Wonderful to to see you, doctor Basra. How are you? I'm very good. How are you? I'm great and I'm very very excited that you're here and excited for this section because I think we talked about it a while back and it's a point of passion for you. It's very important. We see a lot of discussion around ADHD and nutrition and I know you're really looking forward to hearing you speak about it. If I do a quick introduction, you're Medical Director of Diverse Diagnostics which you can find on our marketplace. Fully qualified NHS consultant based in Glasgow. As well as things working with.

A wide range of mental health conditions including ADHD, depression, anxiety, autism. I completed medical school in Leicester University and completed psychiatry specialty training in child and adolescents in Scotland. A consultant child behavior psychiatrist, adolescent psychiatrist since 2018 and medical doctor for over ten years. And Doctor Camila Flores, excited to have you here. Clinical manager at diverse diagnostics, a general physician from originally from Peru, now in Glasgow and completed medical school in Peru and a master's degree in sports medicine from the University of Glasgow, special interest in mental health, working as general physician in Peru since 2017.

Moving to Scotland in 2020 to complete her MSc in sports science and now working in diverse diagnostics since 2021. This is where I hand over to you. What are you going do? And when do you want me to start the presentation?

Well, let me start off by doing telling you guys a little bit about us. So as you have mentioned, Henry, I my name is Dr Jagd Basra. I appreciate my name can be a little bit complex to say. And I am a CAMS consultant for the NHS. I definitely slightly butchered it earlier.

It's been a very, very long night.

That's okay. That's alright. That's alright. And at Diverse Diagnostics, we are a private mental health clinic where we focus on neurodiverse assessments for both adult and children. And my focus here today is on ADHD and nutrition, and it's really to get people to start thinking about what we put in our bodies impacts our minds and our behaviors. Why don't we get started on the slides and we can go through it and have a discussion around it at the end as well?

Okay.

So like I said, our focus here is on ADHD and nutrition. And there's this very common saying, we are what we eat. And Hippocrates said, let food be thy medicine and medicine be thy food. And, you know, these words hold a lot of wisdom even today. Now I wanna be really clear to start with. Like I said, I'm a CAMS consultant, and prior to doing medicine, I had done a degree in psychology. My expertise in CAMS is ADHD and ASD, and I'm not a nutritionist in any way. But it is really important as medical professionals or any professionals that are working with ADHD to be thinking about how what we eat and how that has an impact on who we are as individuals on our physical well-being and our mental well-being, one of which today.

We're focusing is on ADHD. Next slide. Okay, so let's look at modern medicine. So modern medicine is focused on solutions, and those solutions are largely pharmaceutical. Now I'm an absolute firm believer in medication as it can be transformative and life changing for many people. But what if you could do something for yourself on top of medication that could change the trajectory and the severity of your ADHD? Lifestyle plays an absolute role in many illnesses. Let's look at cardiovascular disease like heart attacks and strokes, And one of the things that they give you is medication. They give you blood thinners. They give you blood pressure medication.

But on top of that, they give you lifestyle advice. They tell you to stop smoking, reducing your drinking, eating fruits and vegetables, reducing your cholesterol levels. And we know that from research that the combination of both lifestyle changes and medication leads to the best results. Let's look at mental health conditions like depression or anxiety. We know that when people are low in iron, they can present with having a very low mood. They can be quite tired, lethargic, you know, really struggle with motivation, sleeping a lot, and other behavioral symptoms. But what we also know is that when you change their diet and you increase their iron and they or they start taking iron supplements, these symptoms can change drastically.

And and this applies to even things like cancer. Lots of research has come out in terms of how eating certain foods can reduce your risk of certain cancers. The same applies to ADHD. What we eat and our nutritional state has a really powerful impact on who we are both physically and mentally. So what are the determinants of ADHD? We know that there is absolutely that there's genetic risk factors, and what do I mean by that? I mean that genes absolutely play a role in whether ADHD is present or not. We know that ADHD is seventy to seventy five percent heritable, but what makes up that other 30%? We know that if one sibling in the family has ADHD, there's a three to five times greater risk that another sibling will have ADHD.

We know that if one a parent has ADHD, the increase this increases a child's risk of having ADHD by fifty percent. Now at Diverse Diagnostics, we constantly assess children for ADHD. That's our you know, we that's what we specialize in. And what we often were having was parents coming in to these appointments saying, you know what? All these behaviors that are being described in my child, I used to see in myself, and that's actually some of the same problems that I am having to this day, and that's what led us to actually doing adult assessments.

