Curated paper 1: Interactions of the mind and body

    Although regarded by many to be pseudoscientific quackery, the philosophy behind Ayurveda is beneficial in helping us consider the often overlooked interactions between the mind and body. Ayurveda is an ancient practice with thousands of years of literature that, while not necessarily up to par with today’s scientific standards, provides a solid base of knowledge from which we can conduct more carefully controlled studies. For example, one of the significant personality profiles Ayurveda identifies seems to include characteristics common of Attention Deficit Hyperactive Disorder (ADHD). Vata, known as the Energy of Movement, is associated with restlessness, impulsivity, creativity, flexibility, poor planning skills, and reduced willpower, which seems to correspond with many ADHD symptoms. For these individuals, Ayurvedic philosophy recommends a special diet of warm, well-cooked, oily foods to help bring balance to the lives of Vata-dominant individuals (Lad, 2020). Whether this diet is truly more effective than a placebo for balancing the overall mental and physical health of individuals with these characteristics remains to be seen (and indeed, considering the research explored below, seems entirely contradictory.) However, there are, in fact, links that have been found between diet, metabolism, and the ADHD brain.

    One of these links includes the correlation between ADHD and Type 2 diabetes. A recent study revealed that ADHD was positively correlated with higher rates of Type 2 diabetes. The researchers hypothesized that, because of the damage a diabetic metabolism can have on the brain, including on the frontal lobe responsible for executive functions, it could possibly result in the production of ADHD symptoms (impairments in executive functions, responsible for planning, organizing, and delaying gratification, are often cited as one of the major debilitating features common with ADHD). While the data supported their hypothesis, they did not find any correlation between Type 1 diabetes and ADHD (Chen et al., 2013), which casts some doubt on the assumptions driving that hypothesis.

    While it is possible that diabetes could be causing brain damage resulting in ADHD symptoms, I find it more likely that the causation would be the other way around: ADHD could be resulting in higher rates of Type 2 diabetes. The ADHD brain is known to have deficits in key neurotransmitters (Hynd, 2018), driving its sufferers to seek out substances and circumstances to boost those neurotransmitters. This includes excessive eating, among other addictive behaviors. These impulsive eating habits fostered by the ADHD brain should understandably lead to increased body weight. Indeed, research has confirmed that ADHD correlates positively with obesity. It is this link with obesity, a common cause of Type 2 diabetes, that leads me to believe that ADHD can cause diabetes.

Another interesting article, a meta-analysis of previously conducted studies, confirmed the link between ADHD and obesity. The authors speculate that there may be many different factors involved in this connection, including the way impulsivity and inattention can lead to unhealthy eating patterns, as well as the possibility that comorbid mental health conditions and socioeconomic status could also be playing a significant role (Cortese, 2015). The latter does seem to be a realistic possibility, as other studies have found additional links between low socioeconomic status and ADHD (Russell et al., 2015), possibly caused by ADHD symptoms impeding upward mobility.

A particularly interesting finding in this study was a possible connection between decreased obesity rates in medicated populations. These results were not significant enough to be conclusive, but worth further study. Anecdotally, I have experienced a great deal of weight loss on my ADHD medication, which I believe could be helping me manage the symptoms that might create dysregulated eating habits. Additionally, studies looking at weight loss in children treated with stimulants have established that weight loss is, indeed, a common side effect (Poulton, 2012) (although the studies focused specifically on children, rather than adults.)

Other studies focused on adults with ADHD have looked for links between weight loss and medication. One particularly fascinating study found that some adults treated with medication did lose more weight than untreated groups, but weaknesses in the study cast doubt on which variable of the treatment group actually caused the weight loss. The most interesting part of this article was a reference to another study that found executive function training (remembering that executive dysfunction often plays a key role in ADHD symptoms) had a positive effect on weight loss (Cortese, 2013).

Another link between ADHD and metabolism that deserves mention is the connection between ADHD and dementia. In a study examining a possible correlation between the two, they found that ADHD correlated with higher rates of Lewy Body Dementia and Alzheimer’s Disease (Fluegge & Fluegge, 2018). 

The most interesting finding, however, was summarized in the results:
“However, these relationships may be dependent upon the extent of metabolic dysregulation in a subtype-specific manner, as controlling for diabetes removes the significant association between antecedent ADHD and risk of AD but not LBD.” ADHD only seems to be associated with AD by its link to diabetes, while LBD still correlated with ADHD either way. It would be interesting to see the effect of ADHD medication and treatment on the future development of dementia, especially if there were a way to reduce the risk of LBD in addition to AD.

All of these studies suggest that the treatment of ADHD could possibly lead to better eating habits, and ultimately, healthier metabolic functions and decreased risk of comorbid diseases. It is also worth examining the surrounding comorbid conditions and socioeconomic conditions often associated with ADHD to see if addressing those factors might also play a role in improving overall metabolic function and preventing the diseases associated with metabolic dysfunction.

Chen, H., Lee, Y., Yeh, G., & Lin, H. (2013, April). Association of attention-deficit/hyperactivity disorder with diabetes: a population-based study. Pediatric research. https://pubmed.ncbi.nlm.nih.gov/23329200/.

Cortese, S., Moreira-Maia, C. R., Fleur, D. S., Morcillo-Peñalver, C., Rohde, L. A., Faraone, S. V., … Kooij, J. J. S. (2015, August 28). Association Between ADHD and Obesity: A Systematic Review and Meta-Analysis. American Journal of Psychiatry. https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2015.15020266.

Fluegge, K., & Fluegge, K. (2017, August 12). Antecedent ADHD, dementia, and metabolic dysregulation: A U.S. based cohort analysis. Neurochemistry International. https://www.sciencedirect.com/science/article/abs/pii/S019701861730373X.

Hynd, G. W., Voeller, K. K., Hern, K. L., & Marshall, R. M. (2019). Neurobiological Basis of Attention-Deficit Hyperactivity Disorder (ADHD). Taylor & Francis. https://www.tandfonline.com/doi/abs/10.1080/02796015.1991.12085544.

Lad, V. (2020). Ayurveda: A Brief Introduction and Guide. The Ayurvedic Institute. https://www.ayurveda.com/resources/articles/ayurveda-a-brief-introduction-and-guide.

Poulton, A., Briody, J., McCorquodale, T., Melzer, E., Herrmann, M., Baur, L., & Duque, G. (2012). Weight loss on stimulant medication: how does it affect body composition and bone metabolism? – A prospective longitudinal study. International Journal of Pediatric Endocrinology. https://link.springer.com/article/10.1186/1687-9856-2012-30.

Russell, A. E., Ford, T., & Russell, G. (2015, June 1). Socioeconomic Associations with ADHD: Findings from a Mediation Analysis. PLOS ONE. https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0128248.