Dianne Rishikof, RD, LDN, and Integrative and Functional Nutritionist talks with us about how to raise healthy kids using a foundation of sound nutrition. We love Dianne’s practical approach to working with families—really helping them navigate some of the potential challenges that stand in the way of getting kids to eat to support their own health.
In this podcast you’ll learn about:
– The foundation of good nutrition for children
– Strategies to address picky eating
– Breakfast ideas to set kids up for a day of steady energy and concentration
– How we should completely rethink ‘snack food’
– The role of gut health for children
– How to support a healthy gut microbiome
– Natural strategies to address ADHD
– Practical advice for getting your child on board with making changes
– Supplements for general kids health and specifically for ADHD
Romilly Hodges: Okay. Hello and welcome to this podcast on nutrition for kids and with a special dive into ADHD, which is a significant and still growing concern among children. And the most recent CDC data now shows that more than one in 10 children in US have received diagnosis of ADHD and also that the majority of those are taking medications for their conditions. So I think this is a great topic to discuss.
My name is Romily Hodges. I am the staff nutritionist at the office of Dr. Kara Fitzgerald and I’m here today with the registered dietitian and licensed nutritionist, Dr. Dianne Rishikof. So welcome Dianne.
Dr. Rishikof: Thank you so much.
Romilly Hodges: Great.
Dr. Rishikof: For having me.
Romilly Hodges: Sure. We’re delighted to have you here. And I’ll just read your brief bio here so that our listeners have a bit of a background about you as well.
Dianne is the owner of Dianne Rishikof Nutrition. Did I pronounce that correctly?
Dr. Rishikof: Yes, Rishikof. Yeah.
Romilly Hodges: Great! That’s found at www.DianneRishikof.com or HealthTakesGuts.com, which I love that as well.
And Dianne helps individuals reclaim their health. She is an integrative and functional nutritionist, working with both children and adults and people struggling with digestive disorders or stubborn or confusing digestive symptoms, ADHD, chronic fatigue, anxiety and many other issues as well.
Dianne also has her own line of supplements called Health Takes Guts.
So again, welcome Dianne and thanks for being here. Why don’t we start off…
Dr. Rishikof: Thanks for having me.
Romilly Hodges: Sure. Why don’t we start off by asking you what you see as the biggest challenges for parents who are looking to raise healthy kids?
Dr. Rishikof: That’s a great question, also a broad question. But I think one of the problems is that kids can be picky and parents often find themselves intentionally engaging in a power struggle with their children and that can lead to real problems actually.
What happens is if you think about it, children ultimately have all the control over what they’re actually going to put in their mouths. So either we support them or argue with them for different reasons because we want our children to be healthy. But when parents try to force it, it just turns into more battle and the child starts to say, “Hey, I’m going to dig my heels in and not eat.”
Romilly Hodges: Right.
Dr. Rishikof: So one of the main things I try and help parents with is their own attitude towards feeding. And the earlier they start this, the better. It’s actually not my original idea. It’s originally by Ellyn Satter.
She came up with this division of responsibility where the idea is the parents are in charge of what, where and when – so what the child is eating, what the child gets presented, what’s in the house, what’s purchased, what’s prepared and what’s on the table. And they’re also in charge of where, meaning they should all be eating at the table and not in front of a TV screen, et cetera. And they’re in charge of when if they want the child to run a schedule.
But their child is in charge of how much, which could be zero. So the child is in charge of how much they eat.
If the child is already picky and already engaged with a power struggle, this can seem absolutely absurd. It takes a little while to just undo the damage. But if the child is young, a baby, starting this way, it’s great. Just give the child all the power in terms of how much and they don’t ever have to fight in the end. They know that they don’t have to be pressured into eating more or less. And they get to be regulating how much they eat.
Again, if it comes later, then there are some tweaking and some fighting, but it still can definitely work and undo some of the pickiness.
Romilly Hodges: That’s great! And as a parent myself, yes, I think that’s absolutely a wonderful approach to take. And as you said, the earlier the better because it just helps to normalize that approach.
And I find that kids are really looking for some area of control in their life. For the most part, they don’t have a lot. We’re kind of dictating what we’re doing here and there especially in their younger years. And whenever they do have an area that they control, they like to utilize that.
So I think you’ve gone straight to the heart of one of the biggest challenges, I agree, in terms of parenting. So that’s great. So where do you recommend parents start?
Dr. Rishikof: Again, if you’re starting from if you’re pregnant, this is a great thing to start with a child or an infant. It’s always good to not have to worry, stress out about how much a child is eating because theoretically, the child will know how much they need. And again, it’s the parents just to give them healthy food that will help them (which we can talk about in a bit). And then, the child gets what they need. The earlier, the better.
