By Judy Converse, MPH, RD, LD
In my pediatric nutrition practice, I meet many children and teens on meds for mood, anxiety, OCD, behavior outbursts, attention or depression. Most of these kids have been given a diagnosis like ADD, ADHD, Asperger’s Syndrome, anxiety disorder, what have you. Psych meds are important tools that can make a huge difference for a child. But what if they don’t work, or only work a little? Or, what if side effects are too costly?
Psychotropic meds can fail a child when they’ve been given for the wrong reason. Most kids I meet in practice have unnoticed nutrition problems that worsen features of learning and mood concerns. Here’s the blind spot: Mental health professionals don’t assess nutrition problems, and pediatricians can miss these too. I’ve just released Special Needs Kids Go Pharm-Free (Penguin/Perigee) to help parents navigate this, so kids can use pharmaceuticals more effectively, or wean off them for more effective options, if they were the wrong tool.
How does nutrition impact this stuff? Here are just a few items that can dramatically change a child’s “psychiatric” presentation:
Iron status. Iron affects cognition, behavior, irritability, sleep, and appetite. If focus, attention, and irritability are challenging you, have your pediatrician check ferritin level, serum iron level, and total iron binding capacity (TIBC). A ferritin level at 30 or above, in my experience, is where kids start to function better, even though most reference ranges go down to 10. Don’t use iron supplements without guidance, as these can be toxic if given incorrectly. By the way, when iron status is poor, your body will also be prone to absorbing more lead from any exposures – which is definitely injurious to brain function, IQ, and cognition. You can eat iron-rich foods like organic grass fed beef, beans, lentils, roasted pumpkin seeds, baked potato with skin on, or black rice – or even cook with iron cookware – to boost your own iron intake. You may find you feel more energetic and focused.
Gluten.. again! News is emerging all the time about the impact of gluten on many neurological problems, from seizures to tics, to anxiety, migraines, or mood. Kids with ADHD, ADD, autism, Asperger’s syndrome, and Down’s syndrome have gluten sensitivity more often than typical peers. Your doctor can screen for this with a blood test called gliadin immunoglobulin G (IgG) antibody. This tells if your body is reacting to gluten. If it is, this reaction can worsen neurological symptoms. Luckily, the gluten free universe is rapidly expanding – with new breads, pastas, bagels, pizzas and all kinds of products now available. When it’s indicated, I’ve seen gluten free diets make kids feel better, happier, and healthier – and they learn about new foods they never noticed before. Note: celiac disease tests do not always include gluten sensitivity testing. If you’ve had this done and it was negative, check again – you may need to add the gliadin IgG part of the test to be sure.
Fishy in a good way: Fish oils, a great source of omega 3 fatty acids, can work well for focus, attention or mood – if you use the right dose, and for a long enough time. To boost your brain for more focus and attention, emphasize DHA omega 3 oil and use at least 500mg/day in a good quality supplement. For mood or behavior swings, focus on EPA omega 3 oil and use at least a gram (1000mg) per day. Doses of up to nine grams have been clinically reviewed with promise for effectively treating bipolar disorder. Some people notice improvements quickly, but allow at least two months of consistent use for fish oils to take effect. Eat ample organic fats and oils for healthy brain function by adding flax oil on salads or into smoothies. Avocado, sesame tahini, unprocessed coconut milk or oil, organic meats and dairy foods, organic eggs, and nuts are good sources of healthy fats too. There are good tasting flavored fish or flax oils too. Skip trans fats and genetically modified oils like canola, corn or soybean oil – these have been linked to allergy and organ damage in test animals! Buy organic or look for a non-GMO label.
The downside of skinny: You are officially underweight when your body mass index, or BMI, is below the 5th percentile. You are “excessively thin” according to the British Medical Journal when BMI is around 10-15th percentile. Being too skinny can have a tremendous downside for children and teens. Many kids I work with have a body mass index below the 10th percentile and are too thin for their height. At this low BMI, risk for infections and illnesses goes up; kids can have longer courses of illness when they get sick; and may struggle more with mood, self regulation, and learning. Their bodies are just too depleted to run the immune system at full speed, or cope with all the demanding tasks of school and learning. Long short, eat breakfast, and lunch! Give your brain food to function. Protein and calories in the morning and again midday can help prevent that washed out feeling at the end of the school day. Organic eggs, stir-fried rice with vegetables and chicken or beef, sushi roll with avocado and crab, turkey or chicken salad sandwich, or burritos with rice are choices that will give a steady release of energy and protein for focus.
– Take a good potency multivitamin with minerals in it daily – magnesium, zinc, selenium, chromium, manganese, molybdenum, and iron.
– Make morning power shakes with fruit, flax oil or fish oil (I actually like the taste of Pharmax Finest Pure Fish Oil brand), a protein powder you like, and yogurt or even ice cream, if you need to improve a low body mass index. Make sure the protein source you use is one that you tolerate well without allergy or sensitivity. For dairy sensitive kids, check out So Delicious coconut-based yogurt and ice cream – neither taste overly coconutty!
– Check your own body mass index here: http://apps.nccd.cdc.gov/dnpabmi/
– Slow cooked stews are easy to make in a crock-pot and leave to simmer all day. These deliver protein, minerals, and healthy fats. Fill with organic beef, favorite chopped vegetables, bay leaf and spices you like, a dash of red wine vinegar, potato or rice. Bring some in a thermos for school lunch.
– Herbs showing promise to help cut inflammation are nettles, curcumin, quercetin, or goldenseal. Check with your parents or providers on trying these, if your medications aren’t doing enough.
– The Obama administration has partnered with Whole Foods and Chef Ann Cooper (aka the Renegade Lunch Lady) to roll out 5,000 salad bars in schools nationwide! Is there one coming soon to a school near you? Check out the protein sources and fresh produce, and give yourself a nutrient packed lunch for better functioning throughout the afternoon.