A two arm randomized controlled trial comparing the short and long term effects of an elimination diet and a healthy diet in children with ADHD (TRACE study). Rationale, study design and methods

Bosch, Annick; Bierens, Margreet; Wit, G. Ardine de; Ly, Verena; Velde, Jessica van der; Boer, Heleen de; Beek, Gerry van; Appelman, Danielle; Visser, Sacha; Bos, Lisa; Meer, Jolanda van der; Kamphuis, Niki; Draaisma, J. M. T.; Donders, Rogier; Loo-Neus, Gigi H. H. van de; Hoekstra, Pieter J.; Bottelier, Marco A.; Arias-Vásquez, Alejandro; Klip, Helen; Buitelaar, Jan K.; Berg, Sophie; Rommelse, Nanda

doi:10.1186/s12888-020-02576-2

Cited by 6 publications

(18 citation statements)

References 36 publications

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“…Food elimination diets have been one of the most studied dietetic interventions in ADHD [ 11 , 12 , 100 , 101 , 102 , 103 , 104 ]. They may vary in their specific content but take three main forms: (i) a single-food exclusion diet that excludes one suspected food; (ii) a multi-food exclusion diet, such as the six-food elimination diet, which eliminates the most common food allergens; and (iii) a “few-foods diet”, such as the oligoantigenic diet, which restricts a person’s diet to only a few less commonly consumed foods, such as lamb/venison, quinoa/rice, and others with low allergenic potential.…”

Section: Nutritional and Dietary Interventionsmentioning

confidence: 99%

“…In the following phases, sugar (phase 2), histamine-releasing or histamine-containing products (phase 3), and additives (phase 4) are reintroduced. The procedures during reintroduction phases are all similar to phase 1 [ 101 ].…”

Section: Nutritional and Dietary Interventionsmentioning

confidence: 99%

“…There are two recent studies with an elimination diet in children with ADHD. The TRACE study [ 101 ] is an ongoing two-arm RCT comparing the short- and long-term effects of an elimination diet and a healthy diet in children with ADHD, which is occurring in the Netherlands, and may bring new insights into the long-term effects of dietary treatments for ADHD. The INCA study [ 104 ] is a RCT that consisted of an open-label phase with masked measurements followed by a double-blind crossover phase, where children aged 4–8 years who were diagnosed with ADHD were randomly assigned to 5 weeks of a restricted elimination diet (diet group) or a healthy diet (control group).…”

Section: Nutritional and Dietary Interventionsmentioning

confidence: 99%

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Eating Patterns and Dietary Interventions in ADHD: A Narrative Review

et al. 2022

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Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood, affecting ~7% of children and adolescents. Given its adverse health outcomes and high healthcare and societal costs, other treatment options beyond pharmacotherapy have been explored. Case-control studies have shown that dietary patterns may influence the risk of ADHD, and specific dietary interventions have been proposed as coadjuvant treatments in this disorder. These include nutritional supplements, gut microbiome-targeted interventions with biotics, and elimination diets. The purpose of this review is to examine which dietary patterns are most associated with ADHD and to summarize the existing evidence for the clinical use of dietary interventions. The literature showed that non-healthy dietary patterns were positively associated with ADHD, whereas healthy patterns were negatively associated. As for nutritional supplements, only vitamin D and vitamin D + magnesium appeared to improve ADHD symptoms when baseline levels of vitamin D were insufficient/deficient. Regarding biotics, evidence was only found for Lactobacillus rhamnosus GG and for multi-species probiotic supplementation. Elimination diets have scarce evidence and lead to nutritional deficiencies, so caution is advised. Overall, more robust scientific evidence is required for these dietary interventions to be implemented as part of ADHD therapy.

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Section: Nutritional and Dietary Interventionsmentioning

confidence: 99%

Section: Nutritional and Dietary Interventionsmentioning

confidence: 99%

Section: Nutritional and Dietary Interventionsmentioning

confidence: 99%

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Eating Patterns and Dietary Interventions in ADHD: A Narrative Review

et al. 2022

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“…In newly diagnosed adults with CD, a significant improvement in cognitive functioning when examining “brain fog” with CeD using the Subtle Cognitive Impairment test (SCIT), particularly verbal fluency, attention, and motor function, was noted after a 12-month adherence to GFD [ 27 ]. The TRACE study, a two-armed randomized controlled trial comparing the short- and long-term effects of an elimination diet and a healthy diet that differentiates the gluten-free diet in children with ADHD, is yet to be published [ 46 ].…”

