ADHD and how eating affects focus for kids

If your child has ADHD, you may wonder how eating affects their focus at school. The answer isn’t about perfect meals or strict rules.

In this episode, host Julian Saavedra talks with registered dietitians Elizabeth Davenport and Anna Lutz about how to help kids fuel for school. They share what to do when kids aren’t hungry, why breakfast can be tricky, and how to handle lunches, snacks, and afterschool hunger.

You’ll also hear how to help kids build healthy eating habits without turning food into a battle.

• Read: Should kids with ADHD avoid eating sugar?

• Listen: Picky eating: Why it happens and how to help

Julian Saavedra: If you're raising a child with ADHD or really just any kid at all, I think it's natural to want to grab hold of every strategy out there that might help them stay grounded and focused, especially when they're at school. And food is definitely one of the areas you might look to. Surely there must be some simple rules to help them and their brains thrive.

Elizabeth P. Davenport: It really depends on what the child is willing to eat and feels like eating, right? If we make a suggestion of something, say like eggs and toast and fruit, or a toaster waffle with some seed butter and a banana, but that's not what the child will eat, then it's not a superfood.

Julian: That's Elizabeth Davenport, and she's one half of "Sunny Side Up Nutrition," along with Anna Lutz. Elizabeth and Anna are both registered dietitians who work with parents to make meals stress free and to raise children to have a healthy relationship to food. They also have a blog and a podcast full of excellent advice and resources.

Welcome to "The Opportunity Gap," a show where we talk about how to navigate the education system. I'm your host, Julian, an assistant principal with over 20 years of experience. Today we're talking to Elizabeth and Anna about how to set up our kids for success when it comes to food, at school and at home, without turning meals and eating into yet another set of rules for them to follow.

Anna, Elizabeth, welcome to the show.

Elizabeth: Thanks for having us.

Anna M. Lutz: We're thrilled to be here.

Julian: All right, well, I want to jump right in because there's a lot of things I want to talk about. And listeners, viewers, I was explaining to Elizabeth and Anna earlier, this has been like a passion project for me. Just the idea of nutrition and the connection to food and health and our mental well-being, there's so many connections to it. So I just want to rack your brain about so many things that we can talk about.

First question: In your practice, do you all see a lot of parents who have kids with ADHD? And if so, what are some of the most common concerns they bring to you?

Elizabeth: We do. We see parents of kids with ADHD so often. And a lot of the questions and concerns that we get are children aren't eating meals, especially breakfast, or they come home from school and they are absolutely ravenous — in part because oftentimes medication can dampen and completely negate hunger and fullness cues. And so kids aren't hungry at school and don't eat, and then they come home and the medication wears off and they're famished.

Some of the other concerns we see are kids — and this would be a more serious concern — a child might not be growing as expected, and so parents may come to us in those situations as well.

Julian: And that's something I've heard a lot about in the families that I work with, where if children are taking medicine for ADHD, their appetite is impacted.

Elizabeth: Absolutely.

Julian: So, Anna, I wanted to ask about the breakfast debate. A lot of people have said you have to have a healthy breakfast to be prepared for your day. What's your take on how eating little or no breakfast might impact kids over the course of the day?

Anna: Well, I think the research is clear that eating breakfast helps with attention. Our brain works on glucose. And so when our blood sugar is low, our brain finds it hard to focus, right? So if you have a child with ADHD who already has trouble focusing, and then they also have low blood sugar, it's going to be that much harder.

And so this is where it can get challenging. Families have limited time in the morning, people are trying to get out the door. What will the child eat? We're brainstorming with the family of what can we put together that will help sustain the child's brain and focus for the next several hours.

That's kind often pairing up protein, fat, and carbohydrates, which help stabilize blood sugar levels. So it's one of those things where eating isn't going to quote "cure" ADHD, but it's a tool we have of eating regular meals and snacks can really help a child with their focus and attention at school.

Julian: So what I hear you saying is that if a child is not eating a breakfast that is healthy — maybe not even eating a breakfast at all — it could exacerbate the lack of focus for kids with ADHD.

Anna: That's right.

Julian: So if that's the case, any recommendations for what we should be giving our kids at breakfast? You want to give us a couple of combos that are tried and true that you recommend?

Elizabeth: Yeah. Before we hopped on the recording, we talked about toast with peanut butter — or if somebody has allergies, they could use a seed butter. You know, one of the things I always encourage people to do is really ask their kid what they feel like they can eat, even if they don't feel like eating. You might give them soup, right? They might love soup, and so that's what they have.

Julian: For breakfast?

Elizabeth: Yeah! It doesn't have to be what we think of as a quote-unquote breakfast food. So often drinking something is easier than eating something when we don't feel like eating.

