The Diet Factor in Attention-Deficit/Hyperactivity Disorder

Division of Neurology, Children's Memorial Hospital, Chicago, IL 60614, USA.
PEDIATRICS (Impact Factor: 5.3). 02/2012; 129(2):330-7. DOI: 10.1542/peds.2011-2199
Source: PubMed

ABSTRACT This article is intended to provide a comprehensive overview of the role of dietary methods for treatment of children with attention-deficit/hyperactivity disorder (ADHD) when pharmacotherapy has proven unsatisfactory or unacceptable. Results of recent research and controlled studies, based on a PubMed search, are emphasized and compared with earlier reports. The recent increase of interest in this form of therapy for ADHD, and especially in the use of omega supplements, significance of iron deficiency, and the avoidance of the "Western pattern" diet, make the discussion timely. Diets to reduce symptoms associated with ADHD include sugar-restricted, additive/preservative-free, oligoantigenic/elimination, and fatty acid supplements. Omega-3 supplement is the latest dietary treatment with positive reports of efficacy, and interest in the additive-free diet of the 1970s is occasionally revived. A provocative report draws attention to the ADHD-associated "Western-style" diet, high in fat and refined sugars, and the ADHD-free "healthy" diet, containing fiber, folate, and omega-3 fatty acids. The literature on diets and ADHD, listed by PubMed, is reviewed with emphasis on recent controlled studies. Recommendations for the use of diets are based on current opinion of published reports and our practice experience. Indications for dietary therapy include medication failure, parental or patient preference, iron deficiency, and, when appropriate, change from an ADHD-linked Western diet to an ADHD-free healthy diet. Foods associated with ADHD to be avoided and those not linked with ADHD and preferred are listed. In practice, additive-free and oligoantigenic/elimination diets are time-consuming and disruptive to the household; they are indicated only in selected patients. Iron and zinc are supplemented in patients with known deficiencies; they may also enhance the effectiveness of stimulant therapy. In patients failing to respond or with parents opposed to medication, omega-3 supplements may warrant a trial. A greater attention to the education of parents and children in a healthy dietary pattern, omitting items shown to predispose to ADHD, is perhaps the most promising and practical complementary or alternative treatment of ADHD.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A brain-enriched multi-domain scaffolding protein, neurobeachin has been identified as a candidate gene for autism patients. Mutations in the synaptic adhesion protein cell adhesion molecule 1 (CADM1) are also associated with autism spectrum disorder, a neurodevelopmental disorder of uncertain molecular origin. Potential roles of neurobeachin and CADM1 have been suggested to a function of vesicle transport in endosomal trafficking. It seems that protein kinase B (AKT) and cyclic adenosine monophosphate (cAMP)-dependent protein kinase A (PKA) have key roles in the neuron membrane trafficking involved in the pathogenesis of autism. Attention deficit hyperactivity disorder (ADHD) is documented to dopaminergic insufficiencies, which is attributed to synaptic dysfunction of dopamine transporter (DAT). AKT is also essential for the DAT cell-surface redistribution. In the present paper, we summarize and discuss the importance of several protein kinases that regulate the membrane trafficking involved in autism and ADHD, suggesting new targets for therapeutic intervention.
    International Journal of Molecular Sciences 16(2):3095-3115. DOI:10.3390/ijms16023095 · 2.46 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract As neuropsychologists and psychologists specializing in the assessment and treatment of pediatric mental health concerns, one of the most prominent diagnoses we encounter is attention-deficit hyperactivity disorder (ADHD). Following a pediatric neuropsychological evaluation, parents often request recommendations for treatment. This article addresses our approach to the treatment of ADHD from the private practice perspective. We will review our primary treatment methodology as well as integrative and alternative treatment approaches.
    07/2014; 3(3):188-196. DOI:10.1080/21622965.2013.875300
  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this research was to study the effectiveness of the overall dietary intervention rather than a single nutrient on children with attention deficit hyperactivity disorder (ADHD). This is a randomized controlled trial conducted at a child psychiatry clinic in Iran. Participants were 106 children and adolescents with ADHD. One group received methylphenidate plus dietary recommendations, while the other group only received methylphenidate. ADHD DSM-IV checklist was used to assess inattentiveness and hyperactivity/impulsivity scores at baseline and at the end of the trial. The results revealed no significant difference between the two groups regarding mean age, gender ratio, body mass index, baseline inattentiveness score, and baseline hyperactivity score. Linear regression analysis considering the covariant variables showed that the inattentive score at the end of the trial was significantly associated with the mean change of favorite diet scores. This is the first clinical trial examining the effect of overall dietary characteristics rather than a single nutrient on the children formally diagnosed with ADHD. According to the results, un-favorite diet had no effects on inattentive or hyperactivity/impulsivity score. Encouraging the children with ADHD to increase their intake of recommended diet markedly improves their attention. The trial was registered at the Iranian Clinical Trials Registry (Irct ID: IRCT201311303930N29).
    Annals of General Psychiatry 03/2015; 14:12. DOI:10.1186/s12991-015-0050-6 · 1.53 Impact Factor