sarah Keogh Diet and nutrition

Q My child has been diagnosed with ADHD. I have been told by friends that he should avoid all sweets, sugars and additives in food but his doctors say diet has little effect. What should I do or is it best just to leave him with the foods he likes?

A
ADHD is a common problem in children – and adults. ADHD means children can have short attention spans or find it very difficult to sit still and concentrate. This can be a real problem at school and later on at work. They are generally of average to high intelligence but this doesn’t always show up in schoolwork due to their lack of concentration. ADHD may have a number of causes including genetic links and diet. Studies on diet in ADHD are not common or often, not very well carried out, so it is important not to follow all of the advice you might find on the internet, especially when it comes to sites selling supplements. So what does work? There is no diet that works for every child with ADHD but there are some things that are worth trying:

1
Add in a fish oil supplement. Several studies have looked at the effect of fish oils – especially the omega-3 EPA – on ADHD and most have seen benefits in at least some of the children. It takes about three months to see an effect. You need to give 500mg of EPA per day (other omega-3s like ALA do not show the same benefits).
2
Reduce sugar. Although cutting back on sugar doesn’t work for everyone, it does seem to help with the restlessness in many children. Also, children who cut out a lot of sugary foods tend to eat healthier foods instead, which gives them a wider range of beneficial nutrients. Scientists think that it is the extra nutrients that are of use to the child with ADHD rather than the reduction in sugar. Either way, do limit sweets and sugary treats to once or twice a week and limit fruit drinks to one per day at most.
3
An elimination diet, which cuts out a wide range of foods for a few weeks can be helpful. This is a difficult diet and you MUST see a qualified dietitian to do this as your child can become quite malnourished or miss out on key nutrients for growth. If your child improves on the elimination diet, then you can start to challenge with foods to see which is the offending group. Working with a dietitian is essential for this. Never assume it is wheat or dairy, always check. Make sure the dietitian you see is a member of the INDI to ensure you get the best advice for your child. Apart from these suggestions, do focus on a healthy diet in general, with lots of fresh fruit and vegetables, and protein from meat, chicken, fish, eggs and beans. Go for low GI carbs like pasta, brown rice and jacket potatoes or try some sweet potato as an alternative.

Q I’ve heard a lot about the Paleo diet and as I am very interested in reducing the amount of processed foods and grain based meals my family eats, we are considering following this diet. From what I read it seems to be a back-to-basics type of eating. Is a Paleo diet safe for children? My kids are aged seven and nine.

A
The Paleo diet is one of the most fashionable diets around at the moment. It is also known as the ‘caveman diet’ and is based on cutting out processed foods, starchy foods like bread and potatoes and eating more meat, vegetables and fruit.
As fad diets go, it is not the worst but there are some good and bad sides to it. Reducing the amount of processed foods we eat is always a good idea and by doing that you will usually reduce the amount of fat, salt and sugar you eat, which is a good thing! The problem with the Paleo diet is that it also cuts out dairy (on the basis that cavemen didn’t drink milk) and this means that the diet is very low in calcium. For this reason it is really not suitable for children who do need a lot of calcium for growing bones. How did cavemen manage without dairy? They ate a lot more food than we do (up to 10,000 calories per day compared to the 2,000 most of us eat). By eating that amount of food they were able to pick up just enough calcium from green vegetables and seeds. To put it in perspective, you would need to eat 16 servings of broccoli a day to get all the calcium you need. This is easier to do if you eat 10,000 calories per day rather than 2,000.
The other problem with the paleo diet is that it is not entirely based in science. Many of the Paleo diets out there say you should not eat wheat, even though we know that cavemen did in fact eat wheat and other grains. These diets also don’t recommend that you eat blubber and the big lumps of fat that were also a large part of the caveman diet!
A final problem is that many Paleo diets encourage people to cut out beans and lentils and to get their protein from meat and fish instead. Many studies over the last few years are clear that eating too much animal protein is linked with more cancer and heart disease. Eating some vegetarian meals based on beans and lentils is a great way to get your protein without always going for meat.
Is this a diet we should follow? I think there is a lot we can learn from the Paleo diets. We could all do with eating less salt, sugar and processed foods and adding in more nuts and seeds as well as more vegetables. However, I think following a strict Paleo diet could lead to low levels of calcium and vitamin D and so it is not suitable for children or teens and adults would need to think about a calcium supplement.

