Sugar does not cause attention deficit hyperactivity disorder (ADHD), and there is little scientific evidence that sugar makes ADHD worse. However, a low-sugar diet is beneficial for people with ADHD in terms of good nutrition.
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that presents with symptoms of restlessness, inability to sit still, trouble focusing, and impulsivity.
This article explores how sugar affects people with ADHD, how to reduce sugar intake, and when to see a healthcare provider.
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Link Between Sugar and ADHD
Many parents and guardians of children with ADHD are used to hearing well-meaning but unsolicited advice to limit their children's sugar in order to make them less hyperactive. But does sugar really cause or worsen ADHD symptoms? The science suggests it does not.
There is no evidence that sugar can cause ADHD. And there is very limited evidence that sugar may be a contributing factor in hyperactivity symptoms, both in children with ADHD and without. Studies have released conflicting results and none is conclusive. The studies that show a correlation indicate that more research is needed to confirm their results.
Recent study findings include the following:
- A 2019 birth cohort study found no evidence of an association between the incidence of ADHD and the consumption of sucrose (table sugar, made up of glucose and fructose) in children between 6 and 11 years old.
- A 2020 systematic review (high-level summary of all valid primary research) and meta-analysis (compiling statistics from the data derived from systematic reviews) of seven studies involving 25,945 individuals indicated a positive relationship between overall sugar and sugar-sweetened beverage consumption and symptoms of ADHD. The researchers noted, however, that other factors may have contributed to these results. More research is needed to control for these elements.
- A 2021 study suggests that excessive fructose (fruit sugar) intake may activate a biological survival pathway that stimulates hyperactive foraging behavior (extreme motivation to seek and find more food to protect against food shortages and starvation). This could contribute to behavioral disorders such as ADHD, and aggressive behavior. But more research is needed to confirm results.
If there is such a lack of evidence, why is the belief that sugar causes hyperactivity in children with ADHD so widespread? It's likely because much of the so-called evidence comes from caregiver observation, which can be unreliable.
Studies have shown that parents and caregivers who expect to see an increase in hyperactivity after sugar consumption are more likely to perceive their children as more hyperactive after consuming sugar than an unbiased observer.
This doesn't mean that parents and guardians are always wrong when they notice their children seem more hyper after consuming sugar—it just likely isn't because of the sugar.
Often children are given more sugar than they are used to in situations that are already exciting, like at a birthday party or on Halloween. The stimulation from the environment may be more likely the cause of the hyperactivity than the extra sugar.
It's important to note that organizations such as the American Academy of Pediatrics (AAP) do not recommend special diets to treat ADHD.
Can I Treat My or My Child's ADHD on My Own?
ADHD is a chronic condition that begins in childhood and usually persists into adulthood. Optimal management usually requires guidance and often treatment from a healthcare provider. Treatment needs can also change over time.
If you or your child is showing symptoms of ADHD, see a healthcare provider to discuss how best to proceed.
Do I Have a Sugar Allergy or Sugar Intolerance?
Benefits of a Low-Sugar Diet for ADHD
Experts recommend a low-sugar diet for all Americans. A low-sugar diet, however, doesn't mean cutting out all sugars. Instead, it focuses on minimizing added sugars. Eliminating all sugars would not be healthy because sugar occurs naturally in fruits, milk, and vegetables—foods that provide important nutrients for growth and overall health.
Some of the benefits of a low-sugar diet may include:
Weight Management
Lowering sugar intake can reduce the risk of excess weight and obesity, as well as chronic health conditions. Added sugars also contribute zero nutrients but many added calories that can lead to weight gain.
Diets high in added sugar are linked to belly fat and visceral fat (the fat that surrounds abdominal organs). Excess body fat and visceral fat are associated with an increased risk of chronic diseases, including diabetes, certain types of cancer, and heart disease.
Heart Health
Diets with greater than 20% of total calories from added sugars are associated with high levels of triglycerides—a type of blood fat that can increase your risk for heart disease. Reducing added sugars in the diet can help keep blood pressure, cholesterol, and triglycerides at healthy levels, which decreases your risk forheart disease.
Brain Health
Foods that are good for brain health are low in added sugars. And most likely whatever is good for the brain is likely good for ADHD as well. Research shows that the best brain foods are the same ones that protect your heart, including:
- Dark leafy greens: Kale, spinach, collard greens, Swiss chard, and broccoli are rich in brain-healthy nutrients like vitamin K, lutein, folate, and beta-carotene.
- Fatty fish:Fatty fish are abundant sources of omega-3 fatty acids—healthy unsaturated fats that play a role in brain development and cognition (learning and memory) in children, as well as improved blood pressure and immunity.
- Berries:Flavonoids, the natural plant pigments that give berries their brilliant colors, also help improve memory and reduce the risk of cognitive decline in adults.
