In the US, diagnoses of Attention Deficit Hyperactivity Disorder, or ADHD are on the rise, in part because healthcare experts are more adept at catching early-stage indicators. And while we learn more about how to identify it, we’re also learning more about how to manage ADHD — and it turns out diet, specifically carbs, can play a huge role in how ADHD symptoms manifest.

When the idea of diet therapy for ADHD first emerged in the 19 70s, it focused on the elimination of foods that were believed to encourage hyperactivity, such as artificial colorings and sweeteners, preservatives, and a handful of raw foods with “triggering” natural chemicals. While still noteworthy, looking at more recent studies that link brain health and nutrition, doctors are now considering a diet low in carbs and high in healthy fats (example, a ketogenic diet), which could be even more beneficial toward stabilizing the blood sugar spikes that exacerbates the condition.

When we eat a bowl of breakfast cereal or a white bread peanut butter and jelly, (foods high in refined carbohydrates), our blood sugar and insulin levels spike. And because what comes up must come down, this is followed shortly by a crash of both. To regain balance, somewhat of a neurochemical war ensues. Your brain releases epinephrine (or adrenaline) to the body, and norepinephrine to regulate glucose levels, sending energy to your brain.

As you can imagine, a mind prone to hyperactivity doesn’t bode well with these rapid shifts. This is why ADHD medications target norepinephrine levels — to keep the release of attention-stimulating hormones somewhat steady.

Rather than simply minding unhealthy carbs and sugars, when you make extreme cuts in your carb consumption (keto, for example), you trigger a process called ketosis, which helps your body process fat as energy. This is why you’re encouraged to swap the carbs for protein and healthy fats, as the latter will be turned into ketones in the liver, the other main “brain food” besides glucose.

In a 2006 clinical study published in Experimental Neurology, Patricia Murphy and W.M. Burnham (researchers at the University of Toronto, Department of Pharmacology) found that a ketogenic diet caused a reversible decrease in the activity level of rats, concluding that it could “be of use in the treatment of ADHD.” Komal Saif, a certified dietician practicing at Zia Hospital & Maternity Complex in Lahore, Pakistan, and contributor to Healthwire Pakistan, believes this is because of the way ketones activate the expression of brain-derived neurotrophic factor (or BDNF), which leads to improved function of the cortex, hippocampus, and basal forebrain. These are the areas responsible for higher thinking, memory, and learning. She also confirms that a low-carb diet protects the brain cells from metabolic dysfunction that can trigger ADHD symptoms.

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