And of course, once a child is eight years old and every day is a battle and every meal is a fight, well then they need to seek help from someone like a dietitian who is versed in an area because there is a lot of willpower that needs to go into reversing power struggles. It still is underneath the role of [inaudible 00:05:55], but it has to be [unlocked] as well.
So the parent would have to really be committed because a child will – it’s like a tantrum. If you start fighting with them, they’ll fight more to try and get you to give in. But if you dig your heels in as a parent and don’t fight with them anymore, they will stop eventually depending on the child. There are always exceptions, but this can work. It can definitely work to undo picky eating.
Romilly Hodges: Right, right. I think that’s wonderful. Obviously, there are some kids that have more serious concerns that might involve picky eating. Obviously, this is a potentially great approach to take.
Are there any warning signs that showed that might flag a parent to have to seek help with extreme pickiness?
Dr. Rishikof: Yeah, that’s a great point. There are some kids that have sensory issues. So it’s not a power struggle issue. They don’t want control, it’s not like that. It’s that they actually don’t like the texture of certain foods. If that’s a sensory issue, that’s a different issue. Parents should seek help from a specialist, a sensory feeding specialist.
And then again, if a child has a development delay or ADHD or autism or something else, then the behaviors can be more extreme and they need more help.
It’s still going to work if [inaudible 00:07:25] division of responsibility, but it is going to work better if the child is just run-of-the-mill picky and/or run-of-the-mill power struggle because parenting philosophy or parenting attitude can be the reason why there’s a power struggle. So when the parents change their own attitude, power struggles go away.
But of course, that doesn’t always happen if the child has different reasons for why they are picky.
Romilly Hodges: I think that’s very helpful and just incredibly hopefully incredibly useful for parents who find themselves in this situation, which can be extremely frustrating for them and for children as well as a way to navigate through that.
So tell us some more about what parents should be thinking about in terms of what they children need nutritionally.
Dr. Rishikof: Yeah, that’s great. In general, of course – I mean, this topic is very vast. We could go on for a long time.
Romilly Hodges: Right.
Dr. Rishikof: But generally, make sure that they have all the things they need to develop appropriately and try and minimize the things that interfere with development.
So what they do need to develop are of course good proteins, healthy fats, lots of fruits and vegetables which provide the vitamins and minerals.
And by healthy fats, we’re talking about omega-3s that come from fish. And sometimes, if kids don’t eat fish, then they might need lots of nuts and seeds or possibly supplements. And other healthy fats are things like avocados, nuts, olive oil. All these are very important. The kids certainly also need animal fats from meat and dairy. That’s good for brain development in very young children.
So then in terms of good protein, again, animal protein is really good because it’s complete. But other sources are great too, soy and other sources. And a good amount or a decent amount of protein at every meal and snack so that it’s not just all dairy or something like that because kids really need a steady stream of amino acids all day long.
And the things that interfere would be the junk food that we all know as far as sugar and processed food and processed oils and things like that. But the other thing to think about that a lot of parents don’t think about that we’re only starting to realize recently is the gut microbiome, the trillions and trillions of bacteria and microbes that live in our gut and how crucial these are for our health.
Romilly Hodges: I’m so glad you brought that up, yeah.
Dr. Rishikof: So if the microbiome is healthy, the kid will be healthy. If the microbiome is not healthy, that can cause pretty much anything. It’s a challenge to find any condition that isn’t linked to the microbiome.
A lot of times, sugar is not good for them. It’s not giving them any nutrition. They’re empty calories. But really, what it’s also doing is they feed the bad bacteria and they’re setting up an environment for bad bacteria and bad yeast to flourish. And then, 10 years down the line, 20 years down the line, they have this bad microbiome and that can lead to anything, all kinds of autoimmune diseases and so forth.
So I always try and think about that and try and put that into parents’ heads. The time to set up the child for a lifetime of health is in the early years and the microbiome is a big piece of that.
Romilly Hodges: That’s great.
Dr. Rishikof: We got to think about what we’re feeding. Fruits and vegetables feed the good stuff. Sugar and junk foods feed the bad stuff, et cetera. And that’s a good rule of thumb.
Romilly Hodges: Right, that makes perfect sense, getting in those healthy fibers and healthy carbohydrates that will feed the healthy bacteria populations.
And in your experience, what about the use of probiotic foods in children? Are there any probiotic foods that you find to be child-friendly?
Dr. Rishikof: The yogurt is child friendly and even kefir (it’s more like a yogurt drink). That can be child friendly. I don’t know. It really depends on the child. Some children might love sauerkraut. Who knows?