And so if someone's appetite is low or they don't feel like eating so early in the morning, it's easier to get down something liquid like soup, like a smoothie, a drinkable yogurt. So it may not be the thing that sounds wonderful when we are hungry, but it's what can get down that early in the morning.

Julian: Are there any superfoods that you'd recommend that really they punch above their weight in terms of value for eating in the morning?

Elizabeth: I mean, it really depends on what the child is willing to eat and feels like eating. If we make a suggestion of something, say like eggs and toast and fruit, or a toaster waffle with some seed butter and a banana, but that's not what the child will eat, then it's not a superfood.

So as you can see, we really try to gear this to what each individual child is willing and able to take in.

Julian: So let's pivot to lunch. I'm wondering if we're packing the lunch with the kids — maybe they're even incorporated into the process of packing their lunches and making the choices — but they find that their friends are coming in with snacks and candy and other fun things, and they're coming home with their lunch box still full. What would you recommend a family should do to remedy that situation?

Elizabeth: We get that question a lot. And one of the things that we recommend is it's an opportunity just to ask your kid some questions. Our instinct as parents might be to say, "Oh my gosh, you have to eat your lunch," but just ask them what's happening in the cafeteria or what's going on that's making you not feel like having your lunch and let's see if we can make sure that you're getting some things that you feel like you can eat.

And I think if a child also is super interested in sweets and chips and cookies and things and they're not getting them in their lunch, they're going to be even more interested in them than they would be otherwise. So our recommendation would be to go ahead and ask them to choose a couple things they'd like to have in their lunch that would be fun for them.

Anna: And you know, part of parenting is teaching children what eating looks like, and that's eating in the world that they're living in. And so there are all sorts of foods at school, at people's houses, at after-school programs. And so if we're saying you never can have those foods, we're not teaching them how to interact with those foods.

And so often children that have forbidden foods at home are the children that might overeat those foods outside of the home or eat past fullness because they're so forbidden — rather than making them a part of what they eat and modeling that it's not all of lunch. We have everything in there, but it's not totally forbidden.

07:22 The risks of energy drinks for children

Julian: Speaking of forbidden foods, I do want to ask about energy drinks. In the Saavedra household, energy drinks are not even a conversation starter. The conversation starts and ends with a big no. But from your standpoint as experts, what do you think about energy drinks? What's in them and why we really, really don't want our kids to get into the habit of drinking them?

Elizabeth: I mean, I just think kids don't need caffeine, and that's really it. It's going to impact their mood, their energy level, their ability to focus. If we think about it as adults, if you can think of a time that you've had too much caffeine, I don't know about you all but it honestly will make me feel like there are ping-pong balls loose in my head.

It's super hard to sit still and to focus. So I think they are a problem and kids view them as something that's kind of grown up, for lack of a better word, and they want to feel kind of cool, and so they're appealing to them.

Anna: The other things — there's the caffeine — but there's also oftentimes herbal additives or different things that aren't regulated that we don't really know how a child will react to that. A lot of them have artificial sweeteners, which again, we don't know how certain children will react to the artificial sweeteners.

And I think another concern that Elizabeth and I both share is when they're used instead of eating — that they're used as a substitute for a meal. And so maybe they feel they've gotten a little bit of energy from the caffeine and they can do something, but there's going to be a crash and there's no food behind it to kind of level up blood sugar and really give them real energy.

So yes, there's not a lot of things that we think should be off-limits, but something like an energy drink that has so many different ingredients in it that could be harmful, you want to have a lot of caution about that. And then as the child becomes a teenager and has their own access — maybe they have their own car, their own food, their own money — then it's going to be really talking about: Is there a healthy amount? Is there, they have one a week but they need to have it with food?

Figuring that out together with that child or really having them notice: How do you feel when you drink that? Why don't you tell me what that's like the next time you have one?

Elizabeth: And I'll add one more thing about the caffeine, the energy drinks.

Julian: Uh-huh.

Elizabeth: Some of the medications that kids and teens are on for ADHD can really increase their heart rates, and then if you add the caffeine from an energy drink on top of that, that can be problematic.

Julian: To say the least. It's something that we from the education space really try to be clear about with kids and adults, like no, we just don't want them around because they can be really detrimental to your health.

So thinking about after school, a lot of our kids will be coming home from school and they may have various activities whether it be practices or clubs, what have you, and they come home and they're starving. They want to have a bunch of snacks and dinner might not be until 6:00 or 7:00. And so they're not just going to have a couple pieces of apple slices, right? Like they're not going to have a small little snack. Is there any recommendations you all would have for typical things — and I know it's individualized — but are there typical things that might be recommendations for our listeners and viewers?

