At least 3 million people living in North America are gluten intolerant, with 90% not even realizing it (1). Although some dairy and gluten intolerance symptoms manifest in the digestive tract, other symptoms are neurological; affecting mood, attention span, cognitive capabilities, behaviors, and sometimes even manifesting as attention deficit hyperactivity disorder or ADHD. As a result, the gluten and casein free diet for ADHD children is becoming more common and widespread.
What is Attention Deficit Hyperactivity Disorder—ADHD?
Nearly 10% of US children have been diagnosed with ADHD—an almost 22% increase from 2004 to 2007 (2)! Likewise, 50,000 children in Australia are prescribed medications to treat ADHD (3).
ADHD is not diagnosed by blood tests, but through recognition of at least six of the eighteen core symptom patterns persistent enough to impair normal functioning (4). ADHD is connected to lower academic performance; impulsiveness; forgetfulness; problems with emotional regulation and interpersonal communication manifesting in higher levels of aggression, anger, and sadness; and may even lower life expectancy (5).
Connecting ADHD to Food
Compart and Laake contend that, “Unfortunately, diet and nutrition are often overlooked or dismissed, when, in fact, many of the symptom presentations in ADHD or autism are directly related to nutritional deficiencies, disturbances in nutrient metabolism, poor diet, and the negative effects of specific foods” (6).
A 1985 research study published in the Lancet found that the majority of ADHD children are salicylate sensitive and that 90% of those children have other food intolerances (7). A rigorous 2009 research study validated those results and found that limiting the diet of ADHD children to only a few non-allergenic foods resulted in improved behavior by at least 50% in 70% of the test population (8). Over 48 foods may trigger hyperactivity in children, but cow milk, wheat, soy, corn, and eggs are the most common (9).
The Big Two: Gluten and Casein
In celiac disease, the intestinal border is worn down far enough to be recognized through a small bowel biopsy. Continuing to eat gluten while gluten intolerant may eventually result in celiac disease (1).
A 2006 research study by the Regional Hospital of Bolzano in Italy strongly correlates ADHD symptoms with untreated celiac disease and indicates that a gluten free diet should improve symptoms quickly (10). Gluten and casein are the two proteins with the most common connection to mood disorders, behavioral disorders and ADHD, although there may be others (6, 11). More and more research is finding that gluten intolerance will manifest with neurological symptoms instead of the more traditional digestive complaints (12). A 2004 research study published in the “Journal of Pediatrics” found that celiac disease test subjects were over 50% more likely to develop neurological disorders, including ADHD (13).
In fact, in some people, gluten and/or casein can mimic opiates, such as morphine and heroin. When a food sensitivity or allergy is present, combined with poor intestinal integrity, and poor digestion, the gluten or casein opiate-like peptides can travel through the blood stream and to the brain, resulting in some of the common symptoms of autism and ADHD. As a result, children may intensely crave gluten and/or dairy containing foods and when those foods are removed from their diets, kids may initially become crankier and angrier, as they are, in essence, going through drug withdrawals (6).
Likewise, when gluten containing foods are consumed by a person that has non-celiac gluten intolerance or celiac disease, immune antibodies are triggered that release inflammatory cytokines that damage brain function and result in neurological symptoms (14).
What is Gluten?
Gluten is the protein in some grains, including wheat, barley, spelt, kamut, and rye. Gluten is what holds breads and pastries together and provides elasticity for dough to rise. Gluten is found in most packaged and processed foods, especially breads, pastries, soups, sauces, dressing, and pastas and may be hidden on ingredient lists under the following names: wheat, gluten, natural flavoring, fillers, whey protein concentrate, whey sodium caseinate, white vinegar or white grain vinegar, rice malt (contains barley or Koji), rice syrup (contains barley enzymes), dextrin, malt, maltodextrin, hydrolyzed plant protein (HPP), hydrolyzed vegetable protein (HVP) unless from soy or corn, modified [food] starch (unless from arrowroot, corn, potato, tapioca or maize), mustard powder (may contain gluten), monosodium glutamate (MSG), vegetable gum (unless from carob bean, locust bean, cellulose, guar gum, gum Arabic, gum aracia, gum tragacanth, xantham gum, or vegetable starch) and gelatinized starch. When in doubt, if the label doesn’t explicitly certify that the product is “gluten free” and indicate how many parts per million it tests to, assume it to not be gluten free.
