Low-carb, high fats like the ketogenic diet are popular because they just plain work.
To name a few of its many benefits, keto can help you achieve more energy, lower your blood sugar, and burn more fat without starving yourself.
But what about keto and ADHD?
Research into ketosis and ADHD is currently in very early stages, but recent evidence is extremely compelling.
Keep reading to learn how diet can affect ADHD symptoms, 5 ways keto may help focus, and how to gauge the effects of keto on ADHD for yourself.
What is ADHD?
Attention deficit hyperactivity disorder, ADHD for short, is a type of neurodevelopmental mental disorder.
The main identifying traits of ADHD are trouble paying attention, excessive activity, and behavioral problems. It may also involve difficulty regulating emotions and impulses.
- Trouble staying focused on tasks
- Difficulty paying attention to detail
- Poor time management
- Fidgeting and squirming while seated
- Inability to remain quiet
- Appearing not to listen when spoken to
The disorder can affect children and adults, but appears before age twelve.
Possible Causes of ADHD
While ADHD is the most commonly studied and diagnosed mental disorder in young people, scientists still aren’t sure of the exact causes[*].
Most researchers agree that complex genetic and environmental factors are responsible, which is a fancy way of saying there’s a lot going on[*].
Having a family member or parent with ADHD increases the odds of an ADHD diagnosis two- to eight-fold[*].
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However, having two parents with ADHD does not result in a 100% chance of an ADHD diagnosis, which means it’s not purely genetic[*].
Some studies have found differences in brain structure or neurotransmitter levels when comparing people with and without ADHD[*][*].
But like all psychiatric disorders, ADHD is diagnosed using a questionnaire to discover symptoms, not using brain scans or blood tests.
Researchers have identified the following risk factors for developing ADHD symptoms, but none of them entirely accounts for the disorder:
- Maternal health issues or smoking during pregnancy[*]
- Exposure to toxins like lead or heavy metals[*]
- Nutritional deficiencies in copper, iron, zinc, magnesium, or omega-3 fatty acids[*][*][*]
- Physical or psychological childhood trauma[*]
Additionally, there are several promising theories about how ADHD develops.
3 Theories That Might Explain ADHD
The cell danger response theory states that “chemical, physical, or biological threats” during development affect cellular function, resulting in metabolic changes that cause imbalances in neurotransmitters[*].
According to that theory, cell danger responses in childhood may be responsible for various mental disorders including ADHD, autism spectrum disorder, and schizophrenia.
Other researchers propose that inflammation and autoimmune processes cause ADHD[*].
Some evidence suggests that kids with ADHD have a higher risk of allergies and asthma[*]. However, there isn’t enough proof yet to know for sure if inflammation and autoimmunity cause ADHD.
The environmental oversampling theory states that physical and mental overstimulation in childhood cause problems with dopamine, a neurotransmitter involved in reward and focus[*].
If correct, excessive amounts of junk food, television, and video games may be responsible for some cases of ADHD[*]. This theory would also help explain why ADHD and obesity often occur together.
How Can ADHD Be Improved With Diet?
Most research into ADHD treatment focuses on pharmaceutical medication rather than dietary approaches.
However, there’s substantial evidence that the food you eat can affect both ADHD risk and the severity of symptoms.
Correcting Mineral Deficiencies
At the most basic level, nutrient deficiencies affect brain function.
Studies have found deficiencies in minerals and omega-3 fatty acids occur more often in people with ADHD[*][*][*]. That means anyone with the disorder would be well-served to pay attention to their diet to ensure they aren’t deficient in minerals and other micronutrients.
People with ADHD may have difficulty eating a healthy diet, but eating more fish and veggies might help reduce symptoms[*].
Addressing Sugar, High Body Mass Index, and Insulin Resistance
Studies demonstrate that overweight or obese children have a higher risk of ADHD, and that symptom severity correlates with body mass index (BMI)[*].
Eating less sugar is one way to achieve a healthier weight. Sugary foods may also increase the risk of ADHD by causing dopamine imbalances, and avoiding sugar may help decrease symptoms[*].
One study also found that children with ADHD may have insulin resistance, and evidence shows that some kids experience fewer symptoms when eating lower glycemic index (GI) foods[*][*].
Avoiding Symptom Triggers
Eating fewer processed foods and avoiding artificial food additives may help, too. Preservatives, dyes, and artificial flavors can cause symptom flare-ups in some individuals[*].
Along with food additives, other potential irritants include gluten, casein, dairy, and nuts[*].
A randomized controlled trial published in The Lancet in 2011 found that a strict elimination diet helped improve symptoms in a majority of children with ADHD[*]. Elimination diets involve eating a limited diet to steer clear of potential allergens, then slowly reintroducing foods one at a time to gauge the results.
