Do people with ADHD have a higher incidence of food and/or environmental allergies?
Answer
An increasing number of children are being diagnosed with asthma, allergy, and ADHD in the U.S. 1 A study published in the Annals of Allergy, Asthma & Immunology indicated a possible link between the rise in these three conditions. 2 This study found there is an increased risk of ADHD in boys that have a history of asthma or allergy 2 and "... an even stronger risk associated with milk intolerance." 1 Other studies found children with asthma had an increased risk of ADHD, especially those individuals with severe asthma. 3,4 However, asthma medication does not appear to increase the risk of ADHD. 4 Additionally, children with ADHD born prematurely and/or those children whose mothers underwent stress during pregnancy have a significantly increased risk of developing asthma. 5 Another study found children with ADHD or autism spectrum disorder (ASD) had an increased risk of allergic comorbidities, and those with both ADHD and ASD had the highest risk, however further research to explain the link between ASD, ADHD, and allergic diseases was recommended. 6 A systematic review and meta-analyses from 2017 found strong evidence that ADHD in children and adolescents is associated with atopic diseases (i.e. asthma, atopic eczema, and allergic rhinitis) and that individuals with atopic diseases have a 30% to 50% greater chance of developing ADHD compared to controls. 7
Regarding environmental factors, environmental lead exposure before age 6 may also raise the risk for ADHD. 8 Regarding food, various nutritional factors have been investigated in association with ADHD. 8 Some of these factors include sensitivities to certain food chemicals, deficiencies in fatty acids and zinc, and sensitivity to sugar. 8 There is no conclusive evidence linking any of these dietary factors as risk factors for developing ADHD. 8 Preliminary studies indicate addressing dietary factors (i.e. reducing ingestion of artificial food coloring; eliminating foods through an elimination diet containing rice, meat, vegetables, pears, and water; taking omega -3 fatty acid supplements, and switching to organic foods to reduce pesticide exposure) may improve some of the symptoms associated with ADHD. 9
References:
1. American College of Allergy, Asthma, & Immunology. "Children with Allergy, Asthma May Be at Higher Risk for ADHD." Available at: https://acaai.org/news/children-allergy-asthma-may-be-higher-risk-adhd.
2. Eelko Hak, Tjalling W. de Vries, Pieter J. Hoekstra, Susan S. Jick. Association of childhood attention-deficit/hyperactivity disorder with atopic diseases and skin infections? A matched case-control study using the General Practice Research Database. Annals of Allergy, Asthma & Immunology, 2013; 111 (2): 102. 10.1016/j.anai.2013.05.023
3. Vitalpur, Girish. "Impact of Asthma Medication and Familial Factors on the Association Between Childhood Asthma and Attention-Deficit/Hyperactivity Disorder: A Combined Twin-and Register-Based Study." Pediatrics 136.Supplement 3 (2015): S269-S269.
4. Holmberg, Kirsten, et al. "Impact of asthma medication and familial factors on the association between childhood asthma and attention‐deficit/hyperactivity disorder: a combined twin‐and register‐based study." Clinical & Experimental Allergy 45.5 (2015): 964-973.
5. Grizenko, Natalie, et al. "Increased Risk of Asthma in Children with ADHD: Role of Prematurity and Maternal Stress during Pregnancy." Journal of the Canadian Academy of Child and Adolescent Psychiatry 24.2 (2015): 109.
6. Lin, Ting-Yang, et al. "Autistic spectrum disorder, attention deficit hyperactivity disorder, and allergy: Is there a link? A nationwide study." Research in Autism Spectrum Disorders 8.10 (2014): 1333-1338.
7. Van der Schans, Jurjen, et al. "Association of atopic diseases and attention-deficit/hyperactivity disorder: A systematic review and meta-analyses." Neuroscience & Biobehavioral Reviews (2017).
8. University of Maryland Medical Center. "Attention deficit hyperactivity disorder" Available at: https://umm.edu/health/medical/reports/articles/attention-deficit-hyperactivity-disorder
9. Time Magazine. "ADHD & Kids: The Truth About Attention Deficit Hyperactivity Disorder." Available at: https://time.com/growing-up-with-adhd/.
Amy M. Schlessman, PT, DPT, DHS
Amy is an Assistant Professor in the Physical Therapy Program and a Center of Teaching Excellence Faculty Liaison at the University of Findlay. She is the Website Co-Chair and Zoom Committee Chair for the Academy of Pediatric Physical Therapy. Amy has been practicing as a school-based PT for over 18 years, focusing on health promotion and physical activity embedded into academics and interprofessional collaboration, while closely working with educators, administrators, therapists, and parents. Her research on pediatric health promotion was published in Pediatric Physical Therapy. Amy also published, “Recycle Bin Boogie: Move and Learn with Recyclables,” a physical activity book combining academic concepts with common household recyclables. She has presented regionally and nationally on a variety of topics related to health promotion, active learning, school-based therapy, and special education.
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