But you certainly should introduce those foods, fermented foods and probiotic foods because your child might like them. That’s great. So don’t write them off. Get them to try them over and over again. Introduce them many times.
Yeah, probiotic foods are great. And then, probiotic supplements are okay too for children. You just have to pick the right one or be careful, but yeah.
Romilly Hodges: Great. Great! So what kinds of things would you bear in mind if you were choosing a probiotic for children?
Dr. Rishikof: You want to choose high quality company and high quality supplement. And then the ones that have more than one strain of bacteria are better because in our guts, we have hundreds of strains. The probiotics just have one strain. They might be a good strain of bacteria, but there’s not a lot of variety there. So there are some probiotics that have three strains, eight strains, 12 strains.
It also depends if the child can swallow pills or not because if you could swallow a pill and the pill is, again, made by a high quality company and it’s coated so it can survive stomach acid, that’s better. But chewables are fine too.
It’s not clear how much survives stomach acid, but there are some that do survive stomach acid, especially if there’s food in there coating. And even then, bacteria can be helpful.
Romilly Hodges: Right.
Dr. Rishikof: Yeah. You can always get help from somebody, books or experts or your own dietitian, someone who might know about this.
Romilly Hodges: Right. I think that’s great advice as well. And could you talk a little bit more about the things that folks might want to avoid in their kids’ diets as well. I think you mentioned a couple of things, obviously the sugars. But do you want to explore a few more of those?
Dr. Rishikof: Yeah, sure. Certainly soda and juice, juice like apple juice and fruit juice. Orange juice is different. But soda is usually just sugar and there’s just so much of it that the child can get tremendous amount of sugar without even really feeling full [inaudible 00:14:20]. Liquid sugar is terrible.
And not only it feeds bad bacteria, but it can contribute to inflammation and weight gain and mood problems and blood sugar issues. So anything like that, sugary drinks, definitely stay away from any of those.
We all know junk food is not good and cookies and that kind of stuff because they can also add up really fast. And the main thing about all these foods is they’re not providing anything beneficial. So yeah, we could talk about how unhealthful they are, but they’re also not providing anything beneficial at all.
Unlike some other foods, even pizza, which maybe has its flaws, but also has a lot of proteins, lots of calcium. It has some things that at least provide benefits. Junk foods, empty calories, sugary drinks don’t provide anything good. So they’re not really necessary for the body, especially kids if they’re filling up on junk foods and they’re really going to not eat the healthy food later and then they might not develop properly. They’re going to miss out on some of the necessary nutrients that they need.
Romilly Hodges: Right. And I think I even a saw study as well done that showed that pizza actually was one of highest glycemic foods that we can eat. Even though it has this combination with the dairy, it’s very, very high in glycemic as well.
Dr. Rishikof: Yeah.
Romilly Hodges: And trans fats maybe is something else that’s definitely good to avoid because they even can block that formation of EPA and DHA in the body when it converts from the ALA form of omega-3 fatty acids and obviously those longer chain essential fats that are really important for brain health as well. So there are more reasons to stay away from those processed foods.
Dr. Rishikof: Yes, great. It can bring up trans fats. Absolutely, we should all avoid trans fat 100%. Yeah.
Romilly Hodges: Right. So, we talked a little bit about the influence of fish or if not fish then including supplement with EPA and DHA. If kids do like fish, what do you recommend for folks in terms of choosing fish that’s lower in contaminants and heavy metals?
Dr. Rishikof: Yeah. There are certainly resources online for this. The fishes that are highest in mercury are the bigger fishes, so swordfish, shark and things like that. And the fishes that seem to be lowest of mercury are salmon and catfish and then the white fish are in the middle, but pretty low. So I would pick salmon or some kids like white fish like cod because they have less fishy taste and that’s fine.
There’s [inaudible 00:17:23] environmental working group or somebody, I’m sure, has a list of fishes that have the most contaminants. But even the salmon that you might get – you probably should get it from a good source, so maybe a whole foods market or something that has better sources of their fish, wild-caught fish rather than farm fish, which definitely can have other contaminants.
Romilly Hodges: That’s great to know. That’s really good. And actually on our website, we have a downloadable guide to choosing fish and seafoods. I think it’s covering some of that as well. So if anybody’s interested, that’s up on our website, available as well.
Tuna has been such a staple often in many people’s diets, tuna salad, tuna salad sandwiches or an easy thing that people can reach for, for their kids’ lunches as well. So that’s just something to absolutely bear in mind that that’s one of the high mercury fish and can be detrimental to brain health as well. That’s great information.
