Fast foods, sodas, and ice cream may be American kids' favorite menu items, but they're also probably the worst for those with attention deficit-hyperactivity disorder (ADHD), a new literature review suggests.
According to two researchers from Children's Memorial Hospital in Chicago, a relatively simple diet low in fats and high in whole grains, fruits, and vegetables is one of the best alternatives to drug therapy for ADHD. Omega-3 and omega-6 fatty acid supplements have also been shown to help in some controlled studies, they noted.
Writing online in Pediatrics, Dr. J. Gordon Millichap and Michelle M. Yee reviewed nearly 70 publications on diet-based interventions in ADHD, emphasizing recent research and controlled trials.
They noted that diet is one established contributor to ADHD that parents can modify.
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One of the most provocative findings in recent years came from the Australian Raine study, which was a prospective cohort study that followed children from birth to age 14, Millichap and Yee indicated.
It found that development of ADHD was significantly associated with so-called Western diets rich in saturated fats and sugar, compared with a "healthy" diet of proteins derived from low-fat fish and dairy products and with a high proportion of vegetables (including tomatoes), fruits, and whole grains.
However, their review indicated that controlled trials had failed to show significant benefits for such intensive modifications as oligoantigenic, elimination, or additive-free Feingold-type diets except in small subgroups. Such diets also "are complicated, disruptive to the household, and often impractical," they wrote.
The Feingold diet and others are based on the idea that artificial colors and salicylates contribute to ADHD, which became popular in the 1970s. Federally funded trials showed that most ADHD children did not improve significantly on such diets, although some children with genuine sensitivities to additives and preservatives have been identified.
Such children, the researchers suggested, "might benefit from their elimination." More recent research has also indicated that atopic children with ADHD responded to a highly restrictive diet lacking colorings, preservatives, and certain food types.
Millichap and Yee reached similar conclusions for so-called elimination diets that avoid common allergens such as nuts, dairy, and chocolate, as well as citrus fruits. "Studies have provided mixed opinions of efficacy," they noted.
For both types of diet, the researchers pointed out, "a parent wishing to follow [them] needs patience, perseverance, and frequent evaluation by an understanding physician and dietitian."
In another finding likely to raise eyebrows, if not hackles, Millichap and Yee concluded that only weak evidence supports the widespread belief that refined sugar promotes hyperactivity.