- Nuts and seeds:Nuts are excellent sources of protein and healthy fats, and one type of nut in particular might also improve memory. Walnuts and flaxseeds are high in a type of omega-3 fatty acid called alpha-linolenic acid (ALA). Diets rich in ALA and other omega-3 fatty acids have been linked to lower blood pressure and cleaner arteries. That's good for both the heart and brain.
Oral Health
Reducing the amount of added sugar in your diet can reduce the risk of cavities and gum disease. That's because sugar gets broken down by bacteria in your mouth and can produce an acid that destroys the surface of teeth, causing dental cavities. Too much bacteria can also lead to infected or inflamed gums, resulting ingum disease.
Improved Mood
What we eat and drink may impact our mood. One study showed eating foods like fruits, vegetables, and whole grains was associated with a lower risk of depressive symptoms. Another study showed a higher intake of total sugar was associated with increased depressive symptoms among obese adults.
Some studies have also suggested that sugary beverages are linked to a higher risk of depression. Yet other studies have found no relationship between sugar intake and depression risk. More research is needed to examine how sugar can affect your mood.
Cutting Back Sugar Intake
Even if it's unlikely that sugar significantly affects ADHD symptoms directly, healthy dietary habits are important for people with ADHD, and for everyone. This includes consuming sugar in moderation.
Blood sugar spikes, like those caused by eating sugary foods or ultra-processed grains and starches, and the blood sugar crashes that follow can influence the mood and the ability to focus and concentrate, as well as cause energy levels to fluctuate, both in people with ADHD and without.
Some ways to limit sugar intake include:
- Toss table sugar(white and brown): This also includes syrup, honey, and molasses. Cut back and gradually eliminate the amount of sugar added to things like cereal, pancakes, coffee, or tea.
- Swap out soda:Water is best. Try no-calorie sparkling water or infusing water with sliced fruit (orange, lemon, lime, strawberries) or mint leaves for added flavor. If you want something sweet to drink or are trying to lose weight, no-sugar drinks can be a healthier choice than sugary drinks.
- Eat fresh, frozen, dried, or canned fruits: Choose fruit canned in water or natural juice. Avoid fruit canned in syrup, especially heavy syrup.
- Compare food labels: Choose products with the lowest amounts ofaddedsugars.
- Add fruit:Instead of adding sugar to cereal or oatmeal, try fresh fruit (bananas, cherries, or strawberries) or dried fruit (raisins, cranberries, or apricots).
- Decrease sugar in baking:When making cookies, brownies, cakes, or muffins, cut the sugar called for in your recipe by one-third to one-half. Often you won’t notice the difference.
- Try extracts:While decreasing the sugar in recipes, use extracts like almond, vanilla, orange, or lemon.
- Replace sugar completely:Enhance foods with spices instead of sugar. Try ginger, allspice, cinnamon, or nutmeg.
- Substitute: Switch out sugar with unsweetened applesauce in recipes (use equal amounts).
Try these additional strategies:
- Save sweets for later in the day when focus is less important.
- Eat at regular intervals to minimize blood sugar highs and lows and lessen the likelihood of reaching for something sugary.
- Reach for fruit when craving something sweet. Fruit still contains sugar, but it contains healthy vitamins, minerals, and fiber to help minimize a blood sugar spike and provide valuable nutrition.
- If you eat a lot of sugar, taper your intake by gradually increasing your intake of healthier foods (fruits, vegetables, whole grains, lean protein, and nuts) to replace sweets.
Foods to Avoid
Avoiding added sugars is the key. Added sugars are the different types of sugars and syrups put in foods during preparation, processing, or at the table. Examples of foods and drinks to gradually decrease or eliminate include:
- Sugary beverages: regular soft drinks, sweetened tea and coffee, energy drinks, and fruit drinks
- Candy and chocolate
- Desserts and sweet snacks: cakes, cookies, pies, muffins, doughnuts
- Dairy desserts and milk products: ice cream, sweetened yogurt, and sweetened milk
- Some low-fiber breakfast cereals
- Some snack bars and granola bars
Food Dye and ADHD
The research on food dyes is conflicting. Most don't support food dye as a cause of ADHD, nor are they a problem for most people.
Some studies, however, have suggested that people with ADHD can be sensitive to certain food dyes, which may affect them in ways such as worsening ADHD symptoms.
It isn't suggested that everyone with ADHD avoid food dyes, but an elimination diet to see if it helps is something to discuss with a healthcare provider.
When to Talk to Your Healthcare Provider
If you or your child are showing signs of ADHD, see a healthcare provider. They can help you with a diagnosis and work with you to formulate a treatment plan.
If you have concerns about nutrition and dietary habits, your healthcare provider can refer you to a qualified nutrition specialist.
Summary
ADHD is not caused by sugar, and there is insufficient evidence to support that sugar directly affects ADHD or hyperactivity. Studies on ADHD and sugar are conflicting and have limitations. Even so, blood sugar fluctuations can affect mood and your ability to focus. Eating a balanced diet that includes protein and complex carbohydrates and that limits excess sugar is an important part of a healthy lifestyle for everyone, including people with ADHD.