And they're absolutely right. When we did the adult the adult assessments, the adults would have it as well, so both parent and children. We definitely know from research and from clinical evidence that there is, you know, genetic risk factors to it. But what we need to do is look at the genetic bit into a little into more detail. Firstly, there's not one single gene on its own that determines whether someone has ADHD. It's actually a number of genes that come together that determine whether someone has ADHD. And if we go back to that original point of ADHD is seventy to 75% heritable, what makes up the other thirty percent? One of the things we have to remember are genes are not always expressed, and they're turned on and off.

So what impacts gene expression? The environment. And that's that whole field of what we call epigenetics, where the genes and environment are working together. So what is one environmental factor that we know plays an absolute role in turning genes on and off? Nutrition. And nutrition is one of the mechanisms which can influence and change the expression of our genes. There is little doubt now, and there's a whole absolute huge body of research that confirms that certain foods have the ability to turn genes on and off, and that's what we call nutrigenomics. We know that nutrition impacts the brain development right from the fetus, the baby, the toddler to childhood. This is where we as humans do have control.

This is one of those lifestyle factors that we can change and create change for our bodies and our mind if we have the correct information, and also we need the determination to do so. Now what am I saying about nutrition? I am saying that it plays an absolute huge role in our mental and physical well-being. I am not saying it's a cure, but it plays a significant role in ADHD behaviors and can influence the trajectory of ADHD behaviors. And I'm also saying that it's one of the most instantaneously modifiable factors. We know from research that additives and food coloring can trigger ADHD symptoms like hyperactivity even in kids who don't have ADHD. I'm also saying medication is absolutely important and has its place and is really.

Important for professionals to consider when managing children or adults with ADHD. So I want to give you a bit of background on why I got into the nutritional bit, because you won't see many psychiatrists go into the nutritional bit in a lot of detail. So where did this journey start for me? So in the past year, there's been an incident where I've seen a direct impact that nutrition has had on me and my family, and the first was with my toddler. My toddler started attending nursery at the age one, and as I'm sure many parents will tell you, at this age that, you know, toddlers move from formula to regular cow's milk. So when he started nursery, he started picking cold after cold after cold. I mean, it was absolutely incessant.

He had so many ear infections and multiple bouts of tonsillitis. I had to see an ENT specialist who put him on prophylactic antibiotics. I did that, and it helped a little bit. So now he wasn't getting ear infections every week, but he was still getting them every second week. We were constantly in and out of hospitals because his temperature was so high. It was just unmanageable at home. This went on for months, and I started doing some research, and I was like, okay. Well, what can I do to help my child? I couldn't stop him from going to nursery as that's not feasible. We parents have to work. I wanted him to interact and engage with other kids. He was already on the wait list for grommet surgery.

Which was needed and, you know, for to help with his ear infections. But what I started learning from research was that toddlers are very iron deficient, and they're iron deficient for a lot of reasons. When they move from formula to cow's milk, cow's milk diet increases the risk of iron deficiency. Toddlers, know, are very fussy eaters. Okay? And on top of that, my child was vegetarian, so, again, might not be getting iron sources from certain foods. So when I started doing the research, it came to light that iron deficiency increases the rate of respiratory tract infections and quite significantly. So I thought to myself, I wonder if my child is iron deficient. And, you know, he's picking up all these infections. He's on antibiotics.

We're waiting for grommet surgery. And so I went to the GP and said, listen. I think my child might be iron deficient. I didn't want to give him iron without medical input, and the GP flat out said to me is, you know, we're not going to because we know it's normal for children at this age to be iron deficient, and that's all it would show. And I was thinking, well, it does make a difference because for my child's picking up multiple respiratory tract infections, we know you're saying he's iron deficient, the likelihood is he is iron deficient, and it could make an impact on his immune system. It could make an impact on how often he's picking up respiratory tract infections. So.

I convinced the GP anyways to do some bloods, and lo and behold, he was iron deficient. And so I started giving him iron drops. And what we had noticed was this, that your upper respiratory tract infections were still happening, but they were not happening at the same frequency, and also the severity of the illnesses were not as great. So he we were able to manage him more at home with his ear infections or when he picked up a bug. He wasn't getting sick for as long, and also it wasn't as hard to deal with as a parent. Now did he get grommet surgery? Absolutely. Did it make a difference, the grommet surgery? Absolutely. But I am also very confident that the iron deficiency and that being corrected.

Had made quite a significant difference, and the research does show that iron deficiency does lead to increased rate of respiratory tract infections and the severity of the illness. So that's where my journey with nutrition started. So this is what got me thinking. Okay. Why do we not think about nutrition more often? Why do we not think of nutrition when it comes to mental health? Because we do think of nutrition when it comes to physical health diseases. You know, for, like, for example, heart attacks and strokes, like I was talking about earlier. You know, people are now talking about it with respect to cancer. But why are we not looking at it when it comes to mental health? And more importantly, especially for us at Diverse Diagnostics.

