A new study assessing the effectiveness of a restricted elimination diet on the behavior of children with attention deficit hyperactivity disorder was conducted in the Netherlands and Belgium. They enrolled 100 children (4 – 8 years) and randomly assigned them to either a group that received this special diet or to a control group that was just given instructions for a healthy diet. They were to follow the assigned protocol for 5 weeks. They were assessed before and after using using several ADHD rating scales. The assessment indicated that 64% of those using the elimination diet had a significant improvement in symptoms. (A similar study was conducted in the UK in May of last year.)
So what does this mean?
I think that it probably means that the children who improved using the diet had a food allergy which produced symptoms similar to ADHD. Thus, the diagnosis of ADHD may have been incorrect given these findings.
There are many other questions that were not answered. For instance, the children’s parents knew which treatment they were receiving. Could this have influenced their ratings? Remember, they were recruited by advertising which may have attracted parents who wanted their children off medication and who may have believed that diet might be a significant factor. We also know that increased positive attention by a parent can reduce ADHD symptoms. (I discuss this in depth in Total Focus.) Could increased attention have played a role in the improvement? The study lasted for 5 weeks. Can the results be maintained over a long period of time? And if the offending foods were reintroduced, would the symptoms return?
Another study published in the December 2010 issue of Clinical Pediatrics conducted a systematic and comprehensive review of all the literature related to diet and ADHD and concluded that there are a select group of children who present with ADHD symptoms who show improvement as a result of a change in their diet. The Feingold Diet Program has been around for 35 years. While it has its share of advocates, all of the professional societies issuing treatment guidelines have concluded that there is insufficient evidence to prove its efficacy as a primary treatment for ADHD. Please go to the Feingold Diet website to learn more. Then go to the Quakwatch as well as the Clinical Pediatrics article for another point of view. If you are inclined to try a diet approach, PLEASE CHECK WITH YOUR CHILD’S PHYSICIAN before proceeding.
While diet appears to be helpful for some children (the size of this group is in question), another intervention that has proven to be successful when used with or without medication and most likely would enhance any benefits derived from a dietary approach is behavioral treatment. This is often either overlooked or only partially implemented due to constrictions of time and resources. The result is that many parents, teachers, and providers seek what seems to be the convenient solution. However, in the latest review of the results of the “gold standard” MTA study, children whose family received behavioral interventions had the best long-term outcome. Parents who are looking for an alternative from medication as well as for significant, long lasting improvement may be surprised at the results they achieve by investing just a few hours per week working with their son or daughter implementing researched-based interventions.