There are many non-gluten grains, including amaranth, teff, quinoa, Montina, millet, corn, and buckwheat that can be used in place of gluten containing grains. There are also wide varieties of gluten free flours that can be made from gluten free grains or the grinding of beans, nuts, seeds, or potatoes. Xantham gum, guar gum, and starches such as potato, corn, tapioca, and arrowroot add binding and elasticity capacity to gluten free breads and pastries. However, even when using non-glutinous grains, nuts, seeds, beans, and flours, there is a risk of cross-contamination with gluten if the product isn’t certified as “gluten free”.
What is Casein?
Casein is the main protein in dairy and may be listed on ingredient lists as: dairy, milk, milk solids, lactose, galactose, lactalbumin, lactoglobulin, casein, or caseinate. Breast milk is safe, as human casein protein is a different molecular structure than the casein protein in non-human animal milk (6). There are many substitutes for milk and dairy products that are made of “milks” from nuts, seeds, or grains such as rice.
Food Elimination Test
Food allergies are almost always implicated in the kids with ADHD that also have one or more of the following symptoms: 1) eczema, hives, hay fever, and/or constant runny nose 2) family member with allergies and/or migraine headaches 3) patchy tongue with irregularly flattened patches 4) abnormally red ears 5) food cravings. ADHD children with one or more of those symptoms should go on a limited diet for a couple weeks, eliminating gluten, dairy, corn, soy, eggs, artificial colors, artificial flavors and preservatives. At the end of two weeks, one food at a time should be added back in and if behavioral or the allergic symptoms return, that food should be entirely eliminated from the child’s diet indefinitely (9).
Elizabeth Strickland indicates that “The right nutritional interventions can have a huge impact on your child’s brain function, memory, learning, attention, focus, mood, behavior, growth, and overall health” (15). Even without a diagnosis of ADHD, your child may find improvement in behavioral and cognitive problems through an elimination diet, starting with the elimination of gluten and casein (6). Diagnosis of celiac disease requires a blood test, but most blood tests only test for the gliadin protein (there are other proteins in wheat), false positives are common and may not catch people that have a sensitivity to gluten but do not (yet) have celiac disease. Compart and Laake reason that, “The best test is the child’s own body…. The gold standard for food reactions is the child’s response to elimination of a food. It is better than any blood test. The goal of treatments is not to make the blood tests better; the goal is to make the child better” (6).
A Changed Child
Note provided by parents of child with neurological symptoms who had gluten and dairy removed from her diet: “Karen is completing third grade this year. Prior to removing gluten from her diet, academics, especially math, were difficult. As you can see, she is now soaring in math. Based upon this test, entering the fourth grade next year, she would be at the top of her class. The teacher indicated that if she skipped fourth grade and went to fifth grade, she would be in the middle of her class. What an accomplishment!” (14)
Providing optimal nutritional support and the elimination of problematic foods ensures that kids will also respond more effectively to more traditional medications and with fewer side effects. (6) A University of Sunderland, UK research study correlated a gluten- and casein-free diet with significant improvement within a year for children with ADHD. (16) That said, since there is no one cause of ADHD, there can be no one solution, but eliminating gluten and casein is a start.
Luckily, a gluten free and casein free diet can still be bountiful, delicious, and simple. With the increase in food sensitivities and food allergies, the choices have increased. Many restaurants have gluten free menus with dairy free options and there are many gluten- and casein-free products on the market. There are also organizations that support people living gluten free, such as the Celiac Sprue Association and the Gluten Intolerance Group. Additionally, gluten free cooking classes are becoming more available.
Learn more about foods that will improve the mental and digestive health of both your child and yourself by signing up for our free webinar: The 6 Keys to Optimizing your Mental and Emotional Health Through What You Eat.