What do you think about GMOs as well?
Dr. Rishikof: That’s a tricky one and that’s a [inaudible 00:18:37] topic, but I usually try and avoid them if I can. It’s such a controversial subject for me. I think the researches are mixed or not [inaudible 00:18:49]. So I’m not entirely sure how to advice people on that.
I think they can avoid them. They might as well. But you can’t totally avoid them and I’m not sure if we need to avoid them yet.
In fact, there are some opinions that there’s absolutely no problem with GMOs. I found strong opinions that there are real problems. I think I’ve read that they have gut bacteria, which is where my antennas go up. But I’m not sure we’re certainly buying that yet.
Romilly Hodges: Yeah. There’s definitely no conclusive research either way that I’ve seen as well.
Dr. Rishikof: Right.
Romilly Hodges: I think it’s probably fair to say that the studies that were used to base the approval of GMOs were arguably inadequate, very short term, done in animals. So that’s one potential thing.
And I wonder. The other area that I feel is more strongly backed up is that GMOs can have so much more pesticides used on them. In fact, they’re deliberately bred to be able to withstand higher levels of pesticide use. And that’s obviously one area that can play into the detrimental effects in the gut and I’ve seen it in other areas of the body as well. So maybe that feeds into what you’re saying about potentially adversely affecting gut health.
Dr. Rishikof: Right, that’s a good point. Absolutely. These pesticides will kill the bugs in our gut even if they don’t harm us. And absolutely that’s a real problem. Absolutely the pesticides are a problem.
Romilly Hodges: Yeah.
Dr. Rishikof: That’s a good point. Thank you.
Romilly Hodges: One thing I think that parents often struggle with – it’s all very well to think about kids should be eating healthy. But when it comes down to what they should put on the table for breakfast or what they should put on the table for snacks or to send to school for snack time, I see those as being a couple of the hardest places for parents to find good food choices. So have you got any ideas for us in terms of what to put on the table at those times?
Dr. Rishikof: Yes. First of all, if I could just mention that I do have a breakfast list and a snack list on my website…
Romilly Hodges: Great.
Dr. Rishikof: …if people want to go find them and they might as well want to print them. I think in general, both of them separately, breakfast is very important for the child’s ability to pay attention in a day.
So there needs to be some proteins because when you just have a pop tart or a bowl of cereal or whatever, a lot of simple carbohydrates, they get digested very quickly, they go into the blood stream very quickly. And then by 9:00 or 10:00, the child has low blood sugar and looks like they’re not paying attention and not able to function very well. So there needs to be some protein to balance that. Ideally the carbohydrates should be in the form of whole grains and fruits so that they wouldn’t be digested so quickly anyway.
But the only thing about breakfast is to go and be creative. It doesn’t have to be traditional breakfast food. Eggs are great and that’s traditional and that’s great.
I usually tell people to have fun with toast. A piece of whole wheat bread and then add all kinds of bizarre stuff on it like cheese and avocado, beans and melted cheese in salsa, anything that’s interesting to the child and doesn’t have to be what you might think of as breakfast food. In fact even leftovers from dinner, if it was a healthy dinner would be okay.
Romilly Hodges: I love that.
Dr. Rishikof: Yeah. And then smoothies are okay too as long as they’re made from whole fruits and you can add yogurt, you can add nuts, you can add chia seeds or flax seeds, you can use flaxseeds, you can even add a protein powder. But be careful with the protein powder in children. Smoothies are interesting things because the kids often like them even if they don’t like fruits.
And then for snacks, I definitely think that people need to rearrange how they think about snacks because a lot of people feel like snacks equal “snack foods,” which would be candies, chips and et cetera. And snacks really need to be another piece of the puzzle, another piece of the healthy nutrition part of the day.
So I like to tell parents to think of snacks as a mini meal. When you give your child potato chips and a juice box for dinner and usually hopefully the answer is not. And so then you shouldn’t give it to anyone for a snack. A snack could be half a sandwich or oatmeal and coconuts and nuts and things on top that provide some protein and some carbs, some healthy foods and fibers, et cetera.
Again, the child can eat as much or as little as they want. And if they overeat it and then they don’t eat dinner, which is always a concern, if they had a healthy snack, then it actually doesn’t matter. Whereas if they overeat the potato chips and then don’t eat dinner, that’s a real problem. But if they overeat their healthy snack, that could be their dinner. They’ve still gotten nutrition that they needed I guess is my point.
Romilly Hodges: Yeah. That’s so perfect. I love the way you think about that because if they’re filled up on snack time because it happened to be after school when they were super ravenous because they didn’t have enough time to concentrate on eating food at school and they overeat at snack time, then at least if you’ve given them something that’s more obviously real food and healthy foods, then it’s not such a concern.
