Nutrition Interventions for ADHD and Emetophobia

Attention Deficit Hyperactivity Disorder (ADHD) and its connection to eating disorders is a relatively new field of study. However, early research has uncovered some links connecting aspects of ADHD to certain disordered eating behaviors. [1]

Still, other research is beginning to uncover the roles certain foods and nutrient deficiencies may play in these conditions, indicating that it may be possible to help alleviate some symptoms through diet interventions.

ADHD and Eating Disorders

The idea that eating disorders may be connected to other mental health conditions is nothing new. Anorexia nervosa (AN) has long been tied to aspects of autism, for example.

Still, research is continuing to uncover additional links, including between ADHD and bulimia nervosa (BN), as well as binge eating disorder (BED).

Some overlapping behaviors that drive these conditions include:

• Impulsivity
• Disorganized thinking
• Hyper-fixation
• Higher levels of stress

Scientists believe the same types of chemical imbalances in the brain lead to these behaviors, whether they manifest as ADHD, BN, or BED. These overlapping conditions have also been found to be especially prominent among children. [2]

Emetophobia and Eating Disorders

Emetophobia, or the fear of vomiting, has also been linked to certain eating disorders, some research suggests.

As with the majority of phobias, emetophobia is often triggered by a traumatic event. [3] Generally, this event is linked to vomiting. It’s likely also that the situation caused a great deal of social anxiety and distress.

An intense fear of vomiting can lead someone to highly restrict their diet or food intake, as a precaution against throwing up. [4] This type of behavior is also prevalent in certain types of eating disorders, including ARFID, or avoidant/restrictive food intake disorder.

In fact, the fear of vomiting is a primary driver of ARFID for many people.

Links Between ADHD and Emetophobia

While attention deficit hyperactivity disorder and emetophobia may not seem similar on the surface, the conditions do share a few major underlying factors.

Understanding these common links is important in understanding why a healthy diet, vitamin and mineral supplements, or other nutritional changes may help improve these conditions simultaneously.

Anxiety

Anxiety goes hand in hand with any number of mental health conditions, including nearly every type of eating disorder and most phobias. It also plays a major role in attention deficit hyperactivity disorder.

It’s thought that one in four children with ADHD also struggle with some form of anxiety, and one in four children with an anxiety disorder also showcase ADHD symptoms. This overlap includes all types of anxiety conditions, including phobias. [5]

History of Vomiting

There are several reasons why someone with ADHD might have a traumatic event connected to vomiting.

Many types of medication used for ADHD treatment, including both stimulant and non-stimulant medications, are connected to nausea. In particular, children who use these methods to help manage ADHD symptoms often report feeling nauseas or the urge to vomit.

ADHD has also been linked to Cyclic Vomiting Syndrome, a condition that includes regular bouts of nausea and vomiting. [7] And it’s possible someone struggling with this condition may also go on to develop a fear of vomiting.

ADHD, Emetophobia and Diet

Attention deficit hyperactivity disorder and emetophobia may result in similar disordered eating habits, but it may also be possible to examine the symptoms of these maladies through dietary therapy.

Several types of diet have been proposed to help understand the types of foods that can make these conditions worse—or better.

Some strategies include eliminating problematic foods, including sugary foods and those with food additives, which may make ADHD symptoms worse, as well as focusing on healthy dietary changes that bring on a more balanced diet.

Still, it’s important to note that while these nutrition intervention strategies seem promising, they are based on limited data from clinical trials.

Elimination Diets

An elimination diet, also called the few foods diet, involves the adoption of a very limited diet, for a short period of time. The idea is to get an idea of how certain foods may be affecting certain health issues. (Someone’s sugar intake, for example, may lead to worsening ADHD symptoms.)

Foods are slowly and thoughtfully re-introduced over certain periods of time, to test out someone’s mental and physical reactions to these dietary changes. Once potential links have been identified, day-to-day dietary patterns can be adjusted accordingly.

