At his general pediatric practice in Windham, Dr. Stephen Donnelly, D.O., sees plenty of parents who say, “Just give me the script.” But at the Maine Center for Integrative Medicine, which he founded in Portland two years ago to offer specialty consults for children and adolescents, the parents of his patients want solutions that complement or eliminate the need for prescription drugs.
One common issue that parents seek Donnelly’s help with is when kids exhibit signs of attention deficit hyperactivity disorder, or ADHD.
According to 2011 numbers from the Centers for Disease Control, 5.2 million children have been diagnosed with ADHD. These jittery, unfocused kids can be bouncing off the walls one minute and in meltdown mode the next. They can aggravate teachers and test the limits of their parents’ patience.
Stimulants – such as Adderall and Ritalin – are the conventional medicine answer. But Donnelly says there are many other avenues to explore.
Donnelly studied medicine at the University of New England and did his pediatric residency at the Barbara Bush Children’s Hospital at Maine Medical Center. However, his training goes beyond that of many doctors because of his fellowship at the prestigious integrative medicine program run by Andrew Weil, M.D., at the University of Arizona.
Next week, Donnelly will give a talk on integrative medicine approaches to ADHD at Whole Foods Market in Portland. I caught up with Donnelly ahead of his talk to find out about one area of his treatment plan – how the foods children eat can help lead to a diagnosis of ADHD.
“I approach ADHD from a variety of areas – diet, exercise, school supports, neuro-psych testing,” said Donnelly.
He starts off by having his patients (or their parents) fill out a questionnaire that asks for detailed information about the foods eaten each day. Frequently this information gives Donnelly a picture of a child who is going through his or her day with little real nutrition.
“Oftentimes I find (the foods kids eat are) very heavy in carbohydrates and sugar and lacking in protein, fiber and healthy fat,” said Donnelly. “Some might have Cocoa Puffs for breakfast with skim milk, no snack and ramen noodles for lunch.”
He said these kinds of overly processed, nutrition-devoid foods set off chain reactions in the body that create a rollercoaster of blood sugar highs and lows. In addition, the low blood sugar triggers the release of adrenaline. The result is a kid suffering from both low blood sugar and high levels of adrenaline.
“That looks very much like ADHD,” Donnelly said.
His main message to parents struggling with an ADHD diagnosis is that children need to eat protein, fiber and healthy fats during all meals and snack times.
For the child eating Cocoa Puffs for breakfast, Donnelly said a whole grain cereal and a sliced apple with peanut butter would be a much better breakfast that would help stabilize blood sugar throughout the day. Another good choice would be an egg on whole grain toast with a side of fruit. A kid-friendly snack could be cut fruit with Greek yogurt and granola.
Donnelly said parents should make sure their kids steer clear of foods labeled “low fat.”
“Anything low-fat means high-carb,” said Donnelly, who noted that all those carbohydrates (often in the form of sugar or refined grains) cause blood sugar to spike.
When it comes to fat, Donnelly said, kids should stay away from trans fat (typically in the form of hydrogenated oil) and limit the amount of saturated fat (high in animal-based foods and low in plant-based foods).
He said the best choices for high quality fat and protein are foods such as wild-caught salmon, sardines, walnuts and flaxseeds.
Fiber can be found in whole plant foods, such as grains, fruits, vegetables and nuts.
Donnelly advises parents to read food labels (and vitamin labels, too) and avoid artificial dyes, preservatives and flavorings, as many of these have been linked to behavioral issues in children.
“There are seven dyes banned in Europe, and they’re all throughout our food supply” in the United States, Donnelly said.
Donnelly has also found that many of his patients with ADHD suffer from nutritional deficiencies – particularly low levels of zinc, magnesium and iron.
“I’ve been testing zinc, magnesium and iron levels for three years and about 90 percent of my kids have low zinc,” Donnelly said. “Low zinc alters your sense of taste and smell.”
Because many children with ADHD prefer a narrow range of foods, Donnelly said adding a zinc supplement can improve a child’s taste buds and make him or her more open to trying new foods. This can help the child to eat a broader range of whole foods, which in turn will help maintain proper nutrient levels.
His patient testing has also revealed that 50 percent of the ADHD kids he sees are low in iron and 25 to 30 percent are low in magnesium.
These essential components of whole foods are often lost when foods are processed. Other foods grown on the depleted soils associated with industrial agriculture lack or have only low levels of these essential minerals.
“I do recommend a daily multivitamin, but it doesn’t replace anything,” Donnelly said. “You want to eat a whole food, natural diet. And the vitamin needs to be food-based. Even that will be better absorbed when eaten with a meal.”
If one of his patients starts eating better food and taking supplements to correct deficiencies but still is exhibiting ADHD symptoms, Donnelly said the next avenue to explore is the potential for food allergies or sensitivities. Common foods that can trigger reactions include dairy, wheat, corn, nuts and shellfish.
Donnelly isn’t opposed to prescribing medication for children with ADHD, but he prefers to use it as a bridge until the other interventions – such as a better diet – have time to take effect. Using this approach, Donnelly is often able to wean his patients off their medications over time.
One of the major challenges for parents and kids who want a drug-free approach to healing ADHD symptoms is that none of the solutions presents a quick fix. It’s all about making changes and sticking with them.
“I always tell parents it’s not like a course of antibiotics,” Donnelly said. “It’s really a lifestyle change. Keep treats as treats. But keep the nutritional stuff as the routine on a daily basis.”
Avery Yale Kamila is a freelancer who lives in Portland. She can be reached at: [email protected]