Reflections on the Increase in Autism, ADHD, Anxiety, and Depression: Part 2 – Exposure to Neurotoxins and Ultraprocessed Foods


  • Erik Peper San Francisco State University
  • Julie Shuford Houston Neuroscience & Brain Center



ADHD, anxiety, depression, mental health, diet, vitamins, malnutrition, pesticides, herbicides


Mental health symptoms of attention-deficit/hyperactivity disorder (ADHD), autism, anxiety, and depression have increased over the last 15 years. An additional risk factor that may affect mental and physical health is the foods we eat. Even though our food may look and even taste the same as compared to 50 years ago, it contains herbicide and pesticide residues and often consist of ultraprocessed foods. These foods (low in fiber and high in sugar, animal fats, and additives) are a significant part of the American diet and correlate with higher levels of inattention and hyperactivity in children with ADHD. Due to affluent malnutrition, many children are deficient in essential vitamins and minerals. We recommend that diet and lifestyle are assessed before beginning neurofeedback and behavioral treatments (we call this Grandmother therapy assessment). If the diet appears low in organic foods and vegetable, and high in ultraprocessed foods and drinks, then nutritional deficiencies should be assessed. The next intervention step is to then reduce the nutritional deficiencies and implement diet changes from ultraprocessed foods to organic whole foods. Meta-analysis demonstrates that providing supplements such as vitamin D, reducing simple carbohydrates and sugars, and eating more vegetables, fruits, and healthy fats during regular meals can ameliorate the symptoms and promote health.

Author Biography

Erik Peper, San Francisco State University

Professor Institute for Holistic Health Studies Department of Health Education


Arnold, L. E., Lofthouse, N., & Hurt, E. (2012). Artificial food colors and attention-deficit/hyperactivity symptoms: Conclusions to dye for. Neurotherapeutics, 9(3), 599–609.

Arab, A., & Mostafalou, S. (2022). Neurotoxicity of pesticides in the context of CNS chronic diseases. International Journal of Environmental Health Research, 32(12), 2718–2755.

Barr, E. A., Peper, E., & Swatzyna, R. J. (2019). Slouched posture, sleep deprivation, and mood disorders: Interconnection and modulation by theta brain waves. NeuroRegulation, 6(4), 181–189.

Bayes. J., Schloss, J., & Sibbritt, D. (2022). The effect of a Mediterranean diet on the symptoms of depression in young males (the "AMMEND: A Mediterranean diet in MEN with Depression" study): A randomized controlled trial. The American Journal of Clinical Nutrition, 116(2), 572–580.

Bjørling-Poulsen, M., Andersen, H. R., & Grandjean, P. (2008). Potential developmental neurotoxicity of pesticides used in Europe. Environmental Health, 7, Article 50.

Bommersbach, T. J., McKean, A. J., Olfson, M., & Rhee, T. G. (2023). National trends in mental health–related emergency department visits among youth, 2011-2020. JAMA, 329(17), 1469–1477.

Bouchard, M. F., Bellinger, D. C., Wright, R. O., & Weisskopf, M. G. (2010). Attention-deficit/hyperactivity disorder and urinary metabolites of organophosphate pesticides. Pediatrics, 125(6), e1270–e1277.

Braghieri, L., Levy, R., & Makarin, A. (2022). Social media and mental health. American Economic Review, 112(11), 3660–3693

Cardenas, D. (2013). Let not thy food be confused with thy medicine: The Hippocratic misquotation. e-Spen Journal, 8(6), e260–e262.

Centers for Disease Control and Prevention (CDC). (2023). Quick facts on the risks of e-cigarettes for kids, teens, and young adults. Retrieved September 23, 2023.

Chang, J. P.-C., Su, K.-P., Mondelli, V., & Pariante, C. M. (2017). Omega-3 polyunsaturated fatty acids in youths with attention deficit hyperactivity disorder: A systematic review and meta-analysis of clinical trials and biological studies. Neuropsychopharmacology, 43, 534–545.