The few foods diet was developed by doctors to identify food allergies in patients, but the method has since been expanded to help diagnose various diseases and disorders. Regardless, these programs should always be done with the supervision of a doctor or registered dietician.

The Feingold Diet

“The Feingold Diet,” sometimes also called the ADHD diet, was first introduced in 1974, after Dr. Ben Feingold, in partnership with the Mayo Clinic, published the seminal guide, Why Your Child Is Hyperactive .

The program is a type of elimination diet for attention deficit hyperactive children, recommending the elimination of foods containing artificial additives, including flavorings, food coloring, artificial sweeteners, preservatives, and certain salicylates, which are naturally-occurring compounds in fruits and vegetables.

The Feingold Diet has been met with skepticism over the years, as it’s only undergone a limited number of clinical trials, which had small sample sizes. However, a pair of studies—conducted in 2004 and 2007—have shed more light on the technique’s potential effects, showing positive results connected to hyperactive behaviors and the removal of certain food dyes, sweeteners, and preservatives. [8, 9]

Nutrition to Improve ADHD Symptoms and Emetophobia

While certain diets may be helpful for identifying foods or substances that worsen ADHD symptoms or cases of emetophobia, certain nutritional changes may help someone more proactively manage or even eliminate some symptoms.

That’s because attention deficit hyperactivity disorder—and the emetophobia that may come with it—has been linked to certain chemical imbalances in the brain, which can sometimes be corrected with nutritional supplements or diets higher in certain substances.

Proteins

High-protein foods like meats, cheeses, nuts, and beans have been found to have a positive effect on concentration, especially when consumed in the morning, and may even help ADHD medications work better. [10]

Still, when dealing with someone who’s primary diagnosis is for emetophobia, it’s better to proceed with caution when introducing new foods to their diet. Consulting with a nutritionist may be helpful in these cases.

Complex Carbohydrates

Carbohydrates get a bad reputation among many diet circles, but these foodstuffs are not one-size-fits-all. And, in many cases, the right kind of carbohydrates can be nutritionally beneficial, particularly for children with ADHD.

Complex carbs, like those found in vegetables and citrus fruits, have been fount to be helpful for overall brain health. For people struggling with ADHD, consuming these types of carbs at night can be especially helpful, as they’ve been found to help alleviate restlessness, which is often a symptom of ADHD. Complex carbs can also help promote a good night’s sleep. [10]

However, make sure fruits are kept fresh and ripe, as mushy fruits that are close to being expired can be triggering for people with emetophobia.

Omega-3 Fatty Acids

Omega-3 fatty acids are a known brain food, having been linked to better brain health in a number of studies.

When it comes to improving ADHD symptoms, these nutritional supplements have been shown to help with inattentiveness and a lack of focus in some children with ADHD. [11]

Good sources of this essential nutrient can be found in fish, walnuts, and canola and olive oil. The variety of sources for Omega-3 fatty acids can also be useful when catering to someone with emetophobia.

Foods To Avoid for ADHD and Emetophobia

When it comes to ADHD and emetophobia, there are a number of foods that may be better off avoided, whether to ward off worsening symptoms or to help an individual feel more comfortable about what they’re eating.

Refined Sugars and Simple Carbohydrates

The body burns through refined sugars and simple carbohydrates quickly, which leads to a spike in the blood sugar and a rush of dopamine to the brain. It’s thought that this latter effect may lead to many people with ADHD craving simple carbs, as the disorder has been connected to lower dopamine levels. [12]

But what comes up, must come down. Refined sugars and simple carbs also tend to lead to swift blood sugar crashes, which can cause moodiness and lethargy, among other symptoms. For children with ADHD, this aspect of these foods can be equally as damaging, as it can make focus and energy management even more difficult.

It’s recommended to limit sugar of any type for children with ADHD, while keeping carbohydrates complex and fibrous, so they can provide more long-lasting, focus-friendly energy.

