ADHD and Adult Rowers

As a sports nutritionist, I commonly counsel rowers (or their teens) and other athletes who have Attention Deficit Hyperactivity Disorder—generally referred to as ADHD (or ADD). ADHD is characterized by hyperactivity, impulsivity, and/or inattention. It affects four to 10 percent of all American children and more than four percent of adults 18 to 44. ADHD peaks usually when kids are seven or eight years old. Some of the ADHD symptoms diminish with maturation, but 65 percent to 85 percent of kids with AHDH go on to become adults with ADHD. 

One would hope that  rowers with ADHD have gotten the help they need by now to learn how to manage their time and impulsiveness. The unfortunate truth is that many youth athletes with ADHD receive only negative feedback because they have difficulty learning rules and strategies. This frustrates teammates and coaches. Older athletes with ADHD often exercise to reduce their excess energy, calm their anxiety, and help them focus on the task at hand. But there are ways through nutrition that rowers with ADHD as well as coaches, friends, and parents can learn how to calm annoying ADHD behaviors.  

• To date, no clear scientific evidence shows that ADHD is caused by diet, and no specific dietary regimen has been identified that resolves ADHD. High-quality ADHD research is hard to do because the added attention given to research subjects with ADHD (as opposed to the special diet) can encourage positive behavior changes. But we do know that when and what a person eats plays a significant role in ADHD management and is an important complementary treatment in combination with medication.

• ADHD treatment commonly includes medications such as Concerta, Ritalin and Adderall. These medications may enhance sports performance by improving concentration, creating a sense of euphoria, and decreasing pain. These meds are banned by the World Anti-Doping Agency and the International Olympic Committee. Hence, athletes who hope to compete at a high level are discouraged from taking ADHD medications.

• To the detriment of ADHD rowers, their meds quickly blunt the appetite. Hence, they (and all athletes) should eat a good breakfast before taking medication. 

• The medication-induced lack of appetite can thwart the scrawny teen athlete who wants to gain weight and add muscle. Teens should be followed by their pediatricians to be sure they stay on their expected growth path. If they fall behind, they should meet with a registered dietitian with knowledge of sports nutrition to help them reach their weight goals.

• An easy way for “too thin” rowers to boost calories is to drink milk instead of water (except during exercise). The ADHD athlete who doesn’t feel hungry might find it easier to drink a beverage with calories than eat solid food. Milk (or a milk-based protein shake or fruit smoothie) provides the fluid an athlete needs for hydration and offers simultaneously protein to build muscle and stabilize blood glucose.

• A well-balanced diet is important for all rowers, including those with ADHD. Every brain and body needs nutrients to function well. No amount of vitamin pills can compensate for a lousy diet. Minimizing excess sugar, food additives, and artificial food dyes is good for everyone. 

• Eating on a regular schedule is very important. All too often, high-school athletes with ADHD fall into the trap of eating too little at breakfast and lunch (due to meds) and then trying to perform well during after-school sports. An underfed brain gets restless, inattentive, and is less able to make good decisions. This can really undermine an athlete’s sports career 

• Adults with ADHD also can fall into the same pattern of underfueling; they “forget” to eat lunch and by late afternoon are hangry and in starvation mode. We all know what happens when any rower gets too hungry—impulsiveness, sugar cravings, too many treats, and fewer quality calories. This is a bad cycle for anyone and everyone.

• All rowers should eat at least every four hours. The body needs fuel, even if the ADHD meds curb the desire to eat. ADHD rowers can set a timer: breakfast at 7, first lunch at 11, second lunch at 3 (calling a snack a “second lunch” leads to higher-quality food), dinner at 7. 

•For high-school rowers with ADHD, the second lunch can be split into fueling up before practice and refueling after. This reduces the risk of arriving home starving and looking for ultra-processed foods that are crunchy, salty, and/or sweet.

• Both adults and kids with ADHD are often picky eaters and tend to prefer unhealthy snacks. For guidance on how to manage picky eating, click here for adults and here for kids.   * Fiber-rich fruits, vegetables, and whole grains can be absent from the food list of ADHD rowers. Their low-fiber diet can lead to constipation. Fiber also feeds the zillions of microbes in their digestive tract that produce chemicals that can impact brain function and behavior positively. Eat your fruits and veggies!

• “Quality calories” such as beans (hummus, refried beans in a burrito), seeds (chia, pumpkin, sunflower, sesame), and whole grains (oatmeal, brown rice, popcorn) offer not only fiber but also magnesium, which is known to calm nerves.

• With more research, we’ll learn whether omega-3 fish-oil supplements help manage the symptoms of ADHD. No harm in trying. At least eat salmon, tuna, and oily fish as often as possible, preferably twice a week, if not more.

•  Rowers who do not eat red meat, beans, or dark leafy greens can become iron deficient easily. Inadequate iron intake is associated with interrupted sleep, fatigue, inattention, and poor learning. Iron deficiency is common among female athletes and needs to be corrected with iron supplements

• While sugar has the reputation of “ramping kids up,” the research is not conclusive about whether sugar itself triggers hyperactivity. The current thinking is the excitement of a party ramps kids up more so than the sugary frosted cake. Yet some rowers are sugar-sensitive and know that sugar causes highs and crashes in their bodies. They should choose to limit their sugar intake and consume protein along with sweets, such as a glass of milk with the cookie or eggs with a glazed donut. Moderation of sugar intake is likely more sustainable than eliminating all sugar-containing foods.

• For more information about how to manage ADHD in kids, teens, and adults, use these resources: Feeding the Child with ADHD, a podcast with Jill Castle R.D., and Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)–a national resource center.

Nancy Clark, M.S., R.D., C.S.S.D., counsels both fitness exercisers and competitive athletes in the Boston area (Newton; 617-795-1875). Her best-selling Sports Nutrition Guidebook is a popular resource, as is her online workshop. Visit NancyClarkRD.com for info.