Why are we not looking at this in terms of ADHD? Because as we know, the rates at which ADHD are being diagnosed have been increased, so it's something that is quite predominant in our child population, but also our adult population. So why is this not being given enough of a focus? Next slide. So the slide is why is nutrition advice so limited? So as I was saying, why do we as a society not look at and give nutritional advice, particularly with ADHD, and give it that bigger spotlight? And more importantly, as medical professionals, why don't we give patients advice?

Now when I look back at my own medical school training or look at my own career, which has been fourteen years as a doctor, I've had very I was reflecting on this while I was doing this, session, was my experience and training with dealing with nutritional issues is quite limited. And if I am dealing with nutritional issues, it's very much in keeping with, you know, physical health issues. For example, if I'm dealing with eating disorders, making sure someone's at the right weight, etcetera. It doesn't have to do with the mental health side in, you know, how it impacts people's behaviors or their minds. And when I look back even at medical school.

I realized when I was looking back at my modules, there was only two modules that had some nutrition in it that I would you know, and that was my learning as a doctor. Now I work for the NHS, and as I said, I work for you know, I'm the director at diverse diagnostics. And the amount of nutritional advice before I started delving into the world of nutrition has been very, very limited. And it got me asking the question, why do we shy away as society but also as professionals from this? So I started speaking to families about this in clinic, and I started asking them, you know, what has their experience been about nutrition and what, you know, what they've learned about nutrition from their own research and their own ADHD journey.

Because I really wanted to have a good understanding about why people don't talk about this, whether it's medical professionals or whether it's, you know, just the general population. And what it came out was many, many people comment on the fact that there's just so much information on the Internet about nutrition, and they don't know what's accurate and what's not. So people are getting this massive information overload. And, also, one of the things that you often hear people is there's all this information about magical potions that cure neurodiversity, and that just puts them off at looking at nutrition altogether. While.

I was doing the research for this session as well, I spoke to medical professionals, and I was picking other consultants' brain about this. And one of the things that's come to light, and it's very clear, is they also very much feel the same way that everyone else feels. There's just too much information, and trying to research it on our own is quite difficult. So if it's difficult for everyone, even professionals who are well versed in, you know, looking through journals and research find it quite overwhelming to figure out what is good accurate information around nutrition and what's not. But, also, there's that lack of training.

And because we aren't familiar with it, it's very hard to feel confident to go into a clinic and be offering advice about it. Okay? Again, it's not an excuse for medical professionals, but it does give us an idea of as to why the nutritional advice has been so limited when it comes to offering advice around nutrition and mental health. So that is what my goal is with today, is to look at the nutritional side of things, looking at nutritional deficiencies and how they impact ADHD and what's the evidence out there. I'm not going to be looking at herbs and potions, etcetera, and, you know, saying that this product is good and this product is bad and, you know, offering advice.

Of any sort like that. I'm literally looking at medical research that has been done and nutritional deficiencies, which we can medically monitor, which we know that there is, you know, quite clear significant evidence around ADHD. Okay? So before we dive into that, I want to do a quick anatomy lesson on the brain because I think it's really important to understand a little bit about the brain to be able to understand about the nutrition slide nutrition side of things. Next slide. So let's look at the brain, and I'm not going go into mass amounts of detail. I don't expect anyone to be an anatomist or anything, but the brain basically can be broken down into four lobes. There is the.

Parietal lobe, there's the frontal lobe, there's a temporal lobe, and there's the occipital lobe. The frontal lobe is particularly important, and it's the part of the brain that is different in terms of structure when you compare the ADHD brain versus the non ADHD brain. So what does the frontal lobe do? It is responsible for judgment, decision making, problem solving, memory, and impulse control. Now all of these things are a challenge for the ADHD brain. The parietal lobe is also important as it's responsible for paying attention for longer periods of time. Now all the lobes are very important and have their own roles and have to be able to work together efficiently and effectively.

Now what do we know from research? We know that nutrition, exercise, sleep deprivation, infection, and illness can all cause damage to the brain in smaller big ways. Now when I have, you know, spoken to people, whether it's coming to clinic or whether it's my friends or whether medical, you know, other psychiatrist, everyone knows that when I list off these things to them, everyone feels that that is general knowledge. Okay? So everyone recognizes this, but what there seems to be is that discrepancy between recognizing these factors that can cause damage to the brain and recognizing that that then means that there could be an impact on your mental health. Okay?

