Children diagnosed with attention-deficit hyperactivity disorder should be given a restricted diet as part of their care, according to a new analysis.
A study in the Netherlands of 100 children aged four to eight found that those with dietary restrictions had significantly improved ADHD symptoms. Symptoms of a condition called oppositional defiant disorder, also present in half the children, also decreased.
Writing in The Lancet, Professor Jan Buitelaar, Radboud University Nijmegen Medical Centre, Netherlands, and Dr Lidy M Pelsser, ADHD Research Centre, Eindhoven, Netherlands, and colleagues, said dietary intervention should be considered in all children with ADHD.
Their study randomly split the youngsters with ADHD into two groups for the controlled trial; 50 were given the elimination diet, while the remaining 50 were given instructions for a general healthy diet for five weeks.
Afterwards, the children in the restricted diet group who reacted well to the restricted diet were assigned to a second phase in which two different groups of foods, one after the other, were added to the elimination diet.
The authors say: "We think that dietary intervention should be considered in all children with ADHD, provided parents are willing to follow a diagnostic restricted elimination diet for a five-week period, and provided expert supervision is available.
“Children who react favourably to this diet should be diagnosed with food-induced ADHD and should enter a challenge procedure, to define which foods each child reacts to, and to increase the feasibility and to minimise the burden of the diet.
“In children who do not show behavioural improvements after following the diet, standard treatments such as drugs, behavioural treatments, or both should be considered."
A linked Comment, Dr Jaswinder Kaur Ghuman, Department of Child and Adolescent Psychiatry, University of Arizona, Tucson, Arizona, USA, warned that diagnosing food sensitivity is complex, burdensome and time-consuming.
“In my opinion, a stringent elimination diet should not continue for more than five weeks without obvious benefit because of the time, effort, and resources required to implement the restricted diet and because long-term effects of dietary elimination on the child’s nutritional status are not known,” she adds.
Leave a Reply