Are dietary inter­ven­tions effec­tive for treat­ing ADHD? For many par­ents and pro­fes­sion­als, try­ing to parse through the dif­fer­ent claims about the impact of diet on ADHD has been chal­leng­ing and confusing. At this point, sub­stan­tial research on how dietary inter­ven­tions impact ADHD has accu­mu­lated and sev­eral meta-analyses of this work have been pub­lished. Recently, a review of sev­eral meta-analyses of dietary inter­ven­tions for ADHD was pub­lished [Research review: The role of diet in the treat­ment of attention-deficit/hyper­ac­tiv­ity dis­or­der — an appraisal of the evi­dence on effi­cacy and rec­om­men­da­tions on the design of future stud­ies]. In this paper, the authors sum­ma­rize find­ings across 6 dif­fer­ent meta-analyses of the impact of diet on ADHD to pro­vide a high level sum­mary of the best avail­able evi­dence to date.

Types of dietary interventions

Three types of dietary interventions were reviewed — Restricted Elimination Diets (RED), Artificial food coloring exclusion (AFCE), and supplementation with free fatty acids (SFFA). Although other types of supplements beyond free fatty acids have been investigated, the authors felt there was not sufficient research on any sin­gle approach to include in their summary.

1. Restricted elimination diets (RED) — There are 2 different approaches to implementing this diet. In one approach, the child is placed on an extremely restricted diet, e.g., rice, turkey, a range of veg­eta­bles (let­tuce, car­rots, cau­li­flower, cab­bage, beets), pears and water; this is some­times referred to as the Few Food Diet. When a reduc­tion in ADHD behav­iors results — this would gen­er­ally occur within 2–3 weeks if the diet is going to have a pos­i­tive effect — new foods can be added back one at a time to see if they are well-tolerated or lead to an increase in prob­lem behav­iors. Alter­na­tively, par­tic­u­lar foods that are sus­pected to exac­er­bate a child’s symp­toms may be removed one at a time to see if the child’s behav­ior improves.

2. Arti­fi­cial food col­or­ing exclu­sion (AFCE)- As the title indi­cates, this involves efforts to remove all arti­fi­cial food col­or­ings from a child’s diet, e.g.,Yellow #6, Yel­low #5, Sodium Ben­zoate, Blue #2, etc., and observ­ing whether this is asso­ci­ated with a reduc­tion in ADHD behav­iors. Care­fully con­ducted tri­als have demon­strated that AFC’s – in amounts chil­dren could typ­i­cally con­sume – can increase ADHD symp­toms in many children.

3. Essen­tial fatty acid sup­ple­men­ta­tion — Cer­tain fatty acids, e.g., Omega 3 and Omega 6, pro­mote neural func­tion­ing. These fatty acids are called essen­tial because they are not syn­the­sized in the body and must be ingested. Chil­dren with ADHD may have lower lev­els of essen­tial fatty acids rel­a­tive to peers and sev­eral stud­ies have demon­strated a link between low lev­els of EFAs and the sever­ity of ADHD symp­toms. Stud­ies inves­ti­gat­ing the ben­e­fits of fatty acid sup­ple­men­ta­tion for youth with ADHD raise fatty acid lev­els by admin­is­ter­ing cap­sules con­tain­ing the fatty acids or sometimes by introducing diets rich in fish products.

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