The second thing I want people to just think about is the structure of the brain. Okay? What is it made of? So the brain actually weighs 1.5 kilos, and it's quite surprising at how heavy it is, and it actually is made up of 60% fat. This is a really, really important fact to keep in mind when we look at our first nutritional, source, which is omega three. Okay? Next slide. Okay. So like I said, the brain is made up of 60% fat, and the one of the fats that's very essential in making up the 60% is essential fatty acids. They're quite crucial molecules that make up your physical brain, and they're most crucial in terms of having your brain function to the best of its ability. Now essential fatty acids can make up 60%.

But it's essential fatty acids is also something that your body cannot make on its own, but rather must be something you obtain from your diet. Okay? Now there are a few fatty acids which are important to think of, and that's the omega three fatty acids. So essential fatty acids make up a big portion of your brain. One of those essential fatty acids is omega three. Okay? And which types of omega three are very important? It's DHA and EPA. Okay? So docosahexanoic acid, which is DHA, and eicosapentaic acid is EPA. Okay? So I'm just gonna that they're quite, you know, it's quite a tongue twister to to say them over and over, but the two essential omega threes that we are going to focus on when it comes looking at ADHD is DHA and EPA.

Now DHA is a type of omega three, and it's absolutely vital for babies as it helps to develop their brain, their eyes, and their nervous system, and it is added to formula for this reason. Okay? Now fatty acids do more than just building the brain structure, so they are very, very important in, you know, building the structure of our brain cells, the neurons, but they also play quite a significant role in neurotransmitters. They play a very crucial role in how different brain cells communicate with each other, they play a role in how fast brain cells can communicate with each other, and they play a role in how efficiently brain cells can communicate with each other. So what are some omega three sources? Oily fish.

Has DHA and EPA, those two essential fatty acids, wild caught salmon, fresh tuna, so not canned, mackerel, herring, crab, oysters. Now I always get asked the question, is there a vegetarian omega three? Absolutely is. So this includes algae, spirulina, and chlorella, which contain both EPA and DHA. Okay? So there is absolutely a vegetarian omega three source. You can also have nuts, flaxseed, and chia seeds, which contain a different essential fatty acid called ALA, which converts into DHA and EPA, but it's not as good as the LG version.

Okay? You can also there's lots of supplements out there that contain omega three, that contain and one of the key things is when you look at, omega three supplement is to ensure that it has DHA and EPA, those two very, very essential omega three, essential fatty acids. Okay. So the question is, what is the research and evidence behind it? Because this is what's really important, and this is where I'm my goal is to help parents, to help, you know, the public understand how to look at the evidence around nutritional sources. So the evidence is this, there's been an analysis of nine studies that was done by Oregon Health and Science University, and they found that blood levels of omega three in children with ADHD.

On average is 38% lower compared to children who don't have ADHD. Lower levels of omega three in these ADHD children meant that they had higher levels of hostility, higher levels of defiance, higher levels, you know, there was much more greater mood swings and greater learning difficulties. Another study was done in The UK, which showed that children with ADHD and low levels of omega three had poor emotional regulation. So you know that ability to control and manage their emotions in different situations, they weren't as good with that. Multiple studies have been shown that supplementing a diet with omega three consistently lessens hyperactivity, and this has been evaluated by both parents and teachers.

And other studies have shown that omega three supplementation decreases moodiness and aggression. Brain imaging, diet intervention studies have been done, and there was a study done in 2010, and they gave some children no omega three, so they gave them a placebo. They gave another group of children, a four hundred milligram dose a day of omega three, and then they gave some children twelve hundred milligrams, a day of omega three. And what they had noticed was from the brain scans that the children who were taking higher levels of omega three, the area of the brain that was linked to attention processes increased. It was lighting up more on the brain scans. If we just move on to the next slide.

Oh, I think there's been a oh, there we go. Perfect. So what they also had found in this study was they did test and found that the reaction times of these children decreased, meaning that they became faster and the performance improved. A German study was done with children with ADHD, and they found that supplementing omega three improved their working memory, so that's that short term memory recall. There has been studies that have been done that where you take methylphenidate, so everyone I'm sure is aware that methylphenidate is one of the first lines we use in treating ADHD, especially in children. That when children were taking methylphenidate plus omega three, their hyperactivity and impulsivity symptoms improved.

Much more than just taking methylphenidate alone. Now I always get asked this, I've had parents message and say, know, my child's been taking omega three, and I haven't noticed any change. What's going on? And I ask them, well, how long have they been taking it? Okay? And they all say to me, oh, they've been taking it for a week. I've not noticed anything, etcetera. The first thing I say to them is listen, a, it's not a cure. Okay? It's something that we can use as an adjunct with medicine. And the second thing is, and really, really important is, it does take time for omega three to work. It does take three to six months for you to start seeing the impact and its real effects. Next slide. So the next nutrient.