Chhabra, R., Kolli, S., & Bauer, J. H. (2013). Organically grown food provides health benefits to drosophila melanogaster. PLoS ONE, 8(1), Article e52988.

Davis, D. R., Epp, M. D., & Riordan, H. D. (2004). Changes in USDA food composition data for 43 garden crops, 1950 to 1999. Journal of the American College of Nutrition, 23(6), 669–682.

Derbyshire, E. (2017). Do omega-3/6 fatty acids have a therapeutic role in children and young people with ADHD? Journal of Lipids, 2017, Article 6285218.

Del-Ponte, B., Quinte, G. C., Cruz, S., Grellert, M., & Santos, I. S. (2019). Dietary patterns and attention deficit/hyperactivity disorder (ADHD): A systematic review and meta-analysis. Journal of Affective Disorders, 252, 160–173.

Durukan, İ., Kara, K., Almbaideen, M., Karaman, D., & Gül, H. (2018). Alexithymia, depression and anxiety in parents of children with neurodevelopmental disorder: Comparative study of autistic disorder, pervasive developmental disorder not otherwise specified and attention deficit-hyperactivity disorder. Pediatrics International, 60(3), 247–253.

Effatpanah, M., Rezaei, M., Effatpanah, H., Effatpanah, Z., Varkaneh, H. K., Mousavi. S. M., Fatahi, S., Rinaldi, G., & Hashemi, R. (2019). Magnesium status and attention deficit hyperactivity disorder (ADHD): A meta-analysis. Psychiatry Research, 274, 228–234.

Engel, G. L., Ferris, E. B., & Logan, M. (1947). Hyperventilation; analysis of clinical symptomatology. Annals of Internal Medicine, 27(5), 683–704.

European Commission. (2023). EU legislation on MRLs. Food Safety. Retrieved April 1, 2023.,e.g.%20babies%2C%20children%20and%20vegetarians

Faraone, S. V., & Larsson, H. (2019). Genetics of attention deficit hyperactivity disorder. Molecular Psychiatry, 24(4), 562–575.

Fernandez-Cornejo, J. Nehring, R, Osteen, C., Wechsler, S., Martin, A., & Vialou, A. (2014). Pesticide use in the U.S. Agriculture: 21 Selected Crops, 1960-2008. Economic Information Bulletin Number 123, United State Department of Agriculture.

Gonçalves, N. G., Ferreira, N. V., Khandpur, N., Steele, E. M., Levy, R. B., Lotufo, P. A., Bensenor, I. M., Caramelli, P., de Matos, S. M. A., Marchioni, D. M., & Suemoto, C. K. (2023). Association between consumption of ultraprocessed foods and cognitive decline. JAMA Neurology, 80(2), 142–150.

Hemamy, M., Heidari-Beni, M., Askari, G., Karahmadi, M., & Maracy, M. (2020). Effect of vitamin D and magnesium supplementation on behavior problems in children with attention-deficit hyperactivity disorder. International Journal of Preventive Medicine, 11(1), 4.

Hemamy, M., Pahlavani, N., Amanollahi, A., Islam, S. M. S., McVicar, J., Askari, G., & Malekahmadi, M. (2021). The effect of vitamin D and magnesium supplementation on the mental health status of attention-deficit hyperactive children: A randomized controlled trial. BMC Pediatrics, 21, Article 178.

Henry, K. (2023). An integrative medicine approach to ADHD. Rupa Health. Retrieved September 30, 2023.

Henry, K., & CNS, L. A. (2023). Natural treatments for ADHD [Webinar Presentation]. Integrative Practitioner (sponsored by Rupa Health). Retrieved June 6, 2023

Konofal, E., Lecendreux, M., Arnulf, I., & Mouren, M. (2004). Iron deficiency in children with attention-deficit/hyperactivity disorder. Archives of Pediatrics & Adolescence Medicine, 158(12), 1113–1115.

