It's a bit more than that though. I definitely got plenty of exercise as a child, but my ADHD still manifested in me getting hurt a lot more than my peers, because I either didn't have the impulse control to not do something obviously dumb, or because I would get distracted while playing a game and then get hit in the face with a soccer ball or something as a result. I had a poor summer camp counselor actually start crying to my parents because she felt she was doing her job terribly because I got injured so often. My parents knew that was just how I operated though.

Getting the excess energy out definitely helps with feeling overly-energetic, but it doesn't fix many of the core issues that ADHD causes.

> It seems to me that the real problem is that we have constructed a world that is fundamentally at odds with our biology and then when people cannot function within it, we diagnose them as having a disorder.

I don't know if you meant it this way, but this certainly sounds like you are implying that people with ADHD (or some portion of them) don't really have anything wrong with them, they just need to exercise or something. As someone who has lived with ADHD for their whole life, I find this attitude really offensive. I have a medical disorder, there's a chemical imbalance in my brain that has been diagnosed by doctors. I can't just walk it off.

It's not a case of the modern world being at odds with how we were evolved, I would be struggling in the ancient world too. Without my medication I have real trouble remembering things, making plans, and following directions. Moreover, if the modern world is so at odds with our biology, why does the overwhelming majority of the population have no problem functioning in it while I do? And I don't mean to come off as hostile here, but I find it insulting to be told by someone who presumably has no problem functioning in the modern world that my inability to function in it isn't really a problem.

I actually have ADHD-PI (primarily inattentive), and have struggled my whole life with it. It did not manifest as being hyperactive, just being extraordinarily bad at focusing on anything i don't find highly stimulating and being really damned forgetful. Adderall was a godsend for me as a child and I would have never gotten through school without it. I had to discontinue use of it in High school because it started to have very bad side effects for me as I got older.

I am no way trying to imply that ADHD is not real. I know it is real. But I am skeptical that every single kid diagnosed with it really would still have hyperactivity problems if they were running around and riding bikes for hours every day. If the kid still can't focus in school even with improvements to diet and more exercise, then yeah the kid probably really has ADHD and may need stimulants.

Even though I struggle with it, I don't think it's really a 'disorder' except insofar as it can interfere with one's ability to function in modern society.

It seems to me to be just a different way of thinking, one that is unfortunately much more suited to activities like hunting than it is to remembering to pay my parking tickets on time.

https://en.wikipedia.org/wiki/Hunter_vs._farmer_hypothesis

The majority of the population has lots of problems functioning all the time.

Its not that there isn't a problem, its that you are not the problem. The majority of the population manages to cope in various ways, you don't know how bad it is because everyone is hiding this coping away, as the modern world suggests they do so as not to be a burden.

Are you offended because you actually have tried working yourself to exhaustion and still were hyperactive?

I don’t believe that’s what the OP is saying. I understood his comment to mean that ADHD can be considered more of a “bad fit” for the person’s environment than an objectively diagnosable disease. Perhaps by changing the environment, ADHD’s symptoms may be mitigated. Maybe it’s not a 6-year-old’s fault that he/she cannot sit still and quiet in a room for 8 hours with maybe a 30 minute break for recess? Maybe it’s our expectations that are at fault.

You can really see developmental differences at 5-7. My son is 6, his kindergarten last year had kids between 4-6 on the first day of school and they vary substantially. Their lives vary a lot as well... how do you expect a 6 year old in early day, school and aftercare from 7-5 to behave?

Yes this is what I meant.

I’m sorry, but your individual anecdotal experience does not refute his hypothesis in any way. It is reasonable to hypothesize that the increase in ADHD may be due to environmental factors (diet / exercise / etc). Those factors may affect certain subgroups more than others. Your perceived offense is not helpful to the discussion because you cannot speak for all people with ADHD and it should not shut down any line of inquiry that could help people in the future. I completely understand that you are not considering yourself as part of that group, but please let other people try and find alternative ways to address the problem without trying to shut down the conversation by proclaiming how insulted and offended you are.

The “chemical imbalance” is a myth.

Is "functional impairment of neurotransmitter pathways" better?

More likely.

I don't know, "being able to put dishes in the dish washer", one of the tasks I personally particularly struggle with, doesn't seem like it's an unreasonable social construction.