We're going to look at is magnesium. Again, magnesium is something that we can medically monitor. It's something that actually if you went to your GP and got bloods done, you could actually mark off on the blood sheet magnesium. So you can see if people are magnesium deficient. Okay? Now magnesium plays absolutely a massive role in our body, and not just from a mental health point of view, but from a physical health point of view. Okay? And many of the nutrients that we're actually talking about today don't just play a role in your mental health. They have substantial other roles in our physical health. So they play a role in neurotransmitters, the immune system, you know, managing our blood sugars. You know, low.

Magnesium can lead to poor concentration, low mood and anxiety, mood swings, fatigue, and sleeping difficulties. So what are some sources of magnesium? So when the the diverse diagnostics team was doing their research, one of the key things we wanted to do was look at sources that we could incorporate in our diet on an everyday basis. You know, it's really, really easy to give people dietary advice. One of the hardest things we know about humans is changing our patterns of behavior, changing our habits. So looking at sources that we could, you know, we would commonly have access to and be able to incorporate much easier into our diet is the best way to go. So dark chocolate, avocado, cashews, pumpkin seeds, broccoli, fish.

Bananas, these all are very, very good sources of magnesium. Next slide. So what is the evidence around magnesium? Okay. Studies have shown that children with ADHD are deficient of magnesium. There was an Egyptian study that I looked at, and they were actually seventy two percent deficient. They found that the ones with the lowest magnesium levels had the most hyperactivity and the lowest IQs. Studies have shown that supplementing magnesium in ADHD children leads to less hyperactivity, less impulsivity, less oppositional behavior, and greater attention. There was actually another French study that was done, and that was looking at giving children magnesium, but also they gave them vitamin b six.

Now vitamin b six helps with absorption of magnesium, and what they noted was that magnesium levels went when they went up over two months, there was less hyperactivity, they were less aggressive, more focused, and slept better. But when you started, you know, removing the magnesium supplement, what you found was the ADHD symptoms returned. Again, this is, you know, helping people understand what nutritional sources are important in terms of, you know, ADHD and what nutritional sources, you know, there isn't enough evidence. And what we do know from research is magnesium and omega three are one of the ones that have been most researched, and there is quite a significant body of evidence around it. Next slide. So.

One of the, the studies that's quite important to look at is looking at a study that where they gave children omega three, omega six, zinc, and magnesium combination. Okay? And what they did is they monitored 810 children from the ages of five to 12, and these were children who had been referred for medical help and recommended. What they were recommended was taking this supplement that had all, these three in there, so omega three and six, zinc, and magnesium. And what they did was they gave these children the food this food supplement of omega three, omega six, magnesium, and zinc. And after twelve weeks of taking this food supplement, what they had noted was this. There was a considerable reduction of attention deficit symptoms.

And a significant reduction in hyperactivity and impulsivity symptoms. There was also assessments to look at emotional problems, and what they had found was at the end of the study period compared to the base, you know, the baseline, that the emotional problems had reduced and the sleeping disorder had improved. So problems falling asleep had improved by twelve weeks. Now by the end of the study, sixty one point one percent of the children continued to take the supplement because it was recommended by the pediatricians. Okay? So, again, it's just emphasizing the importance of looking at these nutrients. Next slide. So.

What is one another nutrient that plays an absolutely important role? So I had already talked about iron, and from my own experience with my toddler with upper respiratory tract infections, but iron plays multiple key roles in our physical and mental health. It transports oxygen in our blood cells. It plays a role in the brain cell structure such as myelin. It plays a role in the neurotransmitter synthesis and metabolism. So what are some sources of iron? Red meat, beans such as kidney beans, chickpeas, nuts, dried fruit, and soya bean flour. Next slide. And next slide again. So what is the evidence around iron and ADHD? So what we know is iron poor brains are very common amongst children with ADHD.

A lack of iron can worsen symptoms of ADHD. Iron deficient children score more poorly in math and language tests. The lower the iron, the higher the risk of ADHD. Okay? And this children with iron deficiency anemia have been found to have a sixty percent higher risk of developing ADHD in some studies. Low levels of iron increases your risk of sleeping disorders, which is common in children with ADHD. You know, we know that they struggle to fall oversleep. We know that they wake up throughout the night, and they may have early morning awakening. What we also know is iron supplements can improve ADHD symptoms, so the hyperactivity, the poor impulse control, the learning problems. Next slide. Vitamin d. This is one of the last nutrients.

