Dietary recommendations for ADOA(-plus)
by biologist and naturopath Christina Barckhausen
Hello, I am Christina Barckhausen, contact person for German ADOA patients and mother of a young child with ADOA who faces the challenge of healthy nutrition on a daily basis. 
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As a PhD human biologist and naturopath, I have enthusiastically Rubia Ernest's article on lifestyle recommendations at ADOA read. After all, for many more common conditions, it has already been proven that they can be positively influenced by a healthy diet.
Even though there are no specific studies to date due to the rarity of ADOA(-plus), I assume – just like Rubia – that a healthy lifestyle can favorably influence the course, even though the effects are certainly limited. It not only protects the body in general but also helps prevent other conditions that, in turn, could have a negative effect on ADOA(-plus).
Like Rubia, I am of the opinion that a healthy, balanced whole diet, and not dietary supplements or extracts, should form the basis for our intake of healthy vital substances such as vitamins, minerals, trace elements, fiber, and secondary plant compounds (healthy plant components that do not belong to the first four mentioned).
Eating the whole, unprocessed food is always healthier and safer than taking individual vital substances from it as dietary supplements. Based on these considerations, I would like to recommend the following foods to you:
Foods that may be particularly helpful for ADOA
Chronic conditions are always accompanied by an increased need for healthy micronutrients (e.g., vitamins, minerals, and plant secondary compounds). Exactly which these are in the case of ADOA is unknown due to a lack of research. However, it has been shown that with ADOA, energy metabolism is disrupted, increased oxidative stress occurs (which damages cell membranes and DNA, for example), and nerves are strained. Against this background, I would like to recommend the following foods to you:
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- Poultry and peanuts as sources of vitamin B3: for example, chicken, turkey, and unsalted peanuts. Important for energy absorption, DNA repair processes, nerve function, and antioxidant processes.
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- Liver, salmon, mackerel, and natural yogurt as sources of vitamin B12: for example beef liver, chicken liver, fresh, smoked or frozen salmon, smoked mackerel or canned mackerel. Vitamin B12 protects the nerves, is important for nerve function, energy production and DNA repair processes.
Tip: If you eat a vegetarian or vegan diet, be sure to consult your doctor, as B12 deficiency is common in these diets and cannot be compensated for through diet alone.
- Liver, salmon, mackerel, and natural yogurt as sources of vitamin B12: for example beef liver, chicken liver, fresh, smoked or frozen salmon, smoked mackerel or canned mackerel. Vitamin B12 protects the nerves, is important for nerve function, energy production and DNA repair processes.
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- Native berries, cabbage and nuts/seeds: for example, blueberries, blackberries, raspberries, and red currants; broccoli, kale, white cabbage, and Brussels sprouts; as well as walnuts, almonds, hazelnuts, flaxseed, chia seeds, and sunflower seeds. They contain many antioxidants, which can counteract the oxidative stress increased by ADOA. Try garnishing your muesli or salad with a seed mix as a topping!
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- Nuts and liver as sources of vitamin B2: for example almonds, hazelnuts, walnuts, beef liver, and chicken liver. Supports the production of endogenous antioxidants, important for energy metabolism.
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- Extra virgin olive oil: for example, as a dressing over salads, over vegetables, or mixed into pasta. Protects the heart, blood vessels, and nervous system and counteracts the increased oxidative stress associated with ADOA. Ensure that you do not heat it above 180 degrees Celsius.
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- Mineral water and pumpkin seeds as sources of magnesium: for example, magnesium-rich mineral water and unsalted pumpkin seeds. Magnesium is an incredibly important mineral for muscles, nerves, relaxation, and metabolism. Regularly treat yourself to mineral or medicinal spring water with a magnesium content of more than 100 mg/l.
Whether you are on ADOA(-plus) or not, you should pay more attention to the following foods:
Salmon and mackerel as sources of omega-3 fatty acids, iodine, and vitamin D
For example, frozen or smoked salmon, canned mackerel, or smoked mackerel. Many people do not get enough omega-3 fatty acids. In consultation with doctors or a nutritionist, the use of a dietary supplement may be considered if insufficient blood levels are achieved.
The WHO classifies Central Europe as an iodine-deficient region and explicitly recommends the use of iodized table salt. Vegans, in particular, are at an increased risk of iodine deficiency. Furthermore, it is precisely during the winter months that one must ensure sufficient vitamin D intake, as the majority of it is produced in the skin with the help of sunlight.
Legumes, whole grains, and fruits and vegetables as sources of dietary fiber
Fiber is the underestimated newcomer among health-promoting nutrients. It has been proven that consuming sufficient fiber supports the immune system and protects against excessive inflammatory responses, cancer, mental disorders, and digestive issues. Do not let the opportunity to get fiber pass you by.
Snack on low-salt nuts (preferably instead of chips or candy), regularly eat oat and millet flakes, whole-grain bread, pasta, and whole-grain muesli (minimum 8 g fiber per 100 g), and regularly eat legumes such as lentils, peas, kidney beans, and chickpeas. Kale, parsnip, and beetroot are also vegetables that contain particularly high amounts of fiber. Try to eat 4 handfuls of vegetables and 2 handfuls of fruit daily.
Legumes, spinach, and sunflower seeds as sources of vitamin B9
For example, lentils, chickpeas, white beans, spinach, lamb's lettuce, and sunflower seeds. Both the Robert Koch Institute and the German Society for Nutrition state that at least a significant proportion of Germans do not get enough folic acid.
I want to get you excited about my conviction: nutrition is an underestimated factor for good health – and the best part is: it is in our own hands. I hope that with these tips I have been able to give you an idea of which foods you can incorporate into your diet more often.