Anna: Absolutely. I think the biggest thing to remember is children have really high energy needs because they're growing all the time. And so oftentimes children need an afternoon snack that looks a lot like a meal.

And so if parents can know that — that kids will come home, they're getting ready to go to soccer practice, their lunch was four hours before, their body is probably asking for quite a lot of food. And so we really encourage parents to offer a sit-down snack. Come to the table, and we talk about that pairing of protein and carbohydrate.

So that might be half of a peanut butter and jelly sandwich, or if you do apple slices, we're going to dip it in peanut butter, cheese and crackers, yogurt and granola and berries. So really pairing together that protein with the carbohydrate so that it sustains them through their homework, through their after-school activity. Because like you said, dinner's not for another three to four hours and their body is going to use that for what they're doing, and then they're going to be ready to eat dinner in several hours.

If we don't provide that structure, they come home so hungry and they might get what they can for several hours and they might not be hungry for dinner because we haven't provided that structure.

Julian: Makes sense.

Elizabeth: Sometimes what happens is they don't come home from school before a practice or another activity they have and they go to an after-care. But there isn't really an opportunity to have a snack like that. Plenty of places provide a snack, but it's often just something like crackers, which are fine, it's just not enough to fuel the kids fully until they get home.

Julian: So maybe thinking ahead and packing something that they can have for that afternoon snack is a good idea.

Elizabeth: Exactly.

Julian: To all of you watching on YouTube, I'm wondering if you've discovered a great energy snack for your kids. Over at the Saavedra household, I'm getting really tired of protein bars and chicken potpies. My daughter loves that.

Elizabeth: Sounds like a good snack!

Julian: So, please let me know. Do you have an idea or some great snack ideas or snack hacks? If you do, drop them in the comments, please.

12:44 The role of mealtime rules and the importance of using food to connect kids to their cultural identity.

Julian: All right, Elizabeth and Anna, should we have rules around food? No chips before dinner, no dessert before you've eaten what's on your plate. Are there rules that should be in place?

Elizabeth: Rules can be helpful. They are part of what provides structure. It really depends on the rule. A rule that interferes with the kid's ability to tune into their own cues, that can be detrimental.

So for example, if we say you have to eat your peas to get dessert, that teaches the kids, one, not to pay attention to their hunger and fullness cues, but it also puts dessert on a pedestal. And then there are rules that are helpful. You might say, "Okay, we don't take food into our bedrooms," for example. You may want your kids eating in the kitchen or the dining area.

Anna: Along those lines, you know, we're going to come to the table to eat. We're not going to maybe eat in front of the TV because that helps us tune into our hunger and fullness. There's exceptions to that, right? Movie night, we're going to have popcorn.

The goal is to help the child take time to eat, prioritize eating. Like we're not going to eat while we're playing basketball. We're going to go eat for 10 minutes and then you can go back outside and play basketball. So we're saying this is really important.

We might have stricter rules when they're younger because just like any other developmental skill that we're teaching our children, there might be stricter rules. But as they get older, those rules might start to be a little bit more lax because we're handing over some of the responsibilities to the child about the food.

So really to think about: Why do I have a rule in my house around food? Is it supporting this child in tuning into their hunger and fullness and prioritizing food, or is it a way to control exactly what's going in their body? And to really kind of try to tease that out.

Julian: When I think about the messages that we try to give our kids about food, I think about the food's connection with culture. Food is such a big part of our life experience. We pass on tradition through foods and recipes. Food is where we come together. We have dinner as much as we can together at night. We, in the spring and summer and fall, grow our own food.

My grandmother's from Cuba, her arroz con frijoles is a really big deal in our household. So there's just so many things that we bring like cultural stories about food. And the big message that we try to impart is that food is just not fuel, food is our culture. I wonder from your perspective, are there any other messages that we should try to be giving our kids about food and its place in our lives?

Elizabeth: That's such a great question and such a great point, because food gets so demonized. There's also almost over-importance placed on food and the nutrients, but so often the cultural importance and the connection that it provides us and the traditions that it provides us aren't highlighted.

And cultural foods are also demonized. We are taught in grad school that there are foods people should be avoiding when they're actually part of a person's culture and they provide plenty of nutrients and a connection to their culture.

Julian: I guess from a dietitian's perspective, are there any other things that we really want to make sure as we're raising them that we make sure that they know really important about food?

Anna: The things that pop into my mind are eating enough is the most important. So often we get messages of "Don't eat too much." Really when you look at it, what's the most harmful is not eating enough. And so providing our bodies with enough nutrition is extremely important.