That we're going to look at because I know we're running out of time. What we know is that low vitamin there's quite low vitamin d levels in The UK population. We know sixty five percent of people in The UK are thought to be vitamin d deficient. I'm sure many of you will look out your windows, and it's absolutely pouring rain. I can tell you in Scotland, it has been dark, gloomy, and rainy for the last, you know, I can't even tell you for how long it's iron vitamin d deficiency is very common in The UK, and that's not surprising to anyone. Research shows that expectant mothers with vitamin d deficiency have a higher risk of having a child with ADHD. What we also know from research is there's lower vitamin d in children with ADHD.

But what we also know is if you give them vitamin d, these vitamin d deficient ADHD children a vitamin d supplement, they found that the symptoms of inattention, impulsivity, and hyperactivity improved. So what are some sources of vitamin d? Sunlight, fatty fish, and seafood. Again, you know this common theme of this Mediterranean diet or, you know, fish. There's, you know, really, really important about what we are taking away from our diet. And lastly, I want to quickly touch upon zinc. Next slide. So zinc is not as well researched as the likes of a magnesium, omega three, and iron, but there is an increasing body of evidence and research around it.

Some research has shown that children with ADHD have lower levels of zinc. We also know that giving zinc supplements can show improvements in the particularly in the hyperactivity and the inattention symptoms. And also what we know from, you know, new pieces of research out there is zinc with the likes of methylphenidate can help improve the ADHD more so than just giving methylphenidate on its own. So some sources of zinc are red poultry, dairy products, beans, nuts, and whole grains. Next slide. Last but not least. Now like I said, I've only focused on a couple of nutrients.

Today due to time, but also I just wanted to be able to give, you know, the wider audience an understanding about where there is the most research in terms of nutrients. But other nutrients that do have research behind it in terms of how it can impact ADHD is things like vitamin b, vitamin b one, thiamine, vitamin b two, vitamin b six, because we talked about vitamin b six as helping magnesium become better absorbed, vitamin b twelve, vitamin c, vitamin e, folic acid, and iodine. Now all of these have been shown there's research out there with respect to all of these having a role in ADHD behaviors.

I'm hoping that this has just given you a little bit of a flavor on the nutrients that do play a role in ADHD, and it gives people just something to think about because what we eat absolutely plays a role in our physical health and our mental health. It doesn't take away from medication, and it doesn't take away from the fact that medication may be required or therapy is required, But what it can do is change the trajectory of ADHD behaviors, the intensity and frequency of ADHD behaviors. So I hope you guys have found that very helpful.

And, I would like you know, I missed introducing my team at the beginning. So doctor Flores is our clinical manager at Diverse Diagnostics who's played a huge role in helping put this information together, and our research specialist and assistant psychologist, Shona Thorne Knowles, who has not been able to, log on to the broadcaster bit, but she's been absolutely essential in helping us put this, presentation together. I'm really, really hoping that, one of the things that we can take away as medical professionals as well is to be looking at how do we offer good nutritional advice. It doesn't have to be complex. It doesn't have to be detailed.

But to be able to give people some guidance around this. And interestingly enough, I actually recently had a conversation with a professor in Scotland who plays a big role in, mental health here in Scotland who had given me a call and said, listen. Like, I totally see the value in the nutrition side of ADHD, but I feel that we aren't able to publicly talk about this for lots of reasons because there's just so much misinformation about it. But I'm hoping that this can be a start for people's conversations and really focusing on the evidence that's out there, but also sharing that knowledge in a way that people can process and digest. Changing people's nutritional habits is not as easy as giving them the information.

It's helping them understand how it can impact their behaviors, how it can impact their life, and helping them motivate them to create the change for themselves. Thank you very much to.

Henry, for having diverse dialogue We've got some questions for you. Camila is asking those to you. Is that the plan?

Yes.

Okay. So you've had a lot of questions sent in. If you go to the page, Camila, I'll hand over to you. If you need the page, I've just dropped it into the link for you. People do go in. We've got a little time. Do pop in a question. Go to globaladhd.com. Click q and a, and you can add your questions and upvote, downvote others. Over to you, Camila, to ask the ask the questions.

Okay. Thank you. There's a question about omega three. They are looking at supplements online, but they can't find anything about EPA or DHA in the ingredients.

Oh, there we go. So the first thing is nutritional supplements should have the ingredients at the side. So if you're not seeing the ingredients at the side, I would not have the confidence to be buying those supplements. I'm not able to say, you know, I know, like, get these questions all the time at the clinic is to, you know, provide which omega three is very good, which one's not, because a lot of them, if you notice, you know, will also tell you the doses at the side that they have. So it's important to look at the main thing is you want it to have DHA and EPA, and you want the label to actually show that. Because if it just says omega three, well, you don't know what type of omega three that is. It could be ALA.