References
(1) “Park Ridge MultiMed White Paper”: Celiac Disease and Gluten Intolerance
(2) “CDC Morbidity and Mortality Weekly Report”: Increasing Prevalence of Parent-Reported Attention-Deficit/Hyperactivity Disorder Among Children
(3) “THE Parental Intelligence Report on ‘ADHD’”; Bob Collier
(5) “Encyclopedia of Attention Deficit Hyperactivity Disorders”; Evelyn B. Kelly; 2009
(6) “The Kid-Friendly ADHD & Autism Cookbook: The Ultimate Guide to the Gluten-Free, Cassein-Free Diet”; Pamela Compart, MD, Dana Laake, RDH, MS, LDN; 2009
(7) “Lancet” journal; Controlled Trial of Oligoantigenic Treatment in the Hyper Kinetic Syndrome; Egger J, Carter CM, Graham PJ et, al.; Volume 1, 1985
(8) “European Child and Adolescent Psychiatry” journal; A Randomised Controlled Trial into the Effects of Food on ADHD; Pelsser LM, Frankena K, Toorman J, et al; January 2009
(9) “Huffington Post”: ADHD is on the Rise: How to Use Nutrition to Treat Attention Deficit
(11) “The Autism and ADHD Diet: A Step-By-Step Guide to Hope and Healing by Living Gluten Free and Casein Free (GFCF) and Other Interventions”; Barry Silberberg; 2009
(12) “The Lancet Neurology” journal; Gluten Sensitivity: From Gut to Brain; Marios Hadjivassiliou MD, David S Sanders MD, Richard A Grünewald phD, Phil,Nicola Woodroofe PhD, Sabrina Boscolo PhD, Daniel Aeschlimann PhD; March 2010
(13) “Pediatrics”: Range of Neurologic Disorders in Patients with Celiac Disease
(14) “Huffington Post”: Gluten Sensitivity and the Impact on the Brain
(15) “Eating for Autism: The 10-Step Nutrition Plan To Help Treat Your Child’s Autism, Asperger’s, or ADHD”; Elizabeth Strickland, MS, RD, LD; 2009
It’s so great to read your writing on this. As someone who works to help people to reclaim their personal power, mostly outside the prevailing tyranny of the questionable diagnostics, I am always delighted when someone really nails the connection between the pathologies that disempower people (especially children) and common sense solutions of lifestyle and diet. Thanks for this informative piece 😉
Thanks Caitriona! That means a lot to me!
Very informative article, Katie! My nephew is gluten intolerant but my sister has no power to make him eat gluten-free. She has tried for a while now but then he ends up sneaking…it’s gotten so bad that she fears she is pushing him toward an eating disorder! So she has stopped trying to control what he eats. Unfortunately, gluten seriously affects his mood and everything about his life. I will share this important article so more people are informed. Thanks!
Thanks for sharing your nephew’s story Tricia. It sounds as though gluten may attach to the opiate receptors in his brain which is a common problem. For him, not eating gluten is like going off of heroin! As such, gluten can be a major addiction. You may mention to your sister that it would be beneficial for your nephew’s neurotransmitter levels to be checked. Sometimes low serotonin or dopamine levels can aggravate the addiction. Neurotransmitters can be supported naturally through diet and supplements.
I wasn’t aware of gluten intolerance manifesting in such a high degree of mood symptoms. Like many I thought it was mostly physical symptoms. Thanks for such a detailed look at ADHD, gluten and casein Katie, you are keeping us well educated as usual!
Lynn
Thanks Lynn! It really is amazing isn’t it. We’ve been led to believe that digestive symptoms are the most common symptoms of gluten intolerance when actually neurological symptoms are more common.
Katie,
Wow, this was eye-opening for me…I had no idea gluten was so rampant, and it’s also becoming very clear how diet is SO influential in so many things. I also appreciated the tip on how you can begin testing for what your body may not be doing well with in our diets. Thanks so much for this incredible info, and know that it’s helping me move more towards a gluten-free life.
Thanks Geoff! I’m glad you found it useful. If you ever want to journey to Denver from the far away land of Boulder, I offer a free intro to gluten free living and gluten free store tour on the fourth Tuesday of every month from 7-8:30pm. Having the extra support may make the transition even easier for you. You can register at the bottom of the page here: https://www.nourishedhealth.com/gf/ . Best of luck in this journey and congratulations on making steps toward improving your health!
Here is a link where you can access for an exclusive interview with Arjan
Kuipers on the increasingly negative effects we see of gluten on children with ADHD and Autism in particular.
https://docs.google.com/file/d/0BzqRDoZtZXYWVjFqbmJnMUpfdlE/edit?usp=sharing
Arjan Kuipers is a chiropractic neurologist and has been a practicing clinician for over two decades. He is the founder and chief innovator of Brain Building Company and ADHD & Autism Training, which provides easy-‐to-‐use training programs for parents and professionals that are developed to facilitate a positive, lasting change in children with ADHD and autism.
Great! Thanks Van! I look forward to checking out this interview.
Katie Bauer recently posted..Kick the Crack (aka Sugar) Addiction
Wow I found this blog and I was blown away by the information. My son was diagnosed with ADHD when he was a kid. The schools (yes with an s) made us put him on ritalin and then adderall. I wish I had known about this when he was a kid. When he was about 13 he said he did not want to take it anymore and he has not taking a pill since then. He is 21 now.