Caffeine

Most experts do not recommend caffeine consumption for individuals with ADHD. [13]

For children, caffeine found in soft drinks and other beverages can become highly addictive, due to the hit of dopamine that often accompanies its use. Once again, children with ADHD have an elevated risk of craving foods or beverages that cause this effect.

Furthermore, stimulants are already common in ADHD medication, so adding caffeine on top of the medication may cancel out the medication’s effects.

Caffeine can also impact people struggling with emetophobia, as the substance has been connected to a number of stomach issues, which people with a fear of vomiting may find triggering.

Other Treatment Options for ADHD and Emetophobia

Nutritional changes are not the only tool to help manage ADHD symptoms or bouts of emetophobia.

Therapy can be useful for curbing symptoms of both conditions. Those with emetophobia may benefit from cognitive behavioral therapy (CBT), which focuses on changing someone’s behaviors through changing their thought process, or exposure therapy, which would slowly expose them to triggering foods or situations.

Cognitive Behavioral Therapy

CBT has also been successfully used to help with attention deficit hyperactivity disorder, in these cases helping patients learn new, more positive coping mechanisms to help manage their ADHD symptoms.

And cognitive behavioral therapy also has a long history of helping with disordered eating behaviors, including those involved in bulimia nervosa and binge eating disorder.

If you or a loved one is struggling with any of these conditions, help is always available. Reaching out to a healthcare professional, like a doctor or mental health therapist, is a great first step toward taking a more positive and proactive approach, and getting on the path to recovery.

Resources

1. Reinblatt S. P. (2015). Are Eating Disorders Related to Attention Deficit/Hyperactivity Disorder? Current treatment options in psychiatry; 2(4):402–412.
2. Bleck, J., DeBate, R., Olivardia, R. (2014, July 10). The Comorbidity of ADHD and Eating Disorders in a Nationally Representative Sample. The Journal of Behavioral Health Services & Research; 42:437-451.
3. Treatment for dealing with PTSD, Trauma and Phobias. Human Givens Institute. Accessed January 2023.
4. Maertens, C., Couturier, J., Grant, C., & Johnson, N. (2017). Fear of Vomiting and Low Body Weight in Two Pediatric Patients: Diagnostic Challenges. Journal of the Canadian Academy of Child and Adolescent Psychiatry; 26(1):59–61.
5. Anxiety Disorders and ADHD. HealthyChildren.org. Accessed January 2023.
6. ADHD Drugs: How to Handle Side Effects in Kids. (2021, May 3). WebMD. Accessed January 2023.
7. Boles, R. Cyclic Vomiting Syndrome Explained. (2021, March 1). NeuroNeeds. Accessed January 2023.
8. Schab, D. W., & Trinh, N. H. (2004). Do artificial food colors promote hyperactivity in children with hyperactive syndromes? A meta-analysis of double-blind placebo-controlled trials. Journal of developmental and behavioral pediatrics; 25(6):423–434.
9. McCann, D., Barrett, A., Cooper, A., Crumpler, D., Dalen, L., Grimshaw, K., Kitchin, E., Lok, K., Porteous, L., Prince, E., Sonuga-Barke, E., Warner, J. O., & Stevenson, J. (2007). Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial. Lancet; 370(9598):1560–1567.
10. Roybal, B. ADHD Diet and Nutrition: Foods To Eat & Foods to Avoid. (2021, June 4). WebMD. Accessed January 2023.
11. Study Shows Omega-3s Benefit Some Children With ADHD. (2020, January 16). Children and Adults with Attention-Deficit/Hyperactivity Disorder. Accessed January 2023.
12. Put Down That Pizza – Seriously! (2017, May 14). Attention Deficit Disorder Association. Accessed January 2023.
13. Q&A: What about caffeine for ADHD? (2017, February 2). Children and Adults with Attention-Deficit/Hyperactivity Disorder. Accessed January 2023.

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The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on March 17, 2023
Published on EatingDisorderHope.com