And what we know about ALA is only 20% of ALA gets converted into DHA and EPA by our body, so it's not going to be that helpful or useful. So what I would say is, one of the things we're doing at the clinic is we take a very holistic approach when we come when it comes to ADHD. We look at therapy, we prescribe medication, but we also are starting to provide nutritional advice for families and looking at what's out there and what families can, you know, use in terms of helping support their child or or even their own their own mental health.

Sadly, I cannot go through all the different supplements out there and advise this one's good, this one's not, this one's good, this one's not, because there's lots of things you need to look at. You need to look at, you know, whether it has the right types of omega three, does it have omega six in it, but one of the key things I would say is make sure the label has DHA and EPA in it. Okay? That's the very, very key bit. And the other key bit is once you order it, take it and take it every day consistently. Okay? And.

You know, don't expect overnight magic to happen. This is not a magical cure. Okay? You have to wait three to six months. Okay? So make it part of your everyday routine. Make it part of your normal breakfast routine, you know, just taking those nutrient supplements.

Okay. Next question is, I have recently come across an ex pharmacologist who treats her own ADHD and others through supplementation. What wisdom can you offer here? Can you repeat that? Sorry. I just missed. So the ex pharmacologist is treating her own ADHD ADHD only through supplementation. What is your, like, comments over there?

So I would say that every case is individual. What I would say is that, you know, it's really important that when you get diagnosed with ADHD that there is a holistic plan so, you know, that we're not just looking at medication, we're not just looking at therapy, we're looking at the individual as a whole. Do I think that nutritional supplement on its own can, cure ADHD? No. I don't think that. I think that there is absolutely a role for therapy. I think there's absolutely a role for medication if it's required, but there's absolutely a role for nutritional supplements.

Now when it comes to nutritional supplements, the ones that we focus on at Diverse Diagnostics are the medical ones, the ones that you can medically monitor. We don't advise in terms of, you know, I know there's ginkgo biloba, and there's all these other ones where there isn't as much of a body of evidence or research around it. It would be very hard to comment on your particular case, but what I would say is anyone treating ADHD needs to look at it as holistically as possible. Look at the whole picture. Look at the whole person. And nutritional supplement alone, I'm not sure as a medical professional that I think that's the best way to go. Do I think that it's worth.

Trialing and seeing? Absolutely. If that's, you know, your journey, but I think it's important to get advice about, you know, from a medical professional, what is that whole picture for that person. So for example, I've had a child that's come in and quite severe ADHD, quite severe learning difficulties as well, and what we looked at was therapy plus medication, plus we're looking at nutrition, his, you know, his nutrition side. Because what we know with ADHD is they have sensory difficulties. They could be fussy eaters. You get a lot of oppositional defiance, so they don't eat. Looking at the nutrition side alone wasn't going to just change the trajectory for this child, because this child was, you know, on the border of exclusion.

Parents were really frustrated and upset and not being able to help their child and were looking for support as parents. So it really does depend on an individual case, but what we do is we look at everything and not just nutrition alone. One of the things that we do differently at Diverse Diagnostics is focus on nutrition as well, but we definitely look at what's recommended as per clinical guidelines, which is, you know, therapy and medication because nutrition alone hasn't doesn't have a significant body of research of, you know, curing or taking away all those symptoms of ADHD.

Okay. Next question is someone suggested no need for medication, just just have coffee cause similar effects. Use, should people with ADHD medicated or not avoid caffeine totally, or is it just a useful tool? I like a tea first thing to get me going, but that is also when I take my meds. Have been told this is not a good idea. Any suggestions for time interval should be left?

So I'm going to be very honest and say that in terms of caffeine, I, you know, I don't the research out there is quite mixed. What I would say is if you take caffeine in moderation. Okay? Caffeine in moderation, asking people to just stop something is very difficult. It's like asking people to stop smoking. Just, you know, cold turkey. Can a very small proportion of the population do it? Absolutely. Asking people to just, hey. Lose weight and start eating healthy. Is it possible for a very small proportion of the population to do it? Absolutely.

But it is very hard to change these habits. What I would say is this, that in terms of caffeine, there is a huge body of research how caffeine impacts our sleep patterns, And if you take caffeine after lunchtime, we know it can have an impact on our nighttime sleep pattern. So if you my like, I take caffeine to keep get me going as well. And I do think everything in moderation is okay, but if you feel that, you know, for you that it's impacting your ADHD, it might be worthwhile, you know, eliminating it for a week or two to see how you get on.

