Sugar and ADHD: What You Should Know

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that presents with symptoms of restlessness, an inability to sit still, trouble focusing, and impulsivity.

There has long been speculation that sugar either causes ADHD or makes the hyperactivity associated with some people's symptoms of ADHD worse. However, there is little scientific evidence to support this belief.

This article will explore how sugar affects those with ADHD, how to reduce sugar intake, and when to see a healthcare provider.

Link Between Sugar and ADHD

Many parents and guardians of children with ADHD are used to hearing well-meaning but unsolicited advice to limit their children's sugar in order to make them less hyperactive. But does sugar really cause or worsen ADHD symptoms? The science suggests it does not.

There is no evidence that sugar can cause ADHD. There is very limited evidence that sugar may be a contributing factor in hyperactivity symptoms, both in children with ADHD and without. Recent study findings include:

• A 2019 birth cohort study found no evidence of an association between incidence of ADHD and the consumption of sucrose (table sugar, made up of glucose and fructose) in children between 6 and 11 years old.
• A 2020 systematic review (high-level summary of all valid primary research) and meta-analysis (compiling statistics from the data derived from systematic reviews) of seven studies involving 25,945 individuals indicated a positive relationship between overall sugar and sugar-sweetened beverage consumption and symptoms of ADHD. The researchers noted, however, that there were other factors that may have contributed to these results. More research is needed to control for these factors.
• A 2021 study suggests that excessive fructose (fruit sugar) intake may activate a biological survival pathway that stimulates hyperactive foraging behavior (extreme motivation to seek and find more food to protect against food shortages and starvation). This could contribute to behavioral disorders such as ADHD, and aggressive behavior. But more research is needed to confirm results.

If there is such a lack of evidence, why is the belief that sugar causes hyperactivity in children with ADHD so widespread? It's likely because much of the so-called evidence comes from caregiver observation, which can be unreliable.

Studies have shown that parents and caregivers who expect to see an increase in hyperactivity after sugar consumption are more likely to perceive their children as more hyperactive after consuming sugar than a unbiased observer.

This doesn't mean that parents and guardians are always wrong when they notice their children seem more hyper after consuming sugar—it just likely isn't because of the sugar. Often children are given more sugar than they are used to in situations that are already exciting, like at a birthday party or on Halloween. The stimulation from the environment may be more likely the cause of the hyperactivity than the extra sugar.

Cutting Back Sugar Intake

Even if it's unlikely that sugar significantly affects ADHD symptoms directly, healthy dietary habits are important for people with ADHD, and for everyone. This includes consuming sugar in moderation.

Blood sugar spikes, like those caused by eating sugary foods or ultra-processed grains and starches, and the blood sugar crashes that follow can influence the mood and the ability to focus and concentrate, as well as cause energy levels to fluctuate, both in people with ADHD and without.

Some ways to limit sugar intake and impact include:

• Include a source of protein in meals and snacks, especially if they contain sugar or refined carbohydrates.
• Save sweets for later in the day when focus is less important.
• Eat regularly to minimize blood sugar highs and lows and lessen the likelihood of reaching for something sugary.
• Reach for fruit when craving something sweet. Fruit still contains sugar, but it contains healthy nutrients and has fiber to help minimize a blood sugar spike.
• If you eat a lot of sugar, taper intake by gradually increasing your intake of healthier foods to replace sweets you are decreasing.
  

When to Talk to Your Healthcare Provider

If you or your child are showing signs of ADHD, see a healthcare provider. They can help you with a diagnosis and work with you to formulate a treatment plan.

If you have concerns about nutrition and dietary habits, your healthcare provider can refer you to a qualified nutrition specialist.

Summary

ADHD is not caused by sugar, and there is insufficient evidence to support that sugar directly affects ADHD or hyperactivity. Studies on ADHD and sugar are conflicting and have limitations. Even so, blood sugar fluctuations can affect mood and your ability to focus. Eating a balanced diet that includes protein and complex carbohydrates and that limits excess sugar is important part of a healthy lifestyle for everyone, including people with ADHD.

A Word From Verywell

Sugar does not cause ADHD and eliminating it won't cure it. There is also little evidence to suggest that sugar makes ADHD worse.

So, should you eliminate sugar? Doing so is unlikely to make a significant difference to your or your child's ADHD symptoms, but excess sugar isn't healthy for anyone. If you feel sugar is affecting your or your child's ADHD, it likely won't hurt to limit excess sugar, as long as their nutritional needs are met. Even if it doesn't help with ADHD symptoms, a healthy diet is likely to show other positive effects.