StrongReplicated in multiple well-designed studies
ModerateSignificant findings, needs more replication
PreliminaryInitial findings, observational only
MixedInconsistent or conflicting results
Ultra Processed Food and ADHD: What the Research Says
An evidence-based review of peer-reviewed research on ultra-processed food, artificial additives, and ADHD symptoms in children and adults. This guide covers what science has found -- and what it has not.
12 min read•Health Research•ADHD
Medical Disclaimer
This guide is for educational purposes only and is not medical advice. ADHD is a neurodevelopmental condition with genetic, neurological, and environmental components. Diet is not a cause of ADHD and dietary changes are not a substitute for evidence-based ADHD treatment. If you or your child has ADHD, work with a qualified psychiatrist, pediatrician, or neurologist. Do not modify medication or treatment plans based on information in this guide.
Understanding ADHD and Diet Research
Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental conditions worldwide, affecting an estimated 6-9% of children and approximately 4% of adults. It is characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with daily functioning. ADHD has a strong genetic basis -- heritability estimates range from 70-80% -- and involves differences in brain structure and neurotransmitter function, particularly dopamine and norepinephrine pathways.
First-line treatments for ADHD include stimulant medications (such as methylphenidate and amphetamine-based medications), non-stimulant medications (such as atomoxetine and guanfacine), and behavioral therapy. These treatments are supported by decades of rigorous clinical research and remain the foundation of ADHD management recommended by organizations including the American Academy of Pediatrics, the American Psychiatric Association, and the National Institute for Health and Care Excellence (NICE).
Alongside these established treatments, researchers have explored whether certain dietary factors -- particularly artificial food additives commonly found in ultra-processed foods -- may influence the severity of ADHD symptoms. This is not the same as asking whether diet causes ADHD. The research question is narrower: can specific dietary components modestly affect symptom expression in individuals who already have the condition, or who are predisposed to attention and behavior difficulties?
This guide reviews what peer-reviewed, published research has found on this question. It covers the strongest evidence (artificial food colors), areas where popular belief diverges from scientific findings (sugar), and important limitations that context these results. Every claim in this guide references specific published studies with journal names and dates.
Important context: The effects of dietary factors on ADHD symptoms are consistently found to be small compared to the effects of medication and behavioral therapy. Dietary modifications should be considered as a potential complement to -- never a replacement for -- evidence-based treatment. Always consult your psychiatrist, pediatrician, or neurologist before making changes.
Artificial Food Colors: The Most-Studied Link
Of all the dietary factors examined in relation to ADHD symptoms, artificial food colors have received the most research attention and produced the most consistent results. The relationship between synthetic dyes and children's behavior has been investigated since the 1970s, when Dr. Ben Feingold first proposed that artificial additives contributed to hyperactivity. While Feingold's original claims were broader than the evidence ultimately supported, subsequent controlled research has identified a modest but real effect specifically from artificial food colors.
The Southampton Study (McCann et al., The Lancet, 2007)
Journal: The Lancet, Volume 370, Issue 9598
Participants: 153 three-year-olds and 144 eight/nine-year-olds from the general population
Key finding: Mixtures of artificial food colors combined with the preservative sodium benzoate significantly increased hyperactivity in children from the general population -- not just those with ADHD. This was a randomized, double-blind, placebo-controlled trial, meaning neither the children, parents, nor researchers knew who received the active mixture or the placebo.
The Southampton Study is considered the landmark research in this area because of its rigorous design and its focus on children from the general population rather than only those with diagnosed ADHD. The finding that artificial colors affected behavior in typical children, not just those with existing diagnoses, was particularly significant.
Regulatory Consequences
The Southampton Study had direct regulatory consequences. The European Food Safety Authority reviewed the evidence and, while noting limitations, the European Union subsequently required that foods containing certain artificial colors carry the warning label: “may have an adverse effect on activity and attention in children.” This led many European food manufacturers to voluntarily reformulate products using natural colorings instead of synthetic dyes.
