Intermittent Fasting in Patients with Attention Deficit Hyperactivity (ADHD) Disorder: What a Clinician Needs to Know

Abstract Background: Intermittent fasting (IF) has gained popularity as a dietary strategy with various health benefits, but its effects on attention deficit hyperactivity disorder (ADHD) remain largely unexplored. Although the importance of diet interventions in ADHD has been frequently stressed, there is a scarcity of research needed to establish guidelines.

Abstract Methods: An evidence review examining IF and ADHD was conducted. For inclusivity, a range of fasting strategies was included (Table 1). First, ADHD and IF are defined and described. Second, the neurocognitive effects of fasting are proposed, emphasizing the dopaminergic pathways characteristic of ADHD. Third, contemporary nutritional strategies for ADHD are reviewed, highlighting a potential role for IF. Fourth, the benefits of IF on metabolic comorbidities associated with ADHD are presented. Lastly, pharmaceutical considerations and contraindications to fasting, emphasizing the pediatric ADHD population, are addressed.

Abstract Results: While fasting may be beneficial in reducing ADHD symptoms, more data is needed. Neurocognitively, the catecholaminergic effects characteristic of fasting may improve the dopamine deficient thought to underlie ADHD. In addition, fasting may be an optimal nutrition strategy for ADHD due to its ability to mimic the ketogenic diet, which has shown promise as a nutritional strategy in ADHD, while also combatting metabolic comorbidities associated with ADHD, such as obesity, by offering a simple method of caloric restriction.
Furthermore, the scheduled eating pattern IF prescribes may provide a feasible structured energy consumption style for a patient with ADHD. However, before IF can be strongly recommended in this population, research addressing pharmaceutical considerations, such as the safety of combining stimulants and IF, and best practices with the implementation of this nutrition strategy regarding concurrent mental health and eating disorders, especially in the pediatric population, must be addressed.

Abstract Conclusion: IF shows some promise in benefiting patients, but more clinical studies are needed. As IF becomes increasingly popular in the general population, clinicians caring for ADHD patients should educate themselves on the neurocognitive and metabolic effects of fasting when addressing the nutritional, behavioral and pharmaceutical needs of ADHD patients.

Funding: N/A

Conflict of Interest: The authors report no conflicts of interest related to this research