In terms of the body of research behind it, it's very mixed. Okay? And there isn't a lot, to be honest. And the things that I talked about today are the things that actually have the most body of research. And the other thing I my focus has been on today are nutrients that we can medically monitor. And I wanted to start off with that simply because the it's a way that we can measure and monitor change. With regards to caffeine, you know, it's not easy to go and medically monitor how much caffeine is someone is in someone's bloodstream, etcetera. But with things like magnesium, you know, things like iron, etcetera, they can be easily measured and monitored.

Okay. And I think this is the last questions. Many of the studies mentioned seem to have used children as participants. Is there evidence to say in conclusions on effect of diet supplement supplements can be drawn for adults?

So you're absolutely right. The body of research and evidence is largely around children. Adults have been very much forgotten when it comes to ADHD, and we know this because we know there's a huge proportion of the adult population that hasn't been diagnosed, and many people think of ADHD as something that only children experience. Now the reason why that is is because people thought of it as a children's mental health disorder, that it doesn't really impact adults because adults go on and become you know, they get they move into jobs or they have a family life, and therefore, well, they can't really have ADHD.

Is there more and more research coming out about adults? There is, but it is quite small, and I only wanted to focus on the research that has quite a significant body of evidence. Do I think, though, that you can apply the same things from children to adults? Absolutely. I do think that because although our brains are not exactly the same, the structure of our brain, the, you know, the anatomy of our brain can be quite similar. The difference is children are growing at a phenomenal rate. So do I think that there would be a difference? Absolutely. Do I think that the food sources and the nutrients would be different? No. Because you got to remember, adults who have ADHD also were children who had ADHD.

Remember that for a clinical diagnosis of ADHD, you have to have symptoms before the age of 12. So the same adults were also children. So do I think this body of evidence can apply to adults? Yes. I do. But the research out there in terms of current research, there isn't a lot in terms of looking at these nutrient supplements in adults.

You guys have been amazing. Thank you so much. And I found that really insightful and interesting. And and I I actually the honesty and candor of what we know, what we don't know, what we can measure, what we've seen, what's this research to get beyond the you know, those sort of myths. It's actually when you say ginkgo bilababa, Like, you know, there's a group of supplements that are just always sold. It's like like and and we use just see them, like, just just there there's this constant barrage and a previous charity called Sarcoidosis UK. Some people, like, might know that about me. And Ginka was also promoted there. It's like, like, let's have the science people.

It's No. Absolutely. And that's our thing. Like, you know, if anyone is looking for an ADHD assessment where you do take more of a holistic approach looking at the medication because we do prescribe, we look at therapy, we do do the therapy, individual. But we're very much an evidence based, research based clinic. And if anyone is, you know, looking to get in touch with us, they're more than welcome to contact us via our social media, our website, http://www.diversediagnostics.co.uk. We do offer free fifteen minute consultations for individuals, and I appreciate it might not be, for everyone, but it is really helpful for people to know.

That there is medical professionals who are looking at the nutritional side and who do take a holistic approach when it's treating an individual. This is what it's about. It's treating an individual and what things can we take control of as parents, as adults.

You know, just any in terms an assessment service for both adults and children in ADHD.

And I and do you have an autism service? Like, okay. I'm trying to remember. Yeah. Yes. We do. So we do autism assessments as well as a diverse diagnostics. So we do depression, anxiety. So anything that you would go for CAMS for, you can we do a diverse diagnostics. We have an adult consultant psychiatrist who is an ADHD specialist for the NHS who works for diverse diagnostics doing our adult assessments. Again, our our ethos is look at the individual. You know, not one size fits all, but also we're very much evidence based, science based when it comes to therapy, medication, and nutrition. All of these things in combination, I think, can really create change for people and change the trajectory.

Of their mental health symptoms, whether it be ADHD or anything else. Thank you very much. We're we're running, like, almost exactly on time. We've gotta call it. Thank you so much for being part of this and being part of the ADHD community, being part of changing what it means to have ADHD. That was an incredibly interesting insightful presentation. I know you put an enormous amount of work into it and you're, yeah, really wonderful and and really accessible, which is obviously very, very important. Accessible and achievable, I think you note that difference of sort of trying to oversell like a very detailed difficult package. Thank you so much. That's where we have to say a bit of joy.

Have a wonderful rest of your day. Thank you so much for being part of this. Thank you. We appreciate it. Obviously find them at Diverse Diagnostics, you can find them in our marketplace. But wonderful. Have a great rest of your day. Goodbye. Goodbye. You too. Bye. Bye.