The United States Food and Drug Administration (FDA) reviewed the same body of evidence in 2011. An FDA advisory committee voted 8-6 that the available data did not support a causal link between artificial colors and hyperactivity in the general child population, and the FDA did not mandate warning labels. However, the committee acknowledged that certain susceptible children might be affected.
Meta-Analysis: Artificial Food Colors and ADHD Symptoms
Authors: Nigg et al.
Journal: Journal of the American Academy of Child & Adolescent Psychiatry, 2012
Key finding: A meta-analysis of controlled studies found a small but statistically significant effect of artificial food colors on ADHD symptoms (effect size d = 0.21-0.28). The authors noted that while the effect is modest compared to medication (effect sizes typically 0.8-1.0), it is consistent and reproducible across studies.
Putting effect sizes in perspective: An effect size of 0.2-0.3 for artificial food colors is classified as “small” in behavioral research. By comparison, stimulant medications for ADHD typically produce effect sizes of 0.8-1.0 (“large”). This means medication reduces symptoms roughly 3-4 times more effectively than removing artificial colors. Both findings can be true simultaneously: artificial colors may have a real but small effect, while medication provides substantially greater benefit.
Other Dietary Factors Studied in Relation to ADHD
Beyond artificial food colors, researchers have investigated several other dietary factors for potential links to ADHD symptoms. The evidence varies considerably in strength and consistency. Some of the most widely discussed dietary factors are summarized below, along with what the published research actually shows.
Common Misconception
“Sugar causes hyperactivity in children.” This is one of the most persistent myths in nutrition. A 1995 meta-analysis by Wolraich et al. published in JAMA analyzed 23 controlled studies and concluded that sugar does not affect the behavior or cognitive performance of children. Multiple subsequent studies have confirmed this finding. The belief persists in part because children often consume sugar at exciting events (parties, holidays) where their behavior is already elevated.
Sugar and Hyperactivity
Despite widespread parental belief, systematic reviews have not found a consistent link between sugar intake and ADHD symptoms or hyperactive behavior. Wolraich et al. (JAMA, 1995) conducted the most comprehensive analysis, reviewing 23 controlled studies across multiple sugar types. The conclusion was clear: “sugar does not affect the behavior or cognitive performance of children.” This finding has been replicated in subsequent research. While reducing added sugar intake has many well-documented health benefits, alleviating ADHD symptoms is not supported as one of them.
Evidence level: Strong -- consistent null findings across multiple controlled studies.
Omega-3 Fatty Acids
Omega-3 fatty acids (particularly EPA and DHA) play important roles in brain development and function. Some research has found that children with ADHD tend to have lower blood levels of omega-3s compared to children without ADHD. A 2011 meta-analysis by Bloch & Qawasmi published in the Journal of the American Academy of Child & Adolescent Psychiatry examined supplementation trials and found a small but significant effect of omega-3 supplementation on ADHD symptoms. The effect sizes were modest (approximately 0.2-0.3), similar to those found for artificial food colors but much smaller than medication effects.
Evidence level: Moderate -- consistent small effects in supplementation trials, but not a replacement for standard treatment.
Elimination Diets (Few Foods Diet)
The most dramatic dietary effects on ADHD symptoms have been reported in highly restricted elimination diet studies. The INCA study (Pelsser et al., The Lancet, 2011) used a “restricted elimination diet” in which children ate only a small number of hypoallergenic foods (rice, turkey, pears, lettuce, and a few others) for five weeks. The study found that ADHD symptoms decreased in approximately 64% of children on the restricted diet. When eliminated foods were reintroduced, symptoms returned, suggesting individual food sensitivities rather than a universal dietary trigger.
However, this was a supervised medical intervention conducted under strict clinical conditions. The diet is extremely restrictive, impractical for long-term use, and carries risk of nutritional deficiency. It should only ever be attempted under the direct supervision of a physician and registered dietitian. It is not considered a first-line or general treatment for ADHD.
Evidence level: Moderate -- significant effects in controlled settings, but not a practical general recommendation.
Overall Diet Quality and Western Dietary Patterns
Some observational studies have examined the relationship between overall dietary patterns and ADHD symptoms. A 2019 study published in Pediatrics found an association between “Western dietary patterns” -- characterized by high intake of ultra-processed foods, refined grains, sugary beverages, and processed meats -- and higher ADHD symptom scores in children. Conversely, diets rich in fruits, vegetables, whole grains, and fish were associated with lower symptom scores.