And it makes such a switch over. If you find that your child is really hungry right after the school period, make it a meal. Make it a real meal for them at that particular time when they’re going to be eating more food and then have something lighter maybe later on. So I love the way that you’re thinking about that.
Dr. Rishikof: Yeah. Thank you. Exactly. And I think if they have a meal at 3:00, that’s when their body needs it. And then they have a snack, a healthy snack at 6:00, so what? So yeah, exactly. But if they have a plate of brownies at 3:00 and then they don’t eat dinner, well now [inaudible 00:25:23] their vital nutritional needs.
Romilly Hodges: Right. And so I love that you have those lists on your website so folks can go and find them that. But do you have also any tips or tricks about how to get kids to eat the veggies because that’s always a trick one too?
Dr. Rishikof: Yeah, it is always a tricky one and again I could give you some general tips, but it could be directly individual. But in general, I tell parents to take their children and shopping with them and the child can pick out something at the store in the produce aisle that looks interesting to them. There are a lot of books, children’s books that talk a lot about vegetables and fruits and maybe the child’s interest will be piqued.
And there’s also – not necessarily a new [inaudible 00:26:15] for us, but there’s also the idea of a garden at least in the summer. If the child helps plant the garden and watch the garden grow, they are much more likely to want to eat whatever it is they helped grow.
But they don’t think about fruits and vegetables just to make it fun is you can go on Pinterest and find a million ways to make whatever, Christmas trees and animals and fruits and vegetables.
I find that that actually really does work for people, for kids to be interested in eating fruits and vegetable. But you can make shapes of animals and things with fruits and vegetables and kids will eat it because they think it’s so fun.
Romilly Hodges: I love that. Yes, I agree. I think we don’t have enough fun with foods sometimes. I think that’s really good. And there’s an expectation for kids to relate to food in the same way that adults relate to food and that’s not always maybe the best way to get them interested in eating it. So great suggestion.
Dr. Rishikof: Yeah. The other one is of course to let them smother in butter and cheese or something because at least they’re getting used to having vegetables and there are some tastes in vegetables, the vegetable is mixed in with the taste they like and know. So that can work too.
Romilly Hodges: So using flavors that they already know and like to bring other foods into the mix as well, whether it’d be some healthy butters or cheeses or other flavors that they like as well. I think that’s a good idea.
Dr. Rishikof: Yeah.
Romilly Hodges: Okay.
Dr. Rishikof: Great.
Romilly Hodges: So shall we take a deeper dive into one of the areas that I know. You work a lot with ADHD and obviously I’m sure that a lot of what we’ve already talked about is highly relevant for ADHD such as those essential brain fats, avoiding the mercury, which is neurotoxic, keeping the sugars low or avoiding sugars as much as you possibly can. But what else should we be thinking about?
Dr. Rishikof: Yes. Okay. With someone with ADHD, like you just said, the omega-3 fats, et cetera, but in general, even more whole foods and less processed foods are important for several reasons.
One is that it seems like a lot of kids with ADHD – this has been researched and studied – have a lot of deficiencies in certain vitamins and minerals. So I’ve actually developed the supplements with just those research on vitamins and minerals. So I figured, “Hey, here’s an area.”
But the point is that there’s magnesium and zinc and vitamin E or vitamin C and some B vitamins that they seem to be deficient in. So they need to eat whole foods and foods that have those vitamins in them.
And another reason to avoid processed food is because of the additives. We know for sure that colors, artificial colors can really be very excitatory for the brain. So that’s not good for anybody, especially for someone who’s hyperactive or has struggles with brain challenges. So the colors should be completely removed.
Any preservatives or any food additives, stabilizers, artificial sweeteners, all these chemicals are really not good. So usually removing those is a big step and of course they’re all found in processed foods. So when you remove processed foods, you’ve done one thing [inaudible 00:29:57], so to speak. Does that make sense?
Romilly Hodges: Right, yes, it makes perfect sense. Yeah. In fact, the solution can be quite easy when you focus on whole foods diet and then you’re removing all of these problematic ingredients in one sweep.
Dr. Rishikof: Exactly. But nutrition should be the foundation. Nutrition and sleep really should be the foundational pillars for any child with ADHD because often people just go straight to the meds or something else. And the problem is that those things aren’t going to work as well if the foundation isn’t there. So the child needs really good nutrition, which is the whole foods diet and also supplements and good sleep because think about it, if they’re not getting what they need for their body, including sleep and nutrition, then nothing else is going to work the way it should either, no other treatment options, no therapies or medicines.