I will share on my facebook page. There are lot of people, friends, and family thet are being told thier kid is ADHD and many would be pleased to know by chainging diet it could really help. Thanks for a great post.
Melissa recently posted..Procera Avh Reviews
Thanks Melissa! I appreciate that! That’s impressive and encouraging that your son was able to get off Ritalin at such a young age with just determination. I am sure there are a lot of parents and teens on Ritalin that would love to know more about how he did it.
In my practice, now besides just dietary changes, I also find it can be helpful to have neurotransmitters tested to determine if there is an imbalance. Often dopamine or the other catecholamines are low and can be naturally supported through improving digestion of protein and supplementing with amino acids and nutrient cofactors until balance is reached again. For some people and some conditions, pharmaceuticals may be necessary but there is a lot that can be tried first in relation to diet, digestive health and/or nutrients.
Katie Bauer recently posted..The 10 Second Secret to Igniting Your Digestive Fire
This is a wonderful article, one that motivated me to try going gluten-free for my 2 year old that was exhibiting many classic autism symptoms. I was sick with worry especially since where I live, an assessment will only be made at 3 years old. I just didn’t understand what was happening – why did he regress after 12 months of age?
It’s only been 5 days and wow, what a difference it has made. I can honestly say that I no longer worry that he may be on the spectrum, the difference has been THAT great. He now has great eye contact, awareness of things and people around him, more babbling (speech may take some time to catch up), hands me toys for help, no more spacing out and playing with rocks for hours at a time, no tantrums, and he just seems generally happier. When he kept eye contact and smiled at me through a whole song I was singing to him, I cried. He would have never done that before. I got my little boy back!! Thank you so much
Wow Irene! Thank you SO EXTREMELY much for posting your experience with your son. You made my day. Heck you may have made my month! You have me in tears of happiness in reading your account. Sometimes writing articles becomes a bit lonely and when you don’t hear any comments for a while, you wonder if the articles are being read and if they are actually helpful or just taking up space on the interweb. So thank you so much for sharing! What an incredible turn around in just 5 days! I’m excited to hear how things continue to progress for him and your relationship with him, if you have the opportunity to let us know.
Katie Bauer recently posted..Declare Your Independence Today
hi i am a 31 male from india and i even i am getting these behaviour problems from the consumption of milk products.if i stop it then within a week the dfference is seen.what do you call that? adult adhd?
Hi Himanshu, yes, adults can have ADHD as well as kids. The most common triggers I see for adults as well as kids is gluten, dairy, and soy, although as I mention in the article there are many other triggers as well. That is fantastic that you have discovered that dairy is your trigger. Congratulations!
Katie Bauer recently posted..Low-Glycemic, Veggie Dense, Dairy-Free, Upleveled Shepherd’s Pie (vegan or omnivore)
[…] Noursished Health cited research through a 2006 research study by the Regional Hospital of Bolzano in Italy strongly correlates ADHD symptoms with untreated celiac disease and indicates that a gluten free diet should improve symptoms quickly. Gluten and casein are the two proteins with the most common connection to mood disorders, behavioral disorders and ADHD, although there may be others. More and more research is finding that gluten intolerance will manifest with neurological symptoms instead of the more traditional digestive complaints. A 2004 research study published in the “Journal of Pediatrics” found that celiac disease test subjects were over 50% more likely to develop neurological disorders, including ADHD. […]
Great article. Having trouble with my 7 year old to focus.
he is super sharp but something is interfering with his ability to focus. I totally believe it’s some food items. So i’m going to give it try and update the progress results. Thank you SJ
Thanks SJ! I would love to hear what the results are if you could share them. I think it is helpful for other parents to hear. Best of luck to you and your son.
Katie Bauer recently posted..Sugar-Free Coconut Peppermint Patties (I mean Peppermint Paddies)
Great article. Having trouble with my 7 year old to focus.
He is super sharp but something is interfering with his ability to focus. I totally believe it’s some food items. So I’m going to give it a try and update the progress results. Thank you SJ
Oops! I think a duplicate comment happened–see above… Thanks SJ!
Katie Bauer recently posted..Sugar-Free Coconut Peppermint Patties (I mean Peppermint Paddies)
I agree that gluten-free is a good way to go. I think such foods are healthier for the body. I also think they can improve brain function.
YES! Thanks Elden!