These findings are observational and cannot establish causation. Children with more severe ADHD symptoms may eat differently due to impulsivity, executive function challenges, or family stress -- making it difficult to determine whether diet influences symptoms or symptoms influence diet. Learn more in our guide to ingredients to avoid.
Evidence level: Preliminary -- associations found in observational studies, but direction of causality unclear.
Research Summary: Key Studies on Diet and ADHD
The following table summarizes the most frequently cited peer-reviewed studies on dietary factors and ADHD symptoms. Evidence levels reflect the study design, sample size, replication, and consistency of findings.
| Study | Year | Journal | Finding | Evidence Level |
|---|---|---|---|---|
| McCann et al. (Southampton Study) | 2007 | The Lancet | Artificial color + sodium benzoate mixtures increased hyperactivity in children from the general population | Strong |
| Nigg et al. (Meta-analysis) | 2012 | J. Am. Acad. Child Adolesc. Psychiatry | Small but significant effect of artificial food colors on ADHD symptoms (d = 0.21-0.28) | Strong |
| Wolraich et al. (Sugar meta-analysis) | 1995 | JAMA | Sugar does not affect behavior or cognitive performance in children (null finding) | Strong |
| Pelsser et al. (INCA Study) | 2011 | The Lancet | Restricted elimination diet reduced ADHD symptoms in ~64% of children | Moderate |
| Bloch & Qawasmi (Omega-3 meta-analysis) | 2011 | J. Am. Acad. Child Adolesc. Psychiatry | Small but significant effect of omega-3 supplementation on ADHD symptoms | Moderate |
| Del-Ponte et al. (Western diet pattern) | 2019 | Pediatrics | Western dietary patterns (high in UPFs) associated with higher ADHD symptom scores | Preliminary |
| Bateman et al. | 2004 | Archives of Disease in Childhood | Artificial color and preservative withdrawal reduced hyperactivity in 3-year-olds (predecessor to Southampton Study) | Moderate |
Specific Additives Under Investigation
The research on artificial food colors and ADHD symptoms has focused on a specific set of synthetic dyes, most of which are widely used in ultra-processed foods marketed to children. Below is a summary of the additives most frequently studied, their regulatory status, and the types of products where they are commonly found. For detailed information on any specific additive, visit our ingredients to avoid guide.
| Additive | Common Names | Commonly Found In | Research Status |
|---|---|---|---|
| Red 40 (E129) | Allura Red AC | Candy, fruit snacks, sports drinks, cereals, flavored yogurts | Included in Southampton Study; EU warning label required. Permitted in US without warning. |
| Yellow 5 (E102) | Tartrazine | Soft drinks, chips, pickles, mustard, instant pudding, candy | Included in Southampton Study; EU warning label required. Banned in Norway and Austria. |
| Yellow 6 (E110) | Sunset Yellow FCF | Orange soda, cheese-flavored snacks, sauces, preserved fruits | Included in Southampton Study; EU warning label required. Banned in Norway and Finland. |
| Blue 1 (E133) | Brilliant Blue FCF | Ice cream, canned peas, candy, sports drinks, bakery products | Less studied than the Southampton Six. Banned in some European countries. Permitted in US. |
| Sodium Benzoate (E211) | Benzoate of Soda | Soft drinks, fruit juices, salad dressings, condiments, pickles | Studied in combination with artificial colors in Southampton Study; interaction effects noted. |
| Carmoisine (E122) | Azorubine | Jams, cheesecakes, marzipan, Swiss rolls (mainly European products) | Included in Southampton Study; EU warning label required. Not approved for food use in the US. |
Regulatory differences matter: The fact that the same evidence led to mandatory warning labels in the EU but no action from the US FDA illustrates how the same scientific data can be interpreted differently depending on regulatory philosophy. The EU applied the precautionary principle (act on reasonable evidence of risk), while the FDA required a higher threshold of proof before mandating changes. Neither approach is objectively “correct” -- they reflect different standards for regulatory action.