Improving Gut Bacteria
Lastly, the bacteria living in your gastrointestinal tract also appear to play a role in ADHD[*]. People with ADHD may have different gut bacteria compared to people without the disorder[*].
These gut flora, collectively called your gut microbiome, are strongly influenced by diet and in turn affect brain development, immune function, drug metabolism, and inflammation levels.
Eating fewer processed foods and more probiotic foods may help keep ADHD symptoms under control by enhancing your microbiome[*].
5 Ways Keto Helps Focus
#1: Fueling Your Brain More Efficiently
During ketosis, your body makes ketones. These incredible energy molecules are the most efficient source of fuel for your brain[*].
When you aren’t in ketosis, your brain primarily runs on glucose (a simple sugar). However, blood sugar spikes and dips can easily lead to energy crashes and brain fog.
Interestingly, it also gets harder for your body to transport sugar across the blood-brain barrier (BBB) as the amount of available sugar increases[*][*][*]. In technical terms, you could say that glucose transport is self-limiting rather than inducible.
On the keto diet, you mostly avoid carbs and sugar. That’s why your brain switches over to using ketones for many of its metabolic needs, with a steady but small trickle of glucose from gluconeogenesis.
The truly amazing thing about ketones and brain function, though?
Ketone transport across the BBB is inducible, unlike glucose transport[*][*]. The more ketones are available, the more readily they enter your brain to be used as fuel.
Translation: no brain fog, no crashes, and plenty of energy for proper mental functioning.
Surprisingly, no one has conducted a study of ketones in ADHD (yet).
But we do know that in senior citizens, people with epilepsy, and individuals with mood disorders, keto can boost brain function and focus[*][*].
That means the odds are pretty high that kids and adults with ADHD can benefit from the keto diet.
And for people who aren’t following the keto diet, ketone supplements like beta-hydroxybutyrate can also boost focus and brain function through the same process[*].
#2: Reducing Inflammation and Oxidative Stress
Some scientists think that inflammation and cellular stress play a role in the origins and symptoms of ADHD.
For example, inflammation can damage neurons and interfere with the function of neurotransmitters[*].
Fortunately, ketones are anti-inflammatory and can even help rescue damaged brain cells[*][*].
According to a 2017 paper published in Frontiers in Psychiatry, people with ADHD may have elevated cytokine levels in their blood and nervous system[*].
Inflammatory cytokines are protein molecules released by the body when cells are damaged. During chronic inflammation, high levels of cytokines can lead to further damage[*].
Several studies suggest that the keto diet can lower inflammatory cytokines, which could be beneficial for ADHD symptoms[*][*].
The keto diet also activates a powerful antioxidant system in your body called Nrf2[*]. While eating sugar can increase cellular damage and inflammation that could contribute to ADHD severity, keto may prevent cellular damage from occurring by elevating Nrf2 levels.
Finally, evidence also suggests that going keto helps your body to eliminate damaged cells that impair brain function[*].
#3: Balancing Neurotransmitters
Neurotransmitters are critically important signaling molecules that enable your nervous system to work correctly.
Imbalances in neurotransmitters occur in conditions like anxiety, depression, epilepsy, and ADHD[*].
Many researchers believe that alterations in dopamine function are responsible for ADHD.
Because dopamine is involved in focus, motivation, and reward, this theory makes perfect sense[*]. Not only that, the vast majority of ADHD medications work by increasing dopamine levels or mimicking dopamine to enhance focus[*].
And according to animal studies, it turns out that going keto has the potential to boost dopamine activity and protect neurons that produce dopamine[*][*][*].
Along with dopamine, GABA is another neurotransmitter that may be implicated in ADHD[*].
GABA is what’s called an inhibitory neurotransmitter. In other words, GABA helps regulate activity in your nervous system by reducing the effects of other neurotransmitters called excitatory neurotransmitters.
Imbalances in GABA activity may explain hyperactivity, impulsivity, and aggression that can accompany ADHD[*].
Scientists have also found that people with epilepsy experience higher rates of ADHD, and individuals with ADHD also have a heightened risk of seizures[*][*].
Interestingly, many seizure medications work by increasing or mimicking GABA[*].
Additionally, the ketogenic diet is well-studied and found to be safe and effective for treating childhood epilepsy that doesn’t respond to drugs[*].
Let’s connect the dots:
- Epilepsy and ADHD may share a common cause (GABA imbalance).
- The keto diet works fantastically for treating epilepsy.
- It appears to do this by improving the synthesis and regulation of GABA[*][*].
Unfortunately, human research on the GABA-boosting effects of keto in people with ADHD doesn’t exist at this point.
That said, a study of dogs with epilepsy and ADHD-like symptoms found that the ketogenic diet treated symptoms of both disorders and also reduced anxious behaviors[*].