Katie Bauer recently posted..Low-Glycemic, Veggie Dense, Dairy-Free, Upleveled Shepherd’s Pie (vegan or omnivore)
This is very informative. Thank you so much. I really don’t have any idea regarding this information. For me, we should be wise in choosing our food to eat.
YES! Agreed. We need to focus more in on our food.
Katie Bauer recently posted..Collard Burritos Save the Day and the Leftovers (with Video Tutorial)
Usually, the most obvious symptom is a high level of activity. Parents will often describe their child as “bouncing off the walls” or “running non-stop”. I have heard families describe sleepless nights, temper tantrums that seem unending, constant talking and interrupting, and deep sadness over their child’s lack of friends or other social interactions. It is this high level of activity that leads families to seek help. It is also this high activity level that creates stress within a family.
Then there are children who are not active at all. In fact, some families have described their child as “lethargic” or “spacey”. These children never get into trouble at school, church, or home for their activity level or impulsiveness, but they are constantly being reminded to “pay attention”.
Families have described rooms to me that look like a blast zone, items or clothing that were sent to school never to return, and their exasperation over a child who can play a video game for several uninterrupted hours but can’t pay attention long enough to dress himself.
It is easy to understand why adults feel frustrated and exhausted by child who are so active or so inattentive or a combination of the two. And sometimes it defies our understanding that a diagnosis of ADHD by a medical professional is not easily reached for these children.
Isabelle Clover recently posted..Health and beauty benefits of zucchini
Thanks so much Isabelle for sharing this. I agree that ADHD can defy classification and be misdiagnosed easily. Great information!
Katie Bauer recently posted..Celiac Research Update: Early Life Infections may be Connected to Celiac Disease Development
Great article! Very informative. What are your personal favorite foods to eat for ADHD? Thanks!
Thanks for commenting Dr. Dawn! I tend to find following the auto-immune paleo way of eating can help a lot of people get to the root of what foods trigger them and still allows for a varied way of eating. For extreme cases, the GAPS diet or the Specific Carbohydrate Diet may be a beneficial starting point and moving from there to autoimmune paleo. Eating a rainbow of colors is important in the produce we choose as we get different phytonutrients from different foods so looking at the foods being consumed and making sure it is as colorful as possible.
Katie Bauer recently posted..When Stopping Overeating Isn’t About Breaking a Bad Habit
Great article! Thanks for putting that together. I was hoping you could help me with something. I was wondering, Is it possible to deal with ADHD as an adult without medication? My doctor mentioned that I might have it but I’m not so sure. Thanks in advance for your answer.
Hi Hollis, thanks for your message! I can’t make any individual recommendations regarding taking or not taking medications but I can assure you that there are many non-medication ADHD management options for adults such as looking into meditation as a way to retrain your brain. There may be differences in the way your brain is communicating between regions (and the rest of your body). Meditation can support brain communicating and actually change your brain especially the prefrontal cortex. Second, depending on your symptoms, you need to “hack your productivity” and relationships and way of engaging with the world. You need to set yourself up for success in relationships and getting things done which means figuring out the structure that best works for you. Structuring your day, calendaring, and creating routines may be essential for you. You may find it also essential to de-clutter your life, to help you focus more on what you are working on at the time and minimize distractions. Third, for everyone, food is essential. What foods do you notice trigger the symptoms you experience? How does physical fitness effect your symptoms and what types? Logging your symptoms, what you eat, and what you do or don’t do in the day can help you figure this out.
To give you more specific ideas, I need some more information… You shared that you might have it but aren’t sure – what makes your doctor think you may have ADHD? What makes you question whether you have it? Some symptoms that may result in an adult being labeled with ADHD include challenges with attention, concentration, memory, motivation and effort, learning from mistakes, impulsivity, hyperactivity, organization, and social skills. How you respond to the symptoms you experience, regardless of whether it is ADHD or not, depends on the symptoms. When did these symptoms that your doctor is referencing come on? Have these symptoms been something you’ve dealt with your whole life? If not, then management may be about healing what triggered these symptoms. What was happening at the time when the symptoms came on?
That you are exploring and questioning is important. I’m not a fan of diagnoses. You may have a different way of relating to the world than what is considered “normal” but… What is normal anyway! Take care.
Katie Bauer recently posted..6 Steps to Stop Reacting out of Frustration or Anger
Food and Nutrition Sciences FNS is a peer reviewed international journal dedicated to the latest advancement in food and nutrition sciences The goal of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of food and Nutrient Metabolism
This is very informative for our health, thank you! I did not know about this before. It is important to be wise in choosing the food we have.
great article thanks