Short-term effects of an elimination diet and healthy diet in children with attention-deficit/hyperactivity disorder: a randomized-controlled trial.
ADHD
Child psychiatry
Dietary treatment
Emotion regulation
Journal
European child & adolescent psychiatry
ISSN: 1435-165X
Titre abrégé: Eur Child Adolesc Psychiatry
Pays: Germany
ID NLM: 9212296
Informations de publication
Date de publication:
11 Jul 2023
11 Jul 2023
Historique:
received:
22
11
2022
accepted:
26
06
2023
medline:
11
7
2023
pubmed:
11
7
2023
entrez:
10
7
2023
Statut:
aheadofprint
Résumé
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 ).
Identifiants
pubmed: 37430148
doi: 10.1007/s00787-023-02256-y
pii: 10.1007/s00787-023-02256-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : ZonMw
ID : 837002506
Pays : Netherlands
Organisme : ZonMw
ID : 837002506
Pays : Netherlands
Organisme : ZonMw
ID : 837002506
Pays : Netherlands
Organisme : ZonMw
ID : 837002506
Pays : Netherlands
Organisme : ZonMw
ID : 837002506
Pays : Netherlands
Organisme : ZonMw
ID : 837002506
Pays : Netherlands
Organisme : ZonMw
ID : 837002506
Pays : Netherlands
Organisme : ZonMw
ID : 837002506
Pays : Netherlands
Organisme : ZonMw
ID : 837002506
Pays : Netherlands
Organisme : ZonMw
ID : 837002506
Pays : Netherlands
Organisme : ZonMw
ID : 837002506
Pays : Netherlands
Organisme : ZonMw
ID : 837002506
Pays : Netherlands
Organisme : ZonMw
ID : 837002506
Pays : Netherlands
Organisme : ZonMw
ID : 837002506
Pays : Netherlands
Organisme : ZonMw
ID : 837002506
Pays : Netherlands
Informations de copyright
© 2023. The Author(s).
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