So yeah, always think about nutrition, think about sleep, making sure they get enough sleep and they’re getting the right kinds of foods and the right amount of course. It could be complicated, but the right amount of protein, the right amount of all these vitamins and minerals that they need.
Nutrition, I would say, is the single biggest factor in ADHD treatment and it’s often overlooked because people go straight to the psychiatrists. And pediatricians don’t think about it. It’s not a big money-maker because it’s not a pharmaceutical.
Romilly Hodges: Right. I’m completely with you on that one, 100% with you. We’ve talked a little bit about healthy diet, but how does a condition like ADHD change what we have discussed in terms of diet so far and maybe some of the things like foods that can trigger issues or even more detrimental effects of some of the things like sugars?
I think there are studies that show direct correlations between the amount of sugar consumed and say the destructive, aggressive behavior on the playground. That’s clearly important, but what about some of the things that we’ve talked about so far? Does it change in the context of ADHD?
Dr. Rishikof: That’s a great question. I have several answers. So the first thing is the idea of having proteins for breakfast and not having too much simple sugar or any sugar and not to make simple carbohydrates. It’s crucial because of the same reason we said before, which is that the blood sugar goes up, the blood sugar goes down and then we’re all cranky and inattentive and irritable.
So for someone with ADHD, now they’re even more so than they already were. I mean they already have a challenge in this area and now you set them up and their body chemistry is all out of whack just for breakfast. So that’s what it comes in. It’s really important for them to have proteins for breakfast. That’s been shown over [inaudible 00:32:59] health.
And then again with the heavy metals like mercury, these things are really bad for the brain. So someone who already has challenges with the brain, they don’t need any more challenges. And then like I said, the additives, the preservatives, the colors.
The other thing – and I’m not sure if this is what you’re asking, but I think it fits here – is gluten and dairy can be problematic for some people for a variety of reasons, gut trouble or whatever. But people with ADHD, it would be beneficial and it would be worth it to take them off gluten and or dairy for some time and see if it helps them because gluten can be a real problem for anything, for brain health and gut health and et cetera – and dairy too.
So a lot of kids, when they go on a gluten-free and dairy-free diet, they do improve. And for some, it doesn’t make much difference, but it’s worth a try.
And if there’s something else called Feingold Diet where it’s a chemical salicylate. I’m not sure if I pronounced that right. But it’s tricky and you have to look it up because it’s in a lot of vegetables, strawberries and grapes and cherries. So unfortunately those are healthy foods, but there is a chemical, a food chemical that Dr. Feingold thinks that makes ADHD worse.
So it’s another one to try. I usually encourage all the other things first before that. And then there are food sensitivity tests. There are tests for food sensitivities, different tests, IgG tests, MRT test. Sometimes they work and by eliminating the foods, the kids are reactive too. In general, just get the inflammation in their body down making sure their nutrition is optimal, making sure their brain nutrients are optimal.
I sometimes even do the neurotransmitter testing because it’s easy to do. I think it’s easy to give a child a nutritional precursor to dopamine let’s say because dopamine is very important on concentration and focus. And it’s in the frontal lobe and in the frontal cortex. It’s just where the ADHD challenges reside. So the treatment could be supplements in those areas.
There are a lot of different things with diet and more specific. But again, a whole foods diet, plenty of vitamins and minerals, keeping away the things that hurt the brain, adding things that help the brain, those general ideas.
Romilly Hodges: That makes sense. Right and the protein as well, making sure that we get that protein in for the essential amino acids. The protein also helps regulate the blood sugar levels, right?
Dr. Rishikof: Exactly.
Romilly Hodges: Right. And I think that’s great. How does gut health play into this potential inflammation in the body or even food sensitivities to gluten or dairy or other types of foods as well?
Dr. Rishikof: Gut health is absolutely essential and key to the direction in health and disease and some of these things. If there’s gut bacteria or leaky gut and the barrier of the intestinal wall isn’t healthy, then certainly things, toxins and undigested foods, toxins from the food and also toxins from the bad bacteria that are in there can leak through the wall, those can disrupt the brain and or cause food sensitivity reactions that we might see.
The immune too reacts and have inflammations and inflammatory responses, which can be anything for anybody. It can be skin problems, headaches, ADHD, gut symptoms, et cetera.
But even if someone’s gut health is seemingly okay, there are still going to be problems enough that they’re affecting the rest of the body – because a lot of people say, “Oh, I don’t have bloating, I don’t have diarrhea. So I’m fine.” But the microbiome is not perfectly healthy. The symptoms are actually manifesting somewhere else like joint pain, rashes, skin rashes, headaches, et cetera.
