Short-term effects of an elimination diet and healthy diet in children with attention-deficit/hyperactivity disorder: a randomized-controlled trial.
Study Goal
The researchers aimed to compare the effectiveness of an Elimination Diet (ED) versus a Healthy Diet (HD) in reducing ADHD symptoms in children, and to assess their effects relative to Care as Usual (CAU).
Results Summary
The study found that a Healthy Diet (HD) showed a higher response rate (51%) compared to an Elimination Diet (ED) (35%), with comparable results to Care as Usual (CAU) (56%). Small-to-medium improvements in physical health were noted for both ED and HD, while CAU showed decrements.
Population
Children aged 5-12 years with ADHD in Dutch child and adolescent psychiatry centers.
Effective Dosage
Not specified
Duration
5 weeks
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Elimination Diet (ED) | decrease | symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) | children (5-12 years) with ADHD | - | may be effective in reducing | #1 |
Elimination Diet (ED) | decrease | respondership based on a combination of parent and teacher ratings on ADHD and emotion regulation | ED participants | 35% | Fewer ... showed a partial to full response | #2 |
Healthy Diet (HD) | increase | respondership based on a combination of parent and teacher ratings on ADHD and emotion regulation | HD participants | 51% | showed a partial to full response | #3 |
Care as Usual (CAU) | increase | respondership based on a combination of parent and teacher ratings on ADHD and emotion regulation | CAU-preferring participants | 56% | responded more often favorably | #4 |
Elimination Diet (ED)/Healthy Diet (HD) | increase | physical health (blood pressure, heart rate, and somatic complaints) | children (5-12 years) with ADHD | Small-to-medium | Small-to-medium improvements | #5 |
Care as Usual (CAU) | decrease | physical health (blood pressure, heart rate, and somatic complaints) | children (5-12 years) with ADHD | - | decrements in response to | #6 |
An Elimination Diet (ED) may be effective in reducing symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD), but has never been compared to an active control condition [i.e., Healthy Diet (HD)]. In a two-armed RCT, a total of N = 165 children (5-12 years) with ADHD were randomized by means of minimization (1:1) to either an ED (N = 84) or HD (N = 81) within two Dutch child and adolescent psychiatry centers. The design included a non-randomized comparator arm including N = 58 children being treated with Care as Usual (CAU). Treatment allocation was unblinded. The primary outcome was a 5-point ordinal measure of respondership based on a combination of parent and teacher ratings on ADHD and emotion regulation, determined after 5 weeks of treatment. Ordinal regression analyses were done on an intention-to-treat basis. Fewer ED (35%) than HD (51%) participants showed a partial to full response, despite overall good-to-excellent treatment adherence (> 88%) and comparable high parental prior believes. A younger age and higher problem severity predicted a better respondership. CAU-preferring participants responded more often favorably (56%) compared to ED-but not HD-participants. Small-to-medium improvements in physical health (blood pressure, heart rate, and somatic complaints) were found in response to ED/HD versus decrements in response to CAU (74% received psychostimulants). The lack of superiority of the ED versus HD suggests that for the majority of children, dietary treatment response is not rooted in food-allergies/-sensitivities. The comparable results for treatment with HD and CAU are remarkable given that CAU participants were probably 'easier to treat' than HD (and ED) participants with proportionally fewer with a (suboptimal/non-response to) prior treatment with medication (4% versus 20%). Further assessment of long-term effects is needed to evaluate the potential place of dietary treatment within clinical guidelines. The trial is closed and registered in the Dutch trial registry, number NL5324 ( https://www.onderzoekmetmensen.nl/en/trial/25997 ).