Q I had my first baby just six weeks ago and she is doing really well – breastfeeding like a dream, not sleeping terribly well but not never sleeping either. However, I am a wreck. I am exhausted and irritable and find myself nodding off when I am holding my baby and I can’t concentrate on anything. To add to all of this my hair is falling out in handfuls. Is there anything I could eat to give me more energy and are there any supplements that can help my hair?

A
Go easy on yourself, you are at the six-week stage, which is when tiredness can really kick in and you think you are never going to get a break. It may not feel like it, but things will soon start to get better. In the meantime, though, there are several things that might help while you are waiting for that first full nights’ sleep.
First of all, are you just tired or is there any possibility of postnatal depression? It is normal to be tired after having a baby but to be completely flattened with exhaustion may be something else. Have a chat with your public health nurse or GP and talk to them about how you are feeling – especially if you are crying quite a bit or if you are not enjoying your baby. Some help with postnatal depression can make all of the difference if that is what is going on with you – don’t try to be superwoman!
With regards to food, you can boost your energy with some simple meals and snacks. At this point what you really need are carbs. Wholegrain carbs like wholegrain bread, brown rice and high- fibre cereals will all give you some much-needed energy but they are also good sources of B vitamins. B vitamins help to reduce tiredness and fatigue. They also help your body to turn the food you eat into energy. You could try adding a B-complex vitamin supplement as these are safe to take when breastfeeding.
Do eat regular meals and try not to go more than 3-4 hours without something to eat. If you have any help at home, get them to make you a packed lunch before they leave for the day so that you don’t have to think about getting something ready for yourself at lunchtime. Keep some non-perishable snacks near where you breastfeed so that you always have something to hand. Stock the kitchen with quick, nutritious snacks that you can grab on the go. Cold slices of ham and turkey can be rolled up and eaten and cheese portions are a great way to stave off hunger. Try yoghurts and yoghurt drinks; crackers and oatcakes; nuts and dried fruit or packs of ready-made tuna salads.
Keep hydrated. Getting dehydrated is not unusual after having a baby as lots of women simply forget to drink. If you become dehydrated, you will feel really tired, foggy-headed and irritable. You need at least two litres of water every day. Check your pee when you go to the loo. It should be very light-coloured to clear. If it is dark, then you need to drink!
Make sure you are eating enough protein. Although it is, sadly, very normal for your hair to fall out after having a baby, not eating enough protein can be another culprit. Hair needs lots of protein to grow and your breast-feeding baby will be getting a lot of the protein you eat. This is not a problem as long as you are eating enough protein! You need to have a protein-rich food at lunch and dinner. Try any kind of meat, chicken, fish, eggs, beans or nuts. You can also snack on protein foods like nuts and seeds as well as cheese and yoghurt. You might benefit from a good multivitamin and mineral supplement.

Q. I have struggled with low iron levels for most of my life but now that I am pregnant, iron has become a bigger issue than ever. My doctor has told me that my iron levels are too low and that I need to take an iron supplement. The problem is that iron supplements make me very constipated as well as upsetting my tummy. Are there any foods I can eat to boost iron – I have a very good diet with lots of chicken and green vegetables so I am not sure if there is anything else I can do. Help!