And the authors of a 2006 study found that the keto diet decreased activity levels in rats, leading them to conclude that “the ketogenic diet may be of use in the treatment of ADHD”[*].
#4: Reversing Insulin Resistance
Insulin resistance is bad news. When you eat too many carbs, your cells stop responding to insulin, which can lead to metabolic syndrome, type 2 diabetes, and obesity[*].
It also raises your risk of Alzheimer’s, cardiovascular disease, and premature death, whether or not you have diabetes[*][*].
Some evidence points to the possibility that insulin resistance contributes to ADHD[*]. ADHD is also unusually common in obese adults[*].
Eating too much sugar can make ADHD symptoms worse, while cutting processed foods and eating fewer sweets can improve them[*][*].
The keto diet is one of the most effective ways to reverse insulin resistance, especially when paired with exercise.
And of course, if you commit to going keto, you won’t be eating processed carbs or sweets regularly. That means you may enjoy better concentration and focus.
If insulin resistance turns out to be one of the culprits behind ADHD, keto may decrease ADHD symptoms by reversing insulin resistance[*].
Either way, going keto is an excellent way to improve your physical and mental health and achieve a healthy weight.
#5: Changing the Microbiome
Your gut microbiome helps regulate your development, immune function, and neurotransmitter levels[*][*].
And as you have probably learned by now, ADHD appears to involve disruptions in those three areas.
Numerous studies show that people with ADHD have differences in their microbiome compared to people without the disorder, which may result in imbalances in dopamine and GABA[*][*][*].
And high-quality research proves that going keto can change your gut bacteria.
While there isn’t direct evidence of how they affect ADHD, these microbiome changes are associated with relief from conditions like epilepsy and multiple sclerosis[*][*].
Keto can promote a healthier microbiome, reducing “bad” bacteria and favoring beneficial species[*].
Foods to Avoid for ADHD
There’s no question that certain foods can worsen ADHD symptoms for many people.
So far, the most effective diet studied for ADHD is the strict elimination diet[*].
Elimination diets aren’t very complicated.
To begin with, you simply avoid certain foods for a certain length of time (usually a month, but some people go for two to six months) and monitor your symptoms.
Then you reintroduce the same foods slowly, no more than one or two per week, and look for recurring or worsening symptoms. If you notice a flare-up, that means you’ve identified a trigger food to cut out permanently.
One great thing about the keto diet is that it automatically eliminates the majority of problem foods that could be symptom triggers.
Another thing about problem foods: most (but not all) of them aren’t very healthy to begin with.
Even if they aren’t triggering your symptoms, it’s a safe bet that eliminating most of the ingredients below will lead to better health.
According to research, here are the top foods to avoid for people with ADHD[*][*]:
- Artificial flavors
- Artificial sweeteners
- Added sugar and other sweeteners
- Other chemical additives
- Energy drinks (which are basically nothing but preservatives, dyes, artificial flavors, etc.)
- Any other known or suspected allergens
Of all those foods, nuts and some dairy products–preferably grass-fed, unpasteurized, and organic–are really the only foods that belong in a healthy ketogenic diet anyway.
Even if you don’t eat nuts, the keto diet still offers a plethora of other ways to get healthy fats. Avocados for days!
Generally speaking (as long as they don’t trigger symptoms), and if you aren’t sensitive to casein, cheese and butter are acceptable. Or even if you are, ghee is fine.
Keto and ADHD: Putting It All Together
Current research into possible benefits of the keto diet and ADHD is lacking compared to other keto science, but there’s plenty of reason to be optimistic.
Besides, you don’t need to wait for more research. Strong evidence indicates that keto is safe for adults and kids, with no major side effects[*]..
The best way to gauge how effective keto is for ADHD symptoms is to give it a test run!
Here’s what to keep in mind before you start:
- Read up on keto macronutrients.
- Learn to count net carbs and don’t exceed 30-50 grams of carbs per day.
- Test your ketone levels regularly to figure out if you’re really in ketosis.
- Make sure to include plenty of low-carb veggies and nutritious whole foods, plus fatty fish (or krill oil) for omega-3 fatty acids.
- Keto automatically excludes most ADHD problem foods, but you’ll get better results if you make a conscious effort to avoid all of them, particularly at first.
Do you find the idea of starting a new diet intimidating?
If so, ketogenic supplements like MCT oil or exogenous ketones are the easiest way to figure out how ketone bodies interact with your ADHD symptoms.
MCT oil or BHB can give you a pretty good idea of what to expect in terms of benefits, especially if you also avoid problem foods. You can go “all-in” later if you want.
Have you tried going very-low-carbohydrate for ADHD? Please share your questions or experiences in the comments below!