European Child & Adolescent Psychiatry

, Volume 23, Issue 7, pp 519–529 | Cite as

Nutrition, immunological mechanisms and dietary immunomodulation in ADHD

  • Annelies A. J. VerlaetEmail author
  • Daniela Briceno Noriega
  • Nina Hermans
  • Huub F. J. Savelkoul


Attention-deficit hyperactivity disorder (ADHD) etiology is not completely understood, but common comorbid dysfunction of the gastrointestinal and immune system suggests that these systems may be affected by a common genetic background and molecular mechanisms. For example, increased levels of specific cytokines were observed in ADHD. Moreover, ADHD has a high comorbidity with both Th1- and Th2-mediated disorders like ear infections, eczema and asthma. A common pathophysiological mechanism was suggested to underlie both asthma and ADHD, while several genes that are linked to ADHD have immune functions. Furthermore, immunological recognition of food provoking ADHD-like behavior was suggested. An immune imbalance, probably requiring a predisposing genetic background, is therefore suggested to contribute to ADHD etiology, with immune dysregulation being more likely than a single subcellular defect. However, next to allergic mechanisms, also pharmacological mechanisms (especially in case of food additives) might be involved. In addition, though cellular (cytokine-related) rather than antibody-mediated immune mechanisms seem involved, specific immune-inflammatory markers other than antibodies have not been systematically studied in ADHD. Substantial alterations implicated in ADHD apparently occur in the immune system and epigenetic regulation of gene expression. As a result, chronic inflammation and oxidative stress could develop, which can lead to ADHD symptoms, for example by chronic T-cell-mediated neuroinflammation. If immune pathways contribute to ADHD, both its diagnosis and treatment should be reconsidered. Modulation of immune system activity might have potential in ADHD treatment, for example by nutritional approaches providing safe and low-cost ADHD therapy, but further research in these fields is implicated.


ADHD Dietary intervention Immune mechanism Immunomodulation Nutrition 


Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Annelies A. J. Verlaet
    • 1
    • 2
    Email author
  • Daniela Briceno Noriega
    • 2
  • Nina Hermans
    • 1
  • Huub F. J. Savelkoul
    • 2
  1. 1.Laboratory of Nutrition and Functional Food ScienceUniversity of AntwerpWilrijkBelgium
  2. 2.Cell Biology and Immunology GroupWageningen UniversityWageningenThe Netherlands

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