So ADHD, it’s not 100%, but there have just been a lot of correlations between gut health and ADHD symptoms, gut health and ADHD. So it’s definitely important.
And the food sensitivities, they’re tied together. Usually if your gut is working great and you’re digesting your food completely and your gut barrier, your lining in the gut wall is perfectly intact, you wouldn’t have any food sensitivities theoretically because nothing will be leaking through. That’s not always true because obviously even fully digested food, we can react to. Yeah, gut health is important.
Even just digesting, digestion is important. Making sure kids chew their food and getting enough saliva and stomach acid and enzymes that can digest their food is extremely important.
Romilly Hodges: That’s great. I think that’s really helpful. So in terms of what you think about and in terms of addressing gut health in children, it would be that slowing down eating, making sure the chewing is happening because that stimulates all the gastric and gastrointestinal secretions that will digest the food properly as well. And you’re think about the probiotics and prebiotics.
Is there anything else that you do in the child population to address gut health?
Dr. Rishikof: It depends on the child. I mean certainly making sure – and this is true for gut health and ADHD – making sure they’re getting enough water, enough liquids.
I get a lot of kids who are constipated. So the problem is on fiber and water. I mean that’s not always the problem. That can be the simplest common problem if there are not enough fruits and vegetables and fiber and not enough water. And so, you need to water for your brain to operate too. Make sure you get enough water and simple things like that.
But definitely, the kid’s health depends on the person. If they actually have a digestive problem and I could go on much deeper and we don’t have time for that here. But just the general, if they don’t have certain problems, we want to make sure that their digestion is working well, that they’re chewing and again just nutrition, whole foods. That’s not going to make the digestion worse. Junk foods and et cetera can make it worse. So whole foods.
Romilly Hodges: That’s great. That’s very helpful, very helpful. If you’re doing a trial with a family who has a child who might have dairy sensitive, how do you find that process often go? Sometimes I’ve seen that having a food sensitivity can induce cravings for that particular food.
Let’s say – we talked about this earlier – cheese or other kinds of dairy or gluten-containing foods, do you see that and do you find that it’s sometimes hard to go through those, the elimination period? And how do you help families go through that?
Dr. Rishikof: That’s an excellent question. I’ve been smiling since you started asking because it’s a very tricky thing. The adults are committed to their health and they’re just going to grin and bear it. The parents are ready for this, but the child doesn’t want to deal with this. So it’s very tricky.
I always encourage – I mean these children are very smart. My patients are often very smart. So I often encourage parents to explain to the child what’s going on and explain to them why they’re giving up gluten and dairy. That can help. The child is going to be like, “Okay, I’m going to do this for my health.” It doesn’t make it easy, but it makes them more compliant.
But other kids are absolutely not. I mean other kids just aren’t interested in doing this, [inaudible 00:40:53]. Their behavioral challenges are now just going to get worse.
So how do I help them? I try and just support the parents. I try and brainstorm with the parents on what they can do. It’s very tricky if the child, truly all they eat is white flour products. Then how do you get gluten out on that diet. The answer of course is you just serve them potatoes chicken instead, but this child might not eat.
It just depends again. It’s just so tricky because sometimes you really [inaudible 00:41:28], they could get hungry enough, it might take days or weeks, but they [inaudible 00:41:31]. So you have to see what the parents are willing to do, what the child might be willing to do, ask them, realizing that parents are serious about this. It’s so hard.
Hopefully, in some cases, the children are very compliant and then it’s much easier. I can just say with my own son who has ADHD, I was like, “Let me tell what’s going on. Let’s put it together. But what you might like to eat instead of breads and pastas and da-da-da.” He was great and I was surprised. I was prepared for a lot of push-backs and there really wasn’t much.
And now, even with artificial colors, [inaudible 00:42:11] serve them gummy bears or something that’s colored, he’s like, “Oh, I don’t want the artificial colors.” He’s just very informed and calm about the whole thing. So that’s great.
Romilly Hodges: Yeah.
Dr. Rishikof: But again, that doesn’t happen to everybody. It doesn’t happen with all my clients. It’s very challenging. It just depends on the child. If a child just absolutely won’t do [inaudible 00:42:31], then we move on to something else. There are other options. There are other non-elimination diet options like supplements and just making sure they’re getting enough protein.
That can be the first thing because if a child is only eating white flour products, the problem might not be gluten. The problem might be they’re not getting enough protein. So they have to brainstorm on how to get more protein. And that can be as simple as buying pureed baby food, beef or chicken and hiding it in their pancakes. So get creative.