Kotsi, E., Kotsi, E., & Perrea, D. N. (2019). Vitamin D levels in children and adolescents with attention-deficit hyperactivity disorder (ADHD): A meta-analysis. ADHD Attention Deficit and Hyperactivity Disorders, 11, 221–232.

LaChance, L. R., & Ramsey, D. (2018). Antidepressant foods: An evidence-based nutrient profiling system for depression. World Journal of Psychiatry, 8(3), 97–104.

Landaas, E. T., Aarsland, T. I. M., Ulvik, A., Halmøy, A., Ueland. P. M., & Haavik, J. (2016). Vitamin levels in adults with ADHD. BJPsych Open, 2(6), 377–384.

Leoci, R., & Ruberti, M. (2021) Pesticides: An overview of the current health problems of their use. Journal of Geoscience and Environment Protection, 9(8), 1–20.

Li, M., Fallin, M. D., Riley, A., Landa, R., Walker, S. O., Silverstein, M., Caruso, D., Pearson, C., Kiang, S., Dahm, J. L., Hong, X., Wang, G., Wang, M.-C., Zuckerman, B., & Wang, X. (2016). The association of maternal obesity and diabetes with autism and other developmental disabilities. Pediatrics, 137(2), Article e20152206.

Linday, L. A. (2010). Cod liver oil, young children, and upper respiratory tract infections. Journal of the American College of Nutrition, 29(6), 559–562.

Lustig, R. H. (2021). Metabolical: The lure and the lies of processed food, nutrition, and modern medicine. Harper Wave.

MacInerney, E. K., Swatzyna, R. J., Roark, A. J., Gonzalez, B. C., & Kozlowski, G. P. (2017). Breakfast choices influence brainwave activity: Single case study of a 12-year-old female. NeuroRegulation, 4(1), 56–62.

McCann, D., Barrett, A., Cooper, A., Crumpler, D., Dalen, L., Grimshaw, K., Kitchin, E., Lok, K., Porteous, L., Prince, E., Sonuga-Barke, E., Warner, J. O., & Stevenson, J. (2007). Food additives and hyperactive behavior in 3-year old and 8/9-year-old children in the community: A randomized, double-blinded, placebo-controlled trial. The Lancet, 370(9598), 1560–1567.

Mousain-Bosc, M., Roche, M., Polge, A., Pradal-Prat, D., Rapin, J., & Bali, J. P. (2006). Improvement of neurobehavioral disorders in children supplemented with magnesium-vitamin B6. I. Attention deficit hyperactivity disorders. Magnesium Research, 19(1), 46–52.

Ney, J. (2022). Food deserts and inequality. Social Policy Data Lab. Updated: Jan 24, 2022. Retrieved September 23, 2023.

Peper, E. (2023). Reflections on the increase in autism, ADHD, anxiety and depression: Part 1 – bonding, screen time, and circadian rhythms. NeuroRegulation, 10(2), 134–138.

Pollan, M. (2006). Omnivore’s dilemma: A natural history of four meals and food rules. Penguin Press.

Pollan, M. (2011). Food rules: An eater’s manual. Penguin Press.

Pongpitakdamrong, A., Chirdkiatgumchai, V., Ruangdaraganon, N., Roongpraiwan, R., Sirachainan, N., Soongprasit, M., & Udomsubpayakul, U. (2022). Effect of iron supplementation in children with attention-deficit/hyperactivity disorder and iron deficiency: A randomized controlled trial. Journal of Developmental & Behavioral Pediatrics, 43(2), 80–86.

Porto, A., & Abu-Alreesh, S. (2022). Vitamin D for babies, children & adolescents. Health Living. Retrieved September 24, 2023.

Poudineh, M., Parvin, S., Omidali, M., Nikzad, F., Mohammadyari, F., Sadeghi Poor Ranjbar, F., Rasouli, F., Nanbakhsh, S., & Olangian-Tehrani, S. (2023). The effects of vitamin therapy on ASD and ADHD: A narrative review. CNS & Neurological Disorders - Drug Targets, 22(5), 711–735.