What This Means in Practice
If you or your child has ADHD and you are interested in whether dietary changes might provide modest additional benefit alongside established treatment, the following practical considerations are supported by the current evidence. These suggestions are not a treatment plan -- they are contextual information for conversations with your treatment team.
1
Diet Should Complement Treatment, Not Replace It
Medication and behavioral therapy remain the first-line treatments for ADHD and are supported by decades of clinical evidence. Dietary modifications, even in the best-case scenario, produce much smaller effects. Any dietary changes should be made in consultation with and under the guidance of the professionals managing ADHD treatment -- never as a substitute.
2
If Reducing Additives, Start with Artificial Colors
Artificial food colors have the strongest and most consistent evidence for an effect on hyperactivity symptoms. If you want to experiment with additive reduction, focusing on the “Southampton Six” colors (tartrazine/E102, quinoline yellow/E104, sunset yellow/E110, carmoisine/E122, ponceau 4R/E124, and allura red/E129) is the most evidence-based starting point. Read our guide to reading food labels for practical label-reading strategies.
3
Whole-Foods-Based Diet Benefits Everyone
Regardless of whether specific additives affect ADHD symptoms, a diet built around whole and minimally processed foods provides better overall nutrition. Fruits, vegetables, whole grains, lean proteins, and healthy fats support brain development, energy regulation, and general health. This is sound dietary advice for anyone, with or without ADHD. See our guide to UPF for kids for practical family strategies.
4
Elimination Diets Require Medical Supervision
While the INCA study showed meaningful symptom reduction in some children, elimination diets are not something to attempt independently. They are nutritionally restrictive, psychologically demanding (especially for children), and require careful monitoring by a physician and registered dietitian to prevent deficiencies. Only consider this approach if specifically recommended and supervised by your child's treatment team.
5
Individual Responses Vary Enormously
One of the clearest findings in this research is the wide variability in individual responses. What helps one person may have no effect on another. ADHD itself is heterogeneous -- different people have different symptom profiles, genetic backgrounds, and neurological characteristics. A dietary change that produces noticeable improvement in one child may produce no change in another. Keep expectations realistic and track changes systematically if making any modifications.
What Research Does NOT Support
Misinformation about ADHD and diet is widespread, particularly on social media and in popular health media. The following claims are not supported by the current body of peer-reviewed research. Being clear about what the evidence does not show is just as important as summarizing what it does show.
Common Misconception
“Diet causes ADHD.” ADHD is a neurodevelopmental condition with strong genetic and neurological underpinnings. Heritability studies estimate that 70-80% of ADHD risk is genetic. While environmental factors (including prenatal exposures, lead exposure, and premature birth) may contribute to risk, no dietary factor has been shown to cause ADHD. Research explores whether diet may modestly influence symptom severity -- a fundamentally different question than causation.
Common Misconception
“Sugar causes hyperactivity.” As detailed above, this is one of the most persistent myths in pediatric health. The 1995 JAMA meta-analysis and subsequent controlled studies consistently find no causal relationship between sugar consumption and hyperactive behavior. Reducing sugar intake has legitimate health benefits (dental health, weight management, metabolic health), but alleviating ADHD symptoms is not among them based on current evidence.
Common Misconception
“Removing UPFs will cure ADHD.” No dietary change has been shown to “cure” ADHD. ADHD is a chronic neurodevelopmental condition, not a dietary deficiency. Even in the most favorable elimination diet studies, not all children responded, and the effects were symptom reduction -- not resolution. Dietary changes may provide modest additional benefit for some individuals when combined with evidence-based treatment, but “cure” claims are not supported by any published research.
Common Misconception
“Dietary changes work as well as medication.” The effect sizes tell the story clearly. Stimulant medication for ADHD produces effect sizes of approximately 0.8-1.0 (large). Artificial food color removal produces effect sizes of approximately 0.2-0.3 (small). Behavioral therapy produces effect sizes of approximately 0.4-0.6 (moderate). Dietary modifications are at the bottom of the evidence hierarchy in terms of magnitude of effect. They may be a useful adjunct, but they are not comparable to established treatments.