It’s just a plan work. It just depends on the kid, depends on the family. It can depend largely on the resolve of the parents. But I’m not in their house, so I don’t know. I just don’t know how much the parents are giving in too soon. I don’t know. I’m not in their house.
Romilly Hodges: Yeah, I know. And I think it’s helpful to know, from what you’re saying, there’s always a place to start. So even if it’s not that, there’s always somewhere to start.
And I think just picking up from what you were saying in your own experience with talking it through with your son and this goes back to our conversation right at the start, which is kids like to feel empowered and not have stuff forced upon them, so by doing that, you’ve empowered him to be able to make choices by himself when he was out and about and he bought into that. That sounds a lot like what you were talking about earlier and in terms of getting kids onboard to be able to do this and also just having everybody recognize that the cravings of certain kinds of foods can also be that part of that sensitivity and so it takes a little while for that to die down. And it does die down after a few days.
Dr. Rishikof: Yes. That’s a great point. Thank you for circling back on that, the cravings, definitely. It can be defined that it’s working. If you take the child [inaudible 00:44:23], that’s actually maybe a good time.
And so you have to just stick it out. You have to just stick it out because it might die down and they will be so happy. It will [inaudible 00:44:32]. So yeah, definitely the cravings, the withdrawals can be [inaudible 00:44:41]. That’s a good point.
Romilly Hodges: Is there anything else that you do that you want to mention? Maybe any supplements? I know that sometimes you mentioned that you use certain herbs for children.
Dr. Rishikof: Yeah. Ginkgo biloba has been studied and researched and it can help with attention for ADHD. So that’s relatively safe. So that’s something I went down in my mind when I’m working with kids and clients.
And then there are things like phosphatidylserine and phosphatidylcholine. They are important for all our cells, but they’re good for brain and brain cells.
Just antioxidants from fruits and vegetables. That’s from fruits and vegetables. I think it also comes from supplements because a lot of times, it’s just that the free radicals and the kid just needs to detox. And so good food and antioxidants can sometimes clear out the cobwebs.
One of the main supplements I use the first thing is a multivitamin and then sometimes my additional ADHD supplement, which is the choline and other vitamins and minerals that are really important for brain health. And they have been shown in recent studies to be either helpful in ADHD or [inaudible 00:46:00].
Those are my baseline, multivitamin and ADHD supplement. Those are what I always start talking about. And certainly omega-3s too, I give omega-3s too. They’re not getting enough in the diet.
Then after that, it becomes, “Well, what do we try next?” And there are so many options. Like I said, there are precursors to neurotransmitters. There’s the phosphatidyl lipids and there’s the ginkgo biloba. There’s lots of stuff.
Romilly Hodges: Yeah.
Dr. Rishikof: I could list them all, but it doesn’t matter. But the point is there are a lot of options. There are a lot of things to play with. Yeah.
Romilly Hodges: That’s really helpful I think and hopefully to you parents who are listening too who might be in that similar situation and trying to figure out what to do and worried about medicating the children that there are all these alternative strategies that may be safer and may ultimately be more effective because they get down to some of the root causes of the imbalances that might be going on.
So I think it is really helpful to hear you talk through your experiences and the kinds of protocols that you use in your practice to help kids and help families in that situation too.
Dr. Rishikof: Yeah.
Romilly Hodges: I very much appreciate it.
Dr. Rishikof: Oh yeah, thank you. That’s great.
Romilly Hodges: Good. So I wanted to mention one last time that again you can find out more about Dianne on her website. Do you want to spell your website name?
Dr. Rishikof: Yeah, it’s tricky. It’s Dianne with two Ns. So it’s DianneRishikof.com or HealthTakesGuts.com, much easier, right?
Romilly Hodges: Health takes guts. I love it.
Dr. Rishikof: Yeah, health takes guts, all one word, HealthTakesGuts.com. [Inaudible 00:47:53] domain, it direct you to my website because people misspell my name all the time. So yeah, HealthTakesGuts.com.
Romilly Hodges: That’s great.
Dr. Rishikof: Oh yeah, people can check out my blog and whatever else. And you can always e-mail me if there are any follow-up questions.
Romilly Hodges: Great, yes. And they can find that list of snacks and breakfast ideas on your website as well. And if you want to go reading around for a good sea food guide to choosing good types of sea food that are lower in contaminants and heavy metals, that’s on her website as well.
This has been a really wonderful discussion with lots of great information. Thank you so much, Dianne. It’s been a pleasure having you.
Dr. Rishikof: Thank you. Thank you for having me. Thank you.
Romilly Hodges: Great. Take care. We’ll talk soon.
Dr. Rishikof: Okay. Thanks.