It stands to reason that an adequate diet is necessary for a child’s healthy growth. Proper nutrition, including an array of vitamins, minerals, amino acids, and essential fatty acids (EFAs), is particularly necessary in the first few years of life to support brain development and prevent certain neurologic disorders. Even among older children, a lack of certain dietary components, such as protein, or an insufficient number of calories can negatively affect a child’s learning and behavioral abilities, and vitamin or mineral deficiencies can certainly interfere with learning over the course of a school year. To date no convincing evidence has shown that a poor diet causes ADHD, or that dietary supplements can be used to successfully treat the condition. Nonetheless, healthy eating and family meals are lifestyle choices generally supported by the American Academy of Pediatrics (AAP).
In the 1950s Drs Abram Hoffer and Humphry Osmond began using megavitamins containing large amounts of vitamin B3, vitamin C and, later, pyridoxine (vitamin B6) to treat schizophrenia. This treatment was based on the theory that schizophrenia and some other forms of mental illness are caused by a genetic abnormality that greatly increases the body’s vitamin and mineral requirements. By providing patients with enormous doses (megadoses) of these substances, Hoffer and Osmond felt that psychiatrists could provide an “optimum molecular environment for the mind” in which the symptoms of mental illness would diminish or disappear.
In the 1960s the chemist and Nobel Laureate Linus Pauling put his support behind this theory, giving it the name orthomolecular psychiatry and greatly increasing its visibility among experts and the general public. In the 1970s Dr Allan Cott claimed that hyperactivity and learning disabilities were also the result of vitamin deficiencies and could be alleviated with megavitamins and large doses of minerals. Treating ADHD symptoms in children with nutritional supplements—supplements that contained at least 10 times the recommended daily allowance of vitamins, minerals, and other necessary elements—became an increasingly popular alternative to stimulant medication, particularly among families who considered megavitamins the more “natural” approach.
Research has failed, however, to reveal significant positive results from megavitamin therapy for children with ADHD. While some early studies resulted in improved classroom attention ratings for subjects taking megavitamins, these studies were marred by the fact that the children, their parents, their teachers, and the researchers were all aware that a given subject was being given this new form of treatment. When the studies were repeated using the double-blind method discussed earlier, so that no one knew whether a particular child was taking a megavitamin or a placebo, no behavioral improvement was shown. In fact, it was discovered that disruptive behavior increased in a significant number of the children given the megavitamins.
Studies have also suggested certain abnormalities in the way the liver functions among children on megavitamin therapy, signaling possible toxic effects of this high level of vitamin intake—a strong reminder that “natural” substances are not always safe, especially in the highly “unnatural” doses prescribed here. As a result, experts have concluded that megavitamin therapy for ADHD is of little benefit for nearly all children with the condition—and potentially harmful. In 1976 the AAP Committee on Nutrition issued a formal statement to that effect. No subsequent studies have provided evidence that would change this opinion. This is not to say that children with ADHD should not take any vitamins, just that vitamins at normal doses and even megadoses are not in any way an effective treatment for ADHD.
Other Vitamin and Mineral Supplements
In the wake of the enthusiasm for megavitamin therapy, a number of specific nutritional elements have been studied regarding their possible role in the development of ADHD and their potential for treating the condition.