If so, you’re not alone.
Nutrition is essential for gymnasts to grow, develop, learn, and perform well. Those with ADHD who are on medications that lower the appetite are at risk of what’s called RED-S or underfueling.
Many gymnasts with ADHD struggle to get enough nutrition due to medication side effects, busy school and training schedules, and often picky eating thrown in the mix.
Fueling the gymnast with ADHD and navigating appetite suppressing medications is a challenge.
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Gymnasts with ADHD
Many parents with children who have ADHD enroll them in gymnastics at a young age. The sport is a great way to burn off energy, teach discipline, learn motor control, and build strength. Gymnastics classes are a great alternative to your child flipping around the house, swinging on the furniture, and climbing the door jams.
Unfortunately, as gymnasts advance and start training 15-20 hours per week, they are at greater risk of poor nutrition and growth if on medications for ADHD that blunt the appetite. It takes a lot of nutrition to support a competitive gymnast (2000-3000 calories or more per day for most), and this can be really challenging when the gymnast “isn’t hungry”.
What are the Most Common Medications
Stimulant medications are the most common class of medications used in the treatment of ADHD. Those include medications like Ritalin, Focalin, Concerta which used methylphenidate or medications like Adderall or Vyvyanse which use amphetamines as the active ingredient.
There are also some non-stimulant medications: Atomoxetine, Guanfacine XR, Clonidine XR, and Bupropion.
Many of these also include side effects of nausea, stomach ache, and poor appetite.
ADHD Medication and Appetite
The “appetite medication cycle” is where the appetite is blunted for several hours after taking a medication. It’s common to then see exaggerated hunger or hyperphagia after the medications wear off, which can really concern parents.
These medications can make it difficult for children to gain weight nd develop (because of inadequate nutrition), and can also lead to sleep disturbances, stomach aches, and nausea.
Some of these medications are taken once per day and last 8+ hours, other have to be taken two to three times per day. Because of this, the window of opportunity for “hunger” is slim, especially when they’re at school all day and then gymnastics in the afternoon/evening.
In addition, when a child goes for long periods without eating, his behavior, concentration and learning may deteriorate.
For the gymnast, the other issue is related to underfueling in and around training. It’s not optimal for a gymnast to hardly eat all day and then go to a 4-5 + hour workout. This will impair performance, concentration, and recovery.
ADHD Medications and Underfueling
Gymnasts are already at risk of underfueling or RED-S (relative energy deficiency in sport) because of the aesthetic nature of the sport combined with higher energy needs that gymnastics culture assumes.
When gymnasts aren’t growing or developing, it’s often assumed this is “normal” because of the high intensity and long hours required for the sport. The real issue is a lack of nutrition (calories) to support the training, recovery, and normal growth/development. This is a very fixable issues and has severe consequences if not address.
But, in the case of a gymnast with ADHD who is on medication, getting in adequate nutrition can be a real challenge.
The years of underfueling will catch up and this is when we see overuse injuries (and actue injuries) during the early teen years.
What isn’t talked about is the risk of gymnasts (or anyone) also developing disordered eating from the appetite-blunting side effects of stimulant medications. A lot of individuals will not eat all day as they don’t feel hungry, and then when the medication wears off in the evening they feel like they can’t stop eating. This can set someone up for the binge/restrict cycle which isn’t helpful for health, body composition, or athletic performance.
ADHD and Picky Eating
It’s common for children with ADHD to also be picky eaters, and much of what parents are taught to address the picky eating only makes the situation worse.
Children with or without ADHD need structure with meals and snacks along with adequate nutrition. Focus on at least 3 meals and 2-3 snacks per day at regular intervals. For more information, check out our online gymnast nutrition course for parents which includes training on picky eating.
Nutrition for ADHD
The are many popular diets and alternative therapies floating around on the internet for treatment of ADHD. Many parents do not want to put their children on medication which is very understandable.
But, often these diets include the restriction or elimination of major foods groups and can further perpetuate the weight AND behavioral issues. Read this article on food allergies and intolerances as many of the “tests” that providers will do to diagnoses food intolerances (and blame them on your child’s behavior) are not legitimate.
Sugar and ADHD
Many parents of gymnasts report that all their gymnasts want are carbs, sugar, etc and this is often due to underfueling. When the brain sense there isn’t enough food available, it’s going to increase the drive for quick energy foods. This makes sense given the brain is wired for survival, this is just a protective mechanism.