Puigbò, P., Leino, L. I., Rainio, M. J., Saikkonen, K., Saloniemi, I., & Helander, M. (2022). Does glyphosate affect the human microbiota? Life, 12(5), 707.

Ríos-Hernández, A., Alda, J. A., Farran-Codina, A., Ferreira-García, E., & Izquierdo-Pulido, M. (2017). The Mediterranean diet and ADHD in children and adolescents. Pediatrics, 139(2), Article e20162027.

Ryu, S.-A., Choi, Y.-J., An, H., Kwon, H. J., Ha, M., Hong, Y.-C., Hong, S.-J., & Hwang, H.-J. (2022). Associations between dietary intake and attention deficit hyperactivity disorder (ADHD) scores by repeated measurements in school-age children. Nutrients, 14(14), 2919.

Sagiv, S. K., Kogut, K., Harley, K., Bradman, A., Morga, N., & Eskenazi, B. (2021). Gestational exposure to organophosphate pesticides and longitudinally assessed behaviors related to attention-deficit/hyperactivity disorder and executive function. American Journal of Epidemiology, 190(11), 2420–2431.

Swanson, N. L., Leu, A., Abrahamson, J., & Wallet, B. (2014). Genetically engineered crops, glyphosate and the deterioration of health in the United States of America. Journal of Organic Systems, 9(2), 6–37.

Swatzyna, R. J., Boutros, N. N., Genovese, A. C., MacInerney, E. K., Roark, A. J., & Kozlowski, G. P. (2018). Electroencephalogram (EEG) for children with autism spectrum disorder: Evidential considerations for routine screening. European Child & Adolescent Psychiatry, 28(5), 615–624.

Taleb, N. N. (2014). Antifragile: Things that gain from disorder (incerto). Random House Publishing Group.

Tohidi, S., Bidabadi, E., Khosousi, M.-J., Amoukhteh, M., Kousha, M., Mashouf, P., & Shahraki, T. (2021). Effects of iron supplementation on attention deficit hyperactivity disorder in children treated with methylphenidate. Clinical Psychopharmacology and Neuroscience, 19(4), 712–720.

Unal, D., Çelebi, F., Bildik, H. N., Koyuncu, A., & Karahan, S. (2019). Vitamin B12 and haemoglobin levels may be related with ADHD symptoms: A study in Turkish children with ADHD, Psychiatry and Clinical Psychopharmacology, 29(4), 515–519.

U.S. Department of Agriculture (USDA). (2019). Fish oil, cod liver. FoodData Central. Retrieved September 24, 2024.

U.S. Environmental Protection Agency (US EPA). (2023). Glyphosate. Retrieved April 1, 2023.

van Tulleken, C. (2023). Ultra-processed people: The science behind food that isn’t food. W. W. Norton & Company.

Wahab, S., Muzammil, K., Nasir, N., Khan, M. S., Ahmad, M. F., Khalid, M., Ahmad, W., Dawria, A., Reddy, L. K. V., & Busayli, A. M. (2022). Advancement and new trends in analysis of pesticide residues in food: A comprehensive review. Plants, 11(9), 1106.

Wang, Y., Huang, L., Zhang, L., Qu, Y., & Mu, D. (2017). Iron status in attention-deficit/hyperactivity disorder: A systematic review and meta-analysis. PLoS ONE, 12(1), Article e0169145.

Woo, H. D., Kim, D. W., Hong, Y.-S., Kim, Y.-M., Seo, J.-H., Choe, B. M., Park, J. H., Kang, J.-W., Yoo, J.-H., Chueh, H. W., Lee, J. H., Kwak, M. J., & Kim, J. (2014). Dietary patterns in children with attention deficit/hyperactivity disorder (ADHD). Nutrients, 6(4), 1539–1553.

Zhong, C., Tessing, J., Lee, B. K., & Lyall, K. (2020). Maternal dietary factors and the risk of autism spectrum disorders: A systematic review of existing evidence. Autism Research, 13(10), 1634–1658.