A note on neurodiversity: ADHD is a legitimate neurodevelopmental difference, not a character flaw or the result of poor parenting or poor diet. Many people with ADHD live full, successful lives with appropriate support and treatment. Framing ADHD as something that can be “fixed” by dietary changes alone is reductive, potentially harmful, and not supported by science. Respect the complexity of this condition and the people who live with it.
Frequently Asked Questions
Can ultra-processed food cause ADHD?
No. ADHD is a neurodevelopmental condition with strong genetic and neurological components. Research has not established that diet causes ADHD. What some studies have found is that certain artificial food additives -- particularly synthetic colors -- may modestly increase hyperactivity symptoms in some children, both with and without an existing ADHD diagnosis. These effects are small compared to the effects of established ADHD treatments such as medication and behavioral therapy. Diet is one of many environmental factors that researchers continue to study, but it is not considered a cause of ADHD by any major medical or psychiatric organization.
Should I remove artificial food colors from my child's diet if they have ADHD?
This is a decision to discuss with your child's psychiatrist or pediatrician. The Southampton Study (McCann et al., The Lancet, 2007) and subsequent meta-analyses found small but statistically significant effects of artificial food colors on hyperactivity. The European Union requires warning labels on foods containing certain synthetic dyes based on this evidence. Some families report improvements after removing artificial colors, though individual responses vary considerably. Reducing artificial colors is generally low-risk from a nutritional standpoint, but it should not replace evidence-based ADHD treatment. Never modify medication or behavioral therapy plans without consulting your child's treatment team.
Does sugar cause hyperactivity in children?
Despite being one of the most widely held beliefs among parents, controlled research has consistently failed to find a causal link between sugar consumption and hyperactivity. A landmark 1995 meta-analysis by Wolraich et al. published in JAMA analyzed 23 controlled studies and concluded that sugar does not affect the behavior or cognitive performance of children. Subsequent studies have confirmed this finding. The perception that sugar causes hyperactivity may be influenced by the contexts in which children consume sugar -- such as birthday parties and holidays -- where excitement levels are already elevated. That said, excessive sugar intake has other well-documented health consequences, and reducing added sugars remains sound nutritional advice for reasons unrelated to hyperactivity.
Are elimination diets effective for ADHD?
The INCA study (Pelsser et al., The Lancet, 2011) found that a highly restricted elimination diet reduced ADHD symptoms in approximately 64% of participating children. However, this was a supervised medical intervention conducted under strict clinical protocols -- not a general dietary recommendation. Elimination diets are extremely restrictive, difficult to maintain, and can cause nutritional deficiencies if not properly managed. They should only be attempted under the direct supervision of a qualified medical professional, typically a pediatrician or pediatric allergist working alongside a registered dietitian. They are not considered a first-line ADHD treatment by any major clinical guideline.
What are the "Southampton Six" artificial colors?
The "Southampton Six" refers to six artificial food colors studied in the landmark 2007 Southampton University study (McCann et al., The Lancet): tartrazine (E102/Yellow 5), quinoline yellow (E104), sunset yellow (E110/Yellow 6), carmoisine (E122), ponceau 4R (E124), and allura red (E129/Red 40). The study found that mixtures of these colors combined with the preservative sodium benzoate increased hyperactivity in children from the general population. Following this research, the European Union mandated that foods containing these colors carry the warning: "may have an adverse effect on activity and attention in children." The United States FDA reviewed the same evidence but did not mandate similar warnings.
Continue Learning
UPF and Health Overview →
Comprehensive review of research on ultra-processed food and health outcomes across 200+ studies
UPF for Kids →
Practical strategies for reducing ultra-processed food in your child's diet with age-appropriate approaches
Ingredients to Avoid →
Guide to the most common artificial additives, preservatives, and industrial ingredients in processed food
Disclaimer: All tools and data visualizations are provided for educational and informational purposes only. They are not intended as health, medical, or dietary advice. Product formulations change frequently — always check the actual label for current ingredients and nutrition facts before making purchasing decisions. Consult healthcare professionals for personalized dietary guidance.