the pandemic has been hard, and resetting would be helpful for all of us, but it goes back to some simple things, and here’s why. You know, things like where we get our fiber from: fruit and vegetables, beans, nuts, seeds, legumes, lentils, healthy whole grains. Those feed the microbiome. They feed the 39-odd trillion bugs in the microbiome. So those are good basic things to start eating.

With fruit, I generally suggest lower-glycemic foods like berries, you know, blueberries, strawberries, blackberries. But, you know, a healthy abundance of vegetables in your diet is helpful for that. And then in terms of proteins that you eat, you know, they should be well sourced, and certain types of lean protein are associated with improvements in mood.

So I think that starting off there, and then things like prebiotic- and probiotic-rich foods, and eating the color of the rainbow, while they seem straightforward, these are all related to good science. They’re also related to things like the amount of polyphenols and the different colors of the fruit and vegetables, in addition to the fact that those fruit and vegetables and the polyphenols bring back good antioxidants to your brain. They’re manufactured and processed in the gut and are really healthy ultimately for reducing inflammation and then preventing the onset of things like neuroinflammation, which is what could lead to depression and other mental health symptoms.

So things like your leafy greens, your colorful vegetables. The folates in leafy greens are associated with certain bacteria in the microbiome, which actually will help to improve mood over time. Prebiotic and probiotic foods are super healthy for your brain health, omega-3s, and good sources of fiber. And all of those, really, almost, you know, I talk about the philosophy of “Eat the orange, skip the store-bought orange juice,” because it’s about the whole healthy food and the nutrients, and skipping the processing and the added sugar from the orange juice. And if we start with those basic tenets and then go into specific foods for each condition, I really have seen people start to feel better.

I know that many doctors listening to this may have patients roll their eyes about, “Why are you asking me to eat a salad again?” But there’s actually a good amount of evidence behind, you know, the Mediterranean diet and depression, and those types of diets are really rich in fresh vegetables and fruit and that type of stuff.

Kevin Pho: So you’re also the author of the book This Is Your Brain on Food. Can you share a little bit about that book, and where can people find it?

Uma Naidoo: Thank you so much, Kevin. So the book was released in August. It’s available at all major bookstores or online. It’s basically not necessarily about having a diagnosis; it’s about eating better for your better brain health. So it walks you through different mental health conditions and the symptoms someone might experience, based on case studies, and also the research of foods to embrace or foods to avoid for each condition, with recipes in chapter 11 for you to try. And I would love for people to follow me on social, because you always put out updated scientific information and interesting stuff that I think you might enjoy. My handle is @DrUmaNaidoo, D-R-U-M-A-N-A-I-D-O-O, and I would love it if we have some help from your listeners.

Kevin Pho: And my final question: What is your take-home message that you want to leave with my audience?

Uma Naidoo: I would say a really healthy way to get started in improving your diet is that there are several spices that hit the high notes in certain conditions. If you don’t cook with turmeric and a pinch of black pepper, add it to a super smoothie or a tea. Embrace spices, because you can eat a ton of different roasted vegetables and different proteins of your choice and change that up for your entire family just by changing out the spices, which are sugar-free, calorie-free, and otherwise pretty healthy for you to eat. They also are cost-effective, because they last a long time. So I would encourage people to embrace spices to make your food more interesting, because healthy food doesn’t have to not be tasty. It should be delicious, too.

Kevin Pho: Thank you so much for sharing your time and expertise, and thanks again for being on the show.

Uma Naidoo: Thanks so much, Kevin. It was a pleasure.

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes