Individual Behavioral Reactions in the Context of Food Sensitivities in Children with Attention-Deficit/Hyperactivity Disorder before and after an Oligoantigenic Diet

Abstract

The influence of food intake on behavior problems of children with Attention-Deficit/Hyperactivity Disorder (ADHD) was already described in the early 20th century. Eliminating food components by using the Oligoantigenic Diet (OD) leads to reduction of ADHD symptoms for more than two-thirds of patients. The aim of our study was to reveal how to identify foods having an impact on ADHD symptomatology. Therefore, 28 children with ADHD participating in this uncontrolled, open trial were examined before and after a restricted elimination diet. They kept a daily 24-h recall nutrition and behavior journal and filled out the abbreviated Conners’ scale (ACS) to identify foods which increased ADHD symptoms. The study was completed by 16 children (13 m/3 f). After four weeks of elimination diet the individual food sensitivities were identified in a reintroduction phase. A repetitive increase of ADHD symptoms by at least two points in ACS after food introduction hints at food sensitivity. Twenty-seven food sensitivity reactions were identified. Most of the participants were sensitive to more than one food. Food intolerances could not be identified without preceding OD. The combination of OD and subsequent food challenge appears as a valid method to identify individual food sensitivity in ADHD.

Long-Term Effects of an Oligoantigenic Diet in Children with Attention-Deficit/Hyperactivity Disorder (ADHD) on Core Symptomatology

“…In our open uncontrolled study, Yorgidis et al could replicate and confirm previous results of the efficacy of the OD on children with ADHD in a pre-post design [ 42 , 43 ]. The participants showed individual food sensitivity concerning the type of food, intensity, or pattern of reactivity.…”

“…For all of those, intolerant food items could be identified. In our previous study, significant improvement was observed in all scales of the ADHD rating scale as the primary outcome measure [ 42 ].…”

Role of Nutrition and Diet on Healthy Mental State

“…An open trial conducted by Yorgidis and colleagues explored the role of oligoantigenic diet (OD) as a therapeutic tool within ADHD children [10] and observed that the combination of this diet and the subsequent food challenge was efficient to identify individual food sensitivity in connection with ADHD. OD is an individualized type of elimination diet aimed at identifying specific foods that worsen psychopathological symptoms, followed by reintroducing other alternative foods that improve neuropsychological performance.…”

Physical Complaints Decrease after Following a Few-Foods Diet in Children with ADHD

“…The current consensus is that none of these factors is either a necessary or sufficient cause, although specific risk factors, such as rare genetic variants and environmental factors, can have a major impact [ 4 ]. Research has shown that nutrition can be an environmental risk factor of major impact in (a subgroup of) children with ADHD: double-blind placebo-controlled research, randomised controlled trials (RCTs) and open trials investigating the effect of a few-foods diet (FFD) on ADHD have shown that ADHD symptoms may significantly decrease after following a 5-week FFD [ 9 , 10 , 11 , 12 , 13 , 14 ]. These results suggest that children with ADHD who show clinically relevant behavioural improvements—i.e., a symptom decrease of at least 40% on the ADHD Rating Scale (ARS)—after following an FFD, can be diagnosed with food-induced ADHD [ 14 ].…”