I have multiple food intolerances and as an adult I developed anaphylactic food allergies. One of the reasons I studied to become an RN (after I received my Master's degree in expressive arts therapy and mental health counseling) was because I wanted to understand more about the mind/body connection. After experiencing some extremely beneficial changes in my health and life once I identified my own food intolerances, I became more convinced about the impactful role of diet on one's overall wellness.
I had the pleasure of chatting with Shawna Hughes, a Registered Holistic Nutritionist who specializes in kids’ health issues that are related to diet. She works mostly with families of children who are dealing with childhood obesity, digestive disorders,
and/or ADHD. She is able to work with families all over the world and you can connect with her at her website, on instagram, or facebook.
Please tell us a little about your practice:
I work with families to figure out how they can start to make small, sustainable changes in the diet and lifestyle in order to help them improve their child’s condition. We normally work together for 3-4 months, exploring options that will fit into their lifestyle.
What exactly is a holistic nutritionist?
A Registered Holistic Nutritionist (RHN) is a practitioner who has studied nutrition at an accredited private school. We differ from dietitians in that our training mainly occurs with natural health practitioners like Naturopathic doctors. As the name would imply, we are more holistic in focus. We don’t just learn how to make meal plans and suggest supplements. We also address stress, sleep, and lifestyle issues, along with medications or toxin exposure.
So RHNs take a more individualized approach which takes into account our clients’ health history, culture, food intolerances, or restrictions, even where and with whom people are eating. My clients are always shocked at how thorough our consultations are!
You mentioned you work with a lot of children who have ADHD, can you tell me more about how you support them?
Yes, there are many foods that have been linked to ADHD. There are the well-known triggers like artificial colours, flavours, and preservatives such as BHT, but now we are also seeing that there is also a tendency for specific food sensitivities in individuals with ADHD and these foods can worsen symptoms as well - the most common offenders are wheat, milk, nuts, eggs, soy, chocolate, fish, and shellfish (Müller, 2011 & Ede, n.d.).
There are also several studies which indicate that people with ADHD have trouble processing foods with high levels of substances called salicylates. These are natural substances found in many healthy foods (apples, apricots, and almonds to name a few.) They are generally harmless, but some people with ADHD seem to process them ineffectively which can aggravate symptoms. This salicylate-sensitivity hypothesis is less accepted nowadays but can be worth exploring if parents are really struggling to pinpoint trigger foods.
Now of course, telling a family to eliminate all high-salicylate foods, colors, flavours, preservatives, and those 8 allergens is not a practical approach. Therefore, I take a much more personalized approach.
First, I look at a food diary and try to figure out which of the “usual suspects” are being consumed most often. Next, I look for trends (For instance, if they always have a bad week after your annual apple picking outing, perhaps salicylates are the issue). I also take into account their health history which can help to narrow down potential triggers because certain health conditions (like eczema, for instance) are associated with certain food sensitivities. It’s a bit like detective work, but with this approach, we can usually find a couple of suspected sensitivities.
Next, we work together to come up with the easiest way to replace those foods with better options that are EASY and ENJOYED by the family. This is a big part of an RHN’s job - not just telling people what to eat (or not eat), but helping them to find the practical way to implement changes so that it doesn’t up-end their lives. I also provide specific information to make these changes as easy as possible - specific brands and recipes they can use so they’re not wasting hours of time reading labels and Googling recipes (that’s my job!)
There are also supplements that can help. Omega-3s are nutrients that support cognitive function and there are vegetarian options if there is a fish/seafood intolerance. There is also a link between digestion and cognitive function, so addressing digestion with supplements like probiotics can help balance things out too. We also discuss the non-food approaches like implementing a routine and reducing screen time. Again, it is a very holistic process.
Each year I am reading more information about the brain/gut connection, can you tell us more about that?
Yes! Research now tells us that the brain and gut communicate with each other bi-directionally (John Hopkins University, n.d.) - so many of us are aware of the connection between say, exam stress causing a stomach ache, but new research shows that the impact can go the other way too - poor digestion can send signals to the brain that affect mood. Research is underway to detail how impaired digestion can affect cognitive function too. This is why getting digestion optimized is crucial when dealing with any cognitive or mental health issues.
How can parents make small but impactful changes to help their families build healthy habits?
The first step is always to make the commitment to change. Decide how much time you can dedicate each day - 10-15 minutes even. Then you work with that. Choose one meal or snack each day that you are committed to changing. Maybe replacing white toast with low salicylate fruit and a higher-protein granola. Maybe instead of cookies or a granola bar after school, you choose to offer crackers and cheese.
Then, it is key is to plan how you’ll do this - I give clients worksheets that involve writing steps they can take to achieve goals, which look somewhat like this:
Step 1: Buy “x” amount of granola and pears (action required: put it on the grocery list)
Step 2: Wake up 5 minutes early to cut up the pears (action required: set alarm)
Step 3: Put reminder notes on the fridge to avoid habitually grabbing the cereal (action required: put post-it note up).
You can see there is a lot involved in even a simple 10-minute change - that is exactly why focusing on one healthy change at a time is crucial to sustainability.
