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Home » Restricted Diet for ADHD?

Restricted Diet for ADHD?

April 1, 2011
From The Carlat Child Psychiatry Report
Issue Links: Learning Objectives | Editorial Information
Editor-in-Chief, Caroline Fisher, PhD, MD. 

Subject:
Restricted Diet for ADHD?

Short Description:
ADHD

Background:
Advocates tout restricted diets for the treatment of everything from migraines to autism. Now it’s time to add ADHD to the list—and if a recent study of Belgium and the Netherlands is any indication, this one might really work. The Impact of Nutrition on Children with ADHD (INCA) study was conducted on a group of four- to eight-year-old children to determine whether a restricted elimination diet could improve symptoms of ADHD. The trial spanned 13 weeks—broken into a baseline period, a first phase, and a second phase. One hundred children with ADHD were initially recruited into the study. Exclusion criteria included kids who were already on a restricted diet, or those taking meds or undergoing therapy for ADHD. During the three-week baseline period, all participants were fed a normal balanced diet and assessed with a number of rating scales, including the 18-item ADHD rating scale (ARS) and the abbreviated Connors’ scale (ACS). At week four, the children were equally randomized to either a normal balanced diet (control group, n=50), or an individualized, restricted elimination diet (diet group, n=50), which included “hypoallergenic” foods such as rice, meat, vegetables, and water. At the end of this phase (5 weeks), children were again assessed with the ratings scales. Children in the diet group showed a statistically significant improvement in both ADHD scales from baseline to the end of phase one, compared to the control group, in both physician and teacher ratings. Children from the diet group who showed improvement of at least 40% on the ARS were randomized into the final phase of the trial (32 kids), where they were individually given two consecutive, two-week food “challenges” to reintroduce foods into their diets: one with foods that they had shown little reactivity to (based on blood tests), and one with foods that they had shown sensitivity to. After each challenge these children were again assessed with the usual rating scales. Nineteen of 30 children who completed this phase showed a relapse after one or both challenges (based on rating scale scores). There was no correlation between high sensitivity food or low sensitivity foods and relapse.

TCPR's Take:
Among the kids who showed improvement after the elimination diet, reintroducing foods into their diets led to a relapse of ADHD symptoms. Blood tests indicating a presence or lack of sensitivity to certain foods did not predict whether there would be a relapse. This suggests that perhaps, among a subgroup of children, ADHD symptomscan be alleviated by a specialized, restricted diet. A diet of not much more than chicken, rice, and water is a pretty hard sell, though, so if you want to try this method, you need to be sure to have commitment from parents and kids.


Child Psychiatry
KEYWORDS adhd child-psychiatry research_updates
www.thecarlatreport.com
Issue Date: April 1, 2011
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Table Of Contents
Black Box Redux: SSRIs and Risk of Suicide
Risk Factors for Suicide
Attention Not a Problem in Tic Disorders
Restricted Diet for ADHD?
The Self-Injurious Patient
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