Wicks suggested that the prevalence of junk food could be impacting rates of ADHD in kids

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Image by Steve Buissinne from Pixabay

When Joe Wicks speaks, people listen. The fitness coach, presenter and bestselling cookbook author is a hugely influential voice in the UK with 4.7 million followers on Instagram and 2.8 million on YouTube. He’s also well known as a champion of children’s physical and mental health, thanks to the free online workouts he led when schools were closed in lockdown.

Last week, he weighed into a complex health issue: on a podcast he said that children’s poor diets – around 60 per cent of our daily calorific intake reportedly comes from ultra-processed foods (UPFs) – could be causing attention deficit hyperactivity disorder (ADHD) and would explain a recent spike in diagnoses. Given his own bad diet as a child, he said, he might have been diagnosed himself if at school today.

Experts, including neurodiversity charity ADHD UK, condemned the comments, saying they were “misleading” and “damaging”. Its chief executive, Henry Shelford, said: “Diet, good, bad or ugly, won’t make you have ADHD or not have ADHD. Joe is a force for so much good but on this, he is abjectly wrong.”

Wicks has since apologised and said his comments were taken out of context. “I know that’s not factual, that isn’t true… it’s a neurodivergent disorder, which affects the brain. Lots of factors involved. I do believe food has a massive impact. Whether you have ADHD or not, I think it really impacts our mood and our ability to sit still and focus, and even our energy and our mental health, it has a massive impact.”

He also said he meant to say “misdiagnosed”, clarifying: “I do believe a lot of children are being misdiagnosed with ADHD, and that can stem back to our diet and what we’re eating.”

So is there any relationship between food and concentration levels or neurodivergence?

Joe Wicks has been criticised for his remarks about diet and ADHD in children

What causes ADHD

ADHD is a neurodevelopmental condition that impacts behaviour due to how the brain has developed and is associated with inattention and impulsiveness, though there are many symptoms and signifiers. In the UK it affects around 5 per cent of children and 3 or 4 per cent of adults, but is so complex that no specific cause has been identified. However, it is widely understood by most health institutions, including the NHS, to be genetic.

“We do not know exactly what causes ADHD,” consultant psychiatrist and ADHD specialist Dr Stefan Ivantu tells i. “However we know it has a genetic heritability in the region of 50 per cent. The cause of mental health is generally multifactorial, a combination of social, psychological, biological (substance imbalance at the brain level), physical health and genetic factors.

“Some studies suggest a healthy diet may influence symptom severity,” explains Ivantu. “Deficiencies in certain nutrients like iron, and zinc, might be linked to ADHD symptoms, but there is no link in causing the condition.”

Leading ADHD author and counsellor Sarah Templeton of ADHD Liberty was diagnosed at 51. “It’s a very impactful condition, not something that’s light and frothy and can be cured with a bit of fish and cabbage,” she says. “It has to be diagnosed by a psychiatrist, not by a doctor or a nurse or anyone else. If ADHD could be cured with diet, everyone would be doing that. Eating healthily is as good for anyone as for people with ADHD.”

Blame game

Parents often feel guilty about how they feed their children, but cost and access make eating healthy, whole foods all the time almost impossible, hence the high volume of UPFs in the average child (and adult) diet in Britain.

Wicks is a champion of cooking more and eating well, but it’s dangerous to suggest diet can cure neurological conditions or chronic disease. “There is no evidence to show that eating certain foods or not eating foods causes ADHD or other neurodiverse conditions and I think this is scaremongering to say so,” says specialist dietitian Priya Tew. “We do not want any parents or carers to feel guilt or shame, feeling they have caused their child’s condition.”

Dr James Brown, chair of ADHD Adult UK, has said that in a meta-analysis of seven studies, no evidence was found of any link between sugar consumption and ADHD.

Tew points out that a preference for plain and repetitive meals is common among those with neurodiversity. “Whilst many neurodiverse people can prefer processed foods, beige foods and safe foods, this does not mean that these foods are the cause of their symptoms,” she says. “But they could prevent children reaching all of their nutritional requirements which may contribute to symptoms. It is a good idea to try and expand the diet to make it as varied as possible. This can be very tricky to do, taking time and patience.”

“What we eat and drink can most certainly impact on our mood and how we feel (in both a positive or negative way),” says dietitian Nichola Ludlam-Raine of Nic’s Nutrition, who thinks Wicks’ comments were taken out of context unfairly, and that he works hard to improve our nation’s health.

“However, the links between diets high in UPFs and mental health are far from clear, and are difficult to unpick. This is because of the complex genetic, psychological and social factors that contribute to the development of mental health problems, in addition to the effects that poor mental health can have on food choices and dietary intake.”

Diet and exercise – the impact

“Regardless of ADHD, a balanced diet provides essential nutrients for overall mental and physical health,” says Dr Ivantu. “Healthy eating habits can improve energy levels, mood, and sleep, which can indirectly benefit individuals with ADHD and some other mental health conditions.”

Tew recommends focusing on the Mediterranean diet, rich in whole grains, lean proteins and healthy fats, including the omega 3s found in oily fish, and fruit and vegetables. “Reducing sugar and white carbohydrates is good for overall health and may help with some symptoms,” she says. “Whilst we need more research to fully support this I’d definitely recommend including two servings of oily rich fish a week or using a good quality fish oil supplement as omega-3’s are so good for overall health and brain health.”

Consultant dietitian Ro Huntriss says that tracking what you or your child eats can help. “The NHS suggests that people with ADHD should eat a healthy, balanced diet and to not cut out foods before seeking medical advice,” she says. “It also says that some people may notice a link between types of food and worsening ADHD symptoms. If this is the case, keep a diary of what you eat and drink, and what behaviour follows.”

Both Dr Ivantu and Sarah Templeton highlight exercise as a great way to manage ADHD symptoms. “We have some good data about the benefits of physical exercise in improving attention, executive functioning and motor skills,” says Dr Ivantu. “On the other hand physical exercise has limitations towards managing hyperactivity symptoms, or social problems which often come with someone suffering from ADHD. Something which I tell my patients diagnosed with ADHD is that physical exercise is a free and sustainable medication.”

What now? Wick’s comments that many are “misdiagnosed” has simply opened a different line of attack. Now he’s being schooled for a different mistake – that diagnosis is easy, while most face a wait of years for NHS assessments with specialist psychiatrists.

“Mental health is not a one-size-fits-all,” points out Dr Ivantu. “It’s highly important to consult an appropriately trained healthcare professional before making any decisions regarding your health. In my opinion, physical exercise, lifestyle changes, coaching, therapy, healthy nutrition and positive use of technology should be considered as part of a comprehensive ADHD treatment plan.”