The effect of dietary approaches to stop hypertension (DASH) diet on attention-deficit hyperactivity disorder (ADHD) symptoms: a randomized controlled clinical trial

Abstract

Background The dietary approaches to stop hypertension (DASH) diet has several components that might improve attention deficit hyperactivity disorder (ADHD) symptoms. This randomized controlled clinical trial (RCT) aimed to investigate the effect of the DASH diet on ADHD symptoms in children, for the first time.Methods Children (aged 6-12 years) with ADHD were randomized to receive a DASH or a control diet for 12 weeks. The severity of ADHD symptoms [determined by abbreviated 10-item Conner's scale (ACS), 18-item Swanson, Nolan and Pelham (SNAP-IV) scale and strengths and difficulties questionnaire (SDQ)], as well as dietary intakes, physical activity, and anthropometric measurements, were assessed every four weeks. The symptom scores provided by teachers, parents, and children were compared between the two groups, in multivariable-adjusted models.Results A total of 80 children completed the study. After adjustment for age, sex, energy intake, and baseline values significant group effects were observed for parent-reported ACS score, childrenreported emotional symptoms and peer relationship problems, and parent-reported scores of prosocial behaviors based on the SDQ scale (Pgroup<0.05). Significant group*time effects were indicated in teacher-reported ACS score, teacher-reported Hyperactivity and impulsivity, and parentreported combined score based on SNAP-IV, and teacher/child-reported scores for hyperactivity, parent and teacher-reported scores of emotional symptoms, peer relationship problems, and prosocial behavior, and also teacher/parent/child-reported total SDQ score (Pgroup*time<0.05). The adjusted mean in teacher/parent-reported ACS scores, teacher/parent/child-reported hyperactivity, and total SDQ scores, teacher-reported emotional symptoms, conduct problems, peer relationship problems, and prosocial behaviors assessed by the SDQ were significantly improved in the DASH compared to the control group (P<0.05).Conclusions Adherence to the DASH diet might beneficially improve ADHD symptoms. Further RCTs with more follow-up period which include participants from both sexes are needed to confirm these results.Trial registration: The trial was registered in the Iranian registry of clinical trials (registration code:

Eating Patterns and Dietary Interventions in ADHD: A Narrative Review

“…In conclusion, dietary patterns seem to play a potential role in the risk of ADHD, as patterns described as “Junk-food”, “Processed”, “Snack”, “Sweet”, and “Western-like” are the ones most positively associated with this pathology [ 5 , 6 , 8 ], whereas healthy eating patterns, such as the Mediterranean diet, are inversely associated with ADHD [ 7 , 9 ]. These data support the idea that not only specific nutrients or chemical food compounds but the whole diet should be considered in ADHD.…”

“…The dietary approach to stop hypertension (DASH) is a well-known healthy eating pattern, which is characterized by high amounts of fruits, vegetables, low-fat dairy products, vitamin C, and low amounts of simple sugars. In a 12-week randomized controlled clinical trial in Iran [ 9 ], this dietary pattern appears to improve ADHD symptoms, measured by the Abbreviated Conners Scale (ACS), the 18-item