A
Low iron levels are a common problem for women – whether they are pregnant or not – and low iron levels can have lots of causes. We need iron to help make healthy red blood cells and low levels of iron can leave us feeling wiped out. During pregnancy, iron is also crucial for healthy blood for your baby as well as for baby’s brain development. This is why doctors and dietitians really stress iron at this time. Low iron can be caused by diseases like coeliac disease and colitis, but the most common cause is simply not eating enough. A whopping 48% of women in Ireland do not eat enough iron. Irish men eat much more iron, mainly due to eating more red meat and overall larger portions. Why do women eat so little iron? The main reason is that foods we think are good sources of iron are actually quite low. Although chicken is a good source of iron, the iron is almost all in the leg. This means that if you only eat chicken breast, you are actually getting very little iron. Green vegetables will give you a little iron but you would need to eat two pounds of spinach a day to get what you need.
So where can we get iron? Red meat is a great source of easily-absorbed iron. And it is actually quite good for you if you trim off the fat and make sure you don’t burn it. This means going for red meat in dishes like Bolognese, stews and casseroles instead of barbecued or well-done roasts. Aim to have red meat at least three times a week. Eggs are a good source of iron and you can add one to breakfast or go for an egg sandwich at lunch. Chickpeas are very rich in iron so go for hummus or a chickpea salad. Barley and lentils are also a great source of iron: try a lentil curry or add barley and lentils to a chicken casserole to top up the iron. Green veg will help to add iron, so it is great to “eat your greens,” as our mothers often said. Hazelnuts, raisins and pumpkin seeds are great high-iron snacks and breakfast cereals fortified with iron are another great source.
You need to have a food with iron at every meal – this means fortified cereal at breakfast, egg sandwich at lunch and chilli-con-carne for dinner with a green salad. Pregnancy multivitamins will also include a small amount of iron and shouldn’t be enough to cause digestive upsets.
You do still need to keep in touch with your doctor as you may need to go down the supplement route if your iron levels don’t come up even with eating more iron. Good luck!

ASK LOUISE

Q My son is 18 months old and has just started saying his first words. It is an extremely exciting time in our house and my husband and I are eager to encourage his speaking as much possible. What advice would you give us on how we can foster this without bombarding and confusing him?

AThere is nothing better than hearing your baby begin to talk. All the hard work you have put in over the last two years is coming back tenfold.
Toddlers will vary significantly with ability and speed of which they talk however a guide would be about 50 words by 2 years of age. The most important thing to watch for is that your baby/toddler is cooing and babbling and begins to string sounds together like “Mama/Dada” They should have a wide range of speech sounds and like to imitate you and things they hear.
There are many ways that you can promote Speech and Language development at home:
1. Slowing down your own speech and taking time over conversations with your little one. Every day is a new experience when you are 18 months, nappy changes, bath time, baking a cake brings endless opportunity for you to interact and offer new words for them to hear and repeat. Make eye contact, smile and use exaggerated tones to keep things interesting and fun for your tot.
2. Review the toys that you have on offer to your tot and ensure that they give plenty of open ended play opportunities. Role play is a wonderful way to allow children to take the lead. Kitchens with lots of plates, cups and pots. Fill the pots with dry pasta and allow your child to cook and serve you. Playdoh, painting, gardening and sandpits are also great for allowing your child to take the lead and babble about what they are doing. Read plenty of books together and point and allow them time to answer any questions that you ask.
3. Limit screen time. Overuse of televisions and iPads do not give your child opportunity to interact in a two way manner.
4. Ask your child lots of open ended questions “What’s that?” “Where are we?” Point at things they know the answer to for boosting confidence (Car/ Car, etc.) When they don’t know the answer, explain it to them. Limit baby talk and speak clearly with good pronunciation, remember you are the teacher and they will copy you.
If you are concerned about your child’s speech and language development, be sure to speak with your GP or developmental Health Nurse. They are very skilled at understanding the difference between speech delays and spotting something that may require professional attention.
Enjoy watching their little brains absorb the world around them and listen to what they have to say. It won’t be too long before they won’t stop talking to you, asking “Why Mummy/ Daddy?” every 5 minutes….

YOU MIGHT ALSO LIKE
MUST READ

Ask Tracey

Midwife Tracey Donegan answers your questions about pregnancy and birth

Q When should I have my first pregnancy scan? And how many scans should I get throughout my pregnancy?

A
Your first scan is known as your dating scan and is routine in all hospitals. Most mums will have this scan at their booking visit, which can be anywhere between 12-18 weeks. The earlier the scan the more accurate it will be. If you have experienced recurrent miscarriages some hospitals will scan you earlier. Contact your antenatal clinic for more information. In Ireland, most women will have two scans in a healthy pregnancy – a dating scan and an anomaly scan at around 20 weeks. However, some units provide a dating scan only. Private scans are also available in most cities and many parents use these services for additional reassurance and to find out the sex of their baby.