The aim of this study is to assess the efficacy of a restricted elimination diet in reducing symptoms in an unselected group of children with Attention deficit/hyperactivity disorder (ADHD). Dietary studies have already shown evidence of efficacy in selected subgroups. Twenty-seven children (mean age 6.2) who all met the DSM-IV criteria for ADHD, were assigned randomly to either an intervention group (15/27) or a waiting-list control group (12/27). Primary endpoint was the clinical response, i.e. a decrease in the symptom scores by 50% or more, at week 9 based on parent and teacher ratings on the abbreviated ten-item Conners Scale and the ADHD-DSM-IV Rating Scale. The intention-to-treat analysis showed that the number of clinical responders in the intervention group was significantly larger than that in the control group [parent ratings 11/15 (73%) versus 0/12 (0%); teacher ratings, 7/10 (70%) versus 0/7 (0%)]. The Number of ADHD criteria on the ADHD Rating Scale showed an effect size of 2.1 (cohen’s d) and a scale reduction of 69.4%. Comorbid symptoms of oppositional defiant disorder also showed a significantly greater decrease in the intervention group than it did in the control group (cohens’s d 1.1, scale reduction 45.3%). A strictly supervised elimination diet may be a valuable instrument in testing young children with ADHD on whether dietary factors may contribute to the manifestation of the disorder and may have a beneficial effect on the children’s behaviour.
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We acknowledge the support for this study by the Foundation for Children’s Welfare Stamps Netherlands; Foundation Nuts Ohra; Matty Brand Foundation; and the Foundation of Child and Behaviour. The funding sources had no role in the study design, data collection, analysis or interpretation of the data, had no input into the writing of the report, or in the decision to submit for publication.
Conflict of interest We declare that we have no conflict of interest.
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Pelsser, L.M.J., Frankena, K., Toorman, J. et al. A randomised controlled trial into the effects of food on ADHD. Eur Child Adolesc Psychiatry 18, 12–19 (2009). https://doi.org/10.1007/s00787-008-0695-7