Food intolerance and the few-foods (or oligoantigenic) diet in children with attention-deficit hyperactivity disorder

Abstract

The hypothesis that some children with attention-deficit hyperactivity disorder (ADHD) may show sensitivity or allergic reactions to various food items has led to the development of the the few-foods (or oligoantigenic) diet. The rationale of the diet is to eliminate certain foods from the diet in order to exclude potential allergens contained either naturally in food or in artificial ingredients with allergenic properties. The oligoantigenic diet attempts to identify individual foods to which a person might be sensitive. First, ADHD symptoms are monitored while multiple foods are excluded from the diet. Subsequently, if symptoms remit, foods are re-introduced, while observing the individual for the return of symptoms. An advantage of the oligoantigenic diet is that it can be tailored to the individual. A growing body of evidence suggests that behavioral symptoms of subgroups of children with ADHD may benefit from the elimination of certain foods. The effect sizes of an oligoantigenic diet regarding improvement of ADHD symptoms have been found to be medium to large. Available evidence suggests that the investigation of the role of food hypersensitivities in ADHD is a promising avenue worthy of further exploration. Further large-scale, randomized controlled studies including assessment of long-term outcome are therefore warranted.

Synthetic Colors in Food: A Warning for Children’s Health

“…The drinks were enriched with artificial food colors, including Sunset Yellow [E110], Carmoisine [E122], Tartrazine [E102], Ponceau [4R] and sodium benzoate. Consequently, as described by Lange et al [ 27 ], the authors of this study were able to observe that 79% of children experienced behavioral changes, showing an increase in hyperactivity after consuming at least 85% of the drink. The results, as reported by the authors, were based on the z-scores and the sum of the behavioral changes reported in parent and teacher assessments, and they included a computerized observational test for the 8- and 9-year-old group.…”

“…The restrictive dietary regime known as the oligoantigenic diet was studied by Lange et al [ 27 ]. In their conclusion, the authors highlight the beneficial effects of this approach in the management of ADHD.…”

“…The results are considered convincing, as several studies have indicated that this strategy can significantly reduce ADHD symptoms in children. A meta-analysis included in the study by Lange et al [ 27 ] revealed that artificial colors and preservatives trigger symptoms of hyperactivity, in addition to other related symptoms, in approximately 79% of the children analyzed. In this study, a total of 302 children were tested and divided into 2 groups: 153 children aged 3 years old and 149 children aged between 8 and 9 years old.…”

“…The study conducted by Lange et al [ 27 ] encompasses a variety of meta-analyses, each with distinct approaches, but converging on the conclusion that the elimination of artificial colorings proves to be a beneficial strategy in treating the symptoms of Attention Deficit Hyperactivity Disorder, providing improvements in general. Continuing this theoretical path raised by the researchers, another point observed that reinforces the concern related to color additives is, precisely during the reintroduction of foods phase into the oligoantigenic diet, an integral part of the observational process of children’s behavior that occurs immediately after the restriction period, a notable increase in patients’ hyperactivity was identified, especially when reintroducing foods containing color additives.…”