Section: Resultsmentioning

confidence: 99%

The Association between ADHD and Celiac Disease in Children

Gaur

2022

Children

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Controversy around the association between celiac disease (CeD) and attention deficit hyperactive disorder (ADHD) was addressed by a systematic review in 2015, ultimately showing no association. Since 2015, there have been several studies showing an association between celiac disease and attention deficit hyperactive disorder. This is an updated systematic review. Background: Most experts agree on the recommendation to not screen as part of the standard of care for ADHD in persons with CeD or vice versa. Simultaneously, they propose that untreated patients with CeD and neurological symptoms such as chronic fatigue, inattention, pain, and headache could be predisposed to ADHD-like behavior, namely inattention (which may be alleviated by following a gluten-free diet). The inattentive subtype of ADHD that encompasses the symptoms of inattention is phenotypically heterogeneous, as it includes the clinical construct of sluggish cognitive tempo (SCT). SCT symptoms overlap with the neurological manifestations of CeD. Methods: A systematic search (PRISMA) of PubMed, Google Scholar, EMBASE, Web of Science, Stanford Lane, SCOPUS, and Ovid was conducted for articles up to 21 February 2022. Of these, 23 studies met the criteria. Results: Out of the 23 studies, 13 showed a positive association between ADHD and CeD. Most studies that showed a positive association had been published in the last five years. Inconsistencies in the results remain due to the heterogeneous methodology used, specifically for ADHD and the outcome questionnaires, as well as a lack of reporting on ADHD subtypes. Conclusion: There is an association between ADHD and celiac disease. The current methodological limitations will be lessened if we examine the subtypes of ADHD.

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“…The Cognitive Task Application (COTAPP) measures cognitive performance (29). As described by Bosch, Bierens (30), this Dutch neurocognitive assessment tool is designed to examine (variability in) processing speed, attentional and executive control, working memory, and learning speed with a computer task. The COTAPP is a two-choice reaction time paradigm with seven blocks, in which the child is assisted through the different paradigms in a playlike way (29,30).…”

Section: F Cognitive Performancementioning

confidence: 99%

The short and long-term effects of a lifestyle intervention in children with mental illnesses: a randomized controlled trial (Movementss study). Rationale, Study Design and Methods.

Tetering

Muskens

Deenik

et al. 2023

Preprint

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Background: A lifestyle including poor diet, physical inactivity, excessive gaming and inadequate sleep hygiene is frequently seen among Dutch children. These lifestyle behaviors can cause long-term health problems later in life. Unhealthy lifestyle and poor physical health are even more prevalent among children with mental illness (MI) such as autism, attention-deficit/hyperactivity disorder, depression, and anxiety. However, research on lifestyle interventions among children with MI is lacking. As a result, there are currently no guidelines, or treatment programs where children with MI and poor lifestyle can receive effective support. To address these issues and to provide insight into the effectiveness of lifestyle interventions in children with MI and their families, the Movementss study was designed. This paper describes the rationale, study design, and methods of an ongoing randomized controlled trial (RCT) comparing the short-term (12 weeks) and long-term (1 year) effects of a lifestyle intervention with care as usual (CAU) in children with MI and an unhealthy lifestyle. Methods: A total of 80 children (6-12 years) with MI according to DSM-V and an unhealthy lifestyle are randomized to the lifestyle intervention group or CAU at a specialized child and adolescent mental hospital. The primary outcome measure is quality of life measured with the KIDSCREEN. Secondary outcomes include emotional and behavior symptoms, lifestyle parameters regarding diet, physical activity, sleep, and screen time, cognitive assessment (intelligence and executive functions), physical measurements (e.g., BMI), parenting styles, and family functioning, prior beliefs, adherence, satisfaction, and cost-effectiveness. Assessments will take place at the start of the study (T0), after 12 weeks (T1), six months (T2), and 12 months of baseline (T3) to measure long-term effects. Discussion: This RCT will likely contribute to the currently lacking knowledge on lifestyle interventions in children with MI. Trial registration: trialsearch.who.int/ NL9822. Registered at November 2nd, 2021

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A two arm randomized controlled trial comparing the short and long term effects of an elimination diet and a healthy diet in children with ADHD (TRACE study). Rationale, study design and methods

Cited by 6 publications

References 36 publications

Eating Patterns and Dietary Interventions in ADHD: A Narrative Review

Eating Patterns and Dietary Interventions in ADHD: A Narrative Review

The Association between ADHD and Celiac Disease in Children

The short and long-term effects of a lifestyle intervention in children with mental illnesses: a randomized controlled trial (Movementss study). Rationale, Study Design and Methods.

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