And then to piggyback on what you and Elizabeth said, so often we talk about food is not only the nutrients that it provides, it provides connection, memories, connection to our culture, so much more, and to not get bogged down in the nutrients.

Elizabeth: I would just add that I think other things that we want to teach our kids are — they've been seeing what we give them. As they get older, we want them to be able to put together a balanced meal or a balanced snack once they're in late middle school, high school, and the goal is when they leave home to be able to navigate the foodscape.

18:15 Weight gain and appetite patterns as key indicators for when families should seek a professional consultation.

Julian: And it's a big, really big foodscape out there. So it's a lot to figure out. I want to go back to ADHD for a minute. Thinking back to those that are taking medicine for ADHD and how there could be an adverse impact on appetite or on eating patterns.

If my child is taking medication for ADHD or anxiety or whatever host of things that they could be taking medicine for, where do you decide, "All right, I need to go get some help. I might need to get a consultation from a dietitian or or maybe I need to go talk to Elizabeth or Anna to figure out what's going on"? Like what is the trigger for a family to decide it's not just a passing missing a couple of meals thing, this is more serious?

Elizabeth: The biggest thing is if the child is not gaining weight. Children should always be gaining weight. So if they go to their well-child visit and they have fallen off their growth curve — they haven't stayed on their natural growth curve — that would be a red flag that they're not getting enough nutrition, and sitting down with a registered dietitian would be a good idea.

Anna: If you do see your child skipping whole meals and then not eating more later in the day, because that does happen with the medication. They might eat smaller meals in the morning, but in the evening, their body's cues kind of kick in once the medication wears off and they're able to meet their needs.

But if you see a drastic change in your child's eating from the medication, as a parent I would say preemptively you can get a consult of "How am I going to support this child in getting enough nutrition?" because childhood is so important because of the growth that happens and the bone density that needs to be laid down. Sometimes even doing it preemptively would be a good idea.

Julian: Does insurance typically cover a visit to dietitian?

Elizabeth: That is hard to answer and it's really all over the map. Anna is in a state where it does seem like the coverage is great. Not the case where I am.

Julian: And that leads into my final question. The title of our podcast is "The Opportunity Gap," and we talk about the lack of opportunity for certain groups as it relates to special education and learning and thinking differences.

One of the things that I don't think our culture talks enough about is the gap in food resources for children of certain social classes and certain racial demographics. I work in inner-city Philadelphia, and so many of my students don't have access to healthy food. They live in what one would consider a food desert, where the only thing that they have access to are Takis and whatever other sugary snack or high fructose corn syrup-based thing that they can get their hands on because that's just cheap and that's affordable, but they don't have access to fresh fruits and vegetables or cheese and crackers or apples and peanut butter or things of that nature.

So I'm wondering from that vantage point, what would your advice or recommendation be? And I know it's a really big loaded question, but just wondering what your advice would be with how to make sure that our children are still getting what they need.

Elizabeth: I think it's such a difficult issue and there really isn't one way to fix it. I think some schools can put together or bring in programs to help send food home to kids who are especially in need on the weekends and they're usually staff at the schools that can help identify those kids. I mean, obviously universal free breakfast and lunch, year-round, is really what needs to happen.

Julian: Yes.

Elizabeth: But that could be a whole podcast episode.

Julian: It could be. Listeners, viewers, this has been a really fruitful conversation about a lot of things that I learned about, and I hope that you all have taken something out of this conversation. But I just wanted to say thank you, Elizabeth, thank you, Anna, for coming on "The Opportunity Gap."

Anna: Thanks so much for having us.

Elizabeth: Thanks so much for having us.

Julian: Everyone at home watching, listening, you can find out more great advice from Anna and Elizabeth on their website, Sunny Side Up Nutrition. If you found this video helpful, you might also like a conversation the folks over at "In It" had on how to make the morning routine easier for families with kids who have ADHD. You'll find a link in the show notes. Until next time family, see y'all out there.

Thanks for listening to "The Opportunity Gap." We love hearing from our listeners. So if you have any thoughts about today's episode, you can email us at opportunitygap@understood.org. And be sure to check out the show notes for links and resources to anything we mentioned in the episode.

This show is brought to you by Understood.org. Understood.org is a nonprofit organization dedicated to empowering people with learning and thinking differences, like ADHD and dyslexia. If you want to help us continue this work, donate at understood.org/give.

"The Opportunity Gap" is produced by Julie Subrin and Gretchen Vierstra. Video is produced by Calvin Knie and edited by Jesse DiMartino. Briana Berry is our production director. Jordan Davidson is our editorial director. From Understood.org, our executive directors are Laura Key and Scott Cocchiere.

Thanks again for listening. Until next time, OG family.