If you have to write a page of preparation for every meal and snack, you’re not going to stick with that. If you’re struggling to find out which foods are likely most affecting your child, consider working with a natural health practitioner like an RHN who can help take the guesswork out of the process and lead to you faster results.
Why should we pay attention to diet when looking at overall health and development of children?
If we don’t address diet, nothing else is optimized. For instance, emotional and social development are dependent on brain development. Brain development is dependent on certain nutrients, so you can go to therapy, participate in programs, but without properly nourishing the brain, you won't get optimal results.
How can we find the balance to encourage our children to make healthy food choices, without inadvertently promoting unhealthy body-image concerns?
Great question. This is a huge concern for me (an ED survivor), as well as most kids’ nutritionists. Because of social media, kids are bombarded with images of “perfect” people and it gives us a skewed view of reality since most people’s pictures are filtered.
It helps if parents gain a little bit of information regarding how food is really affecting kids’ health. It’s not about what those kids look like, or even their behaviour, it’s about the underlying issues that food can aggravate. We don’t want to scare children, but emphasize that certain foods are helpful and others just provide “excess work” for our bodies. Be honest but do not give so much information that we frighten them. So, rather than saying “you might get a disease called diabetes or your brain won’t work properly” (that is seriously scary for a little kid), use simple phrases like “it’s hard for your body to digest that much sugar and I don’t want you to get tummy aches” or “it’s cold season and we don’t want to give your body too much work to do - it needs to save some energy to fight off germs”. You don’t need to go into much detail, but they will start to figure out that foods can heal and foods can harm.
Can you share your top 3 tips for helping children move from "picky eaters into adventurous foodies?"
Start small: Always start with a very small amount of a new food, paired with a food you know they like. The key is not to bombard them with a big new thing, but just get them familiar with the food. Most people don’t want to eat a new food - even adults are not usually in a rush to try something new and unusual (think of the average North American’s reaction to hearing that some people eat soup made of Bird’s Nests, or eggs with little chicken fetuses inside.) Beets might seem fairly common to us, but to a kid who’s never seen one, they’re bizarre and kind of scary.
Repeated exposure is the key to food acceptance (Aldrige, Dovey & Halford, 2009.) Not just eating the food either - ANY exposure helps. This is why it is essential to get kids involved in food preperation! They might not agree to eat the beet the first time, but maybe they’ll peel it or scrub it for you. Every bit of exposure helps to bring about normalization and acceptance of that food. And try a food AT LEAST 12 times before you give up on it. And even then, try it a couple more times in a few months.
Don’t expect magic! At first, they might just look at or sniff the new food. Next time, they might lick it. Don’t worry, they will get there. It’s a marathon, not a race and a big emotional reaction can really slow things down.
Can you share your top 3 tips to help a child who is a picky eater due to sensory or texture issues?
This is another area when involving the child in food preparation can help. If they get more familiar with the texture in their hands, it’s less jarring when it’s in their mouths.
Using sensory bins, especially with the textures they don’t like to eat can also help to familiarize them with these foods.
Another tip is to build on foods they like. If they like peanut butter toast, try peanut butter energy balls, if they’ll eat frozen blueberries, try blueberry pancakes. Pairing the unfamiliar with a familiar food makes it less unusual.
Do you have any helpful and reputable resources for people who want to learn more about nutrition and the impact of food on mental health?
Sure. The Mind Gut Connection by Emeran Mayer is a great resource. He is a medical doctor who educates about the brain-gut connection.
Another good book is Nutrition Essentials For Mental Health by Leslie Korn. She is a doctor of behavioural medicine whose work also focuses on digestion’s impact on mental health. Neither is specific to ADHD but their work is fascinating.
Please share a favorite kid-approved recipe to share with our readers?
Oh yes. We are energy ball junkies in my house! I find people love these little snacks because they are super easy to make in about 10 minutes and you can do a lot of different flavour combinations with all of the nut and seed butters out there these days.
You can even replace the honey with jam for a more “PB and J” feel. They’re a much more balanced snack than most packaged kids’ snacks because they contain a lot of fiber and protein, which fills you up and prevents blood sugar highs and lows that lead to cravings.
Energy Ball Ingredients:
1 cup rolled oats
½ cup unsweetened shredded coconut
½ cup ground flax seeds
1 cup any nut or seed butter with NO ADDED OIL
¼ cup honey
1 tsp vanilla
⅓ cup mini dark chocolate chips
Energy Ball Instructions:
Just mix everything together in a big bowl - best to use your hands because it gets sticky! Then just roll the batter up into little ping-pong sized balls. Keep in the fridge for about a week.
References
Aldridge, V., Dovey, T. M., & Halford, J. C. G. (2009). The role of familiarity in dietary development. Developmental Review, 29(1), 32–44. https://doi.org/10.1016/j.dr.2008.11.001
Ede, G. (n.d.). Food Sensitivities and ADHD. Diagnosis Diet. https://www.diagnosisdiet.com/full-article/food-sensitivities-and-adhd.
The Brain-Gut Connection. Johns Hopkins Medicine. (n.d.). https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-brain-gut-connection.
Müller, M. (2011). Faculty Opinions recommendation of Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial. Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature. https://doi.org/10.3410/f.11179957.12159055