Lifestyle and attention deficit/hyperactivity disorder


  • Klaus W. Lange



Attention deficit/hyperactivity disorder, lifestyle, food, diet, physical activity, media use, sleep, circadian rhythm, ambient light


Attention deficit/hyperactivity disorder (ADHD) is a frequent diagnosis in childhood and adolescence and the disorder may also be found in adulthood. The core symptoms of ADHD, inattention, impulsivity and hyperactivity, frequently cause significant impairment in behavioral, social, academic, and occupational functioning. Short-term symptomatic benefits of the commonly used treatments, such as pharmacotherapy and behavior management techniques, have consistently been shown in many individuals with ADHD. However, it is unclear whether or not the currently available treatments improve the outcome in individuals with ADHD over an extended time period, and little is known about long-term safety of the medications administered in ADHD. Extended use of stimulant medication in ADHD from childhood through adolescence is associated with suppression of growth and consequent reduction in adult height with no reduction in symptom severity. Long-term administration of methylphenidate may result in the development of tolerance to the neurotransmitter changes induced by medication, lessening the effectiveness of the drug. These findings regarding the long-term management of ADHD and the failure of a “magic bullet†strategy targeting well-defined biological alterations in ADHD call for alternative research approaches. A wide range of lifestyle factors have been proposed as potential precursors or consequences of ADHD. Various nutrients have been linked to brain development and functioning, and diet may be an important factor in psychiatric disorders including ADHD. The role of vitamins and minerals in the etiology and treatment of ADHD is unclear, and benefits may be confined to individuals with respective deficiencies. The efficacy of polyunsaturated fatty acid supplementation in ADHD seems to be negligible. Clear evidence supporting a role of single nutrients in the etiology and therapy of ADHD has not been produced, and the interrelationship between diet in general and other lifestyle factors may be of greater importance. Emerging evidence suggests that physical activity may be a protective factor in ADHD. While exercise may be a promising alternative or additional treatment option for individuals with ADHD, the currently available studies assessing the impact of physical activity on ADHD symptoms have several limitations. Large-scale, well-designed studies investigating the effects of physical exercise on ADHD should be conducted, since exercise may have additional health benefits regarding cardiovascular function and the prevention of noncommunicable diseases such as diabetes and obesity. The well-established relationship between ADHD and insomnia, and the small but significant association between media use and ADHD-related behaviors call for further investigations. In summary, the interaction of environmental, social and societal factors in ADHD needs to be addressed. The consideration of lifestyles may contribute to a more holistic and interactive understanding of ADHD. Lifestyle research in regard to etiology and treatment appears to be a promising approach to ADHD, and the conducting of such research independent of commercial interests will be a future challenge. Furthermore, lifestyles associated with ADHD should be considered in clinical practice