Pairing multiple food groups at snacks and balanced meals with all the food groups plus fiber can help give steady energy.
It’s not wrong to minimize added sugar in the diet. But, it’s also important to recognize that over-restriction of sugar can also lead to increased wanting/obsession, poor behavior, and then eating the restricted foods in larger quantities when finally available.
This is why we teach including the “fun foods” a frequent interval to make them emotionally neutral. You want to raise your gymnast to be a competent eater who feels confident around all foods. So, it’s really the chicken or the egg. Is it the sugar that causes issues in children with ADHD, or a lack of nutrition, lack of balanced nutrition, and over-restriction which leads to increased obsession.
Food Dyes and ADHD
The research on food dyes and ADHD is limited and mixed. It’s not wrong to eliminate food with added dyes, but also at the same time it’s appropriate to keep nutrition in context. Focus on adding whole foods like whole grains, fruit, vegetables, proteins, dairy products, etc at meals and snacks. One meta-analysis reports up to 8% of children being sensitive to food dyes, particularly synthetic red dye 40 and similar derivatives.
ADHD and Vitamin Deficiencies
Many children with ADHD are found to have lower than normal levels of iron, zinc, and magnesium. It can be beneficial to supplement these if the levels were already low before treatment of ADHD. Additionally, these nutrients are also important for gymnast performance and recovery.
Iron and ADHD
Iron levels should be checked at least once a year in gymnasts. Iron plays an important role in the nervous system, brain development, and energy levels. Iron is what binds oxygen in red blood cells to be carried throughout the body, which is why symptoms of low iron include shortness of breath, fatigue, lethargy, etc.
This is particularly important for female gymnasts.
Focus on iron rich foods in the diet which include heme and non-heme iron sources (animal vs plant). I like to see gymnasts get red meat at least 2 times per week, which also provides some high quality protein.
Zinc and ADHD
Zinc is important for brain development, metabolism of neurotransmitters (brain hormones), melatonin (sleep hormone), and prostaglandins (chemical messengers involved in repair/recovery).
Animal proteins are the best sources of zinc and you can also get plant based sources of zinc through whole grains, nuts, and seeds.
Magnesium, ADHD, and Athletic Performance
Many athletes are already deficient in magnesium along with children who have ADHD.
Magnesium is an essential mineral in the body that is involved in hundreds of chemical reactions in the body. Magnesium helps w/ blood glucose regulation, lowers lactate production during exercise, helps with Vitamin D absorption in those with deficiency, and is often low in conditionals like type 2 diabetes, metabolism syndrome, etc. Magnesium is also supplemented at times in individuals experiencing migraines.
The best foods for magnesium include leafy greens, nuts (brazil nuts, almonds), whole grains (oat bran, brown rice), and cow’s milk.
Omega 3s and ADHD
Omega 3 fatty acids have been well studied as a complementary treatment for those with ADHD. These fatty acids are involved in brain development and function. It’s difficult for most of us to get adequate amounts of DHA in the diet, so supplementing is not a bad ideas especially for athletes.
These fatty acids can also be effective in blunting delayed onset muscle soreness, about 48 hours after the exercise.
Should you choose fish or a daily supplement? Ideally, you’ll obtain nutrients from whole foods sources when able to maximize your nutrition. A 3-4 oz serving of salmon has ~1.2 mg of omega 3 (EPA, DHA), but most don’t consume salmon everyday.
The “adequate intake” for girls ages 9-12 and 13-17 is 1000-1100 mg, and for optimal recovery doses of 1500-2000 mg are suggested (based on age/weight) for athletes to help with muscle soreness and inflammation. In my opinion, omega 3 supplementation can be one of the best “advanced strategies” a gymnast can use for optimal performance, repair, and recovery.
Learn to Fuel the Gymnast with (or without) ADHD
Hopefully this article gives you and your gymnast some things to work on. If you’re a parent who is a concerned and needs support, start with our online program The Balanced Gymnast® Program that will teach you to optimize your gymnast’s nutrition, work with her busy schedule, tackle the issues of sugar, picky eating, and learn how to know if she’s getting the nutrition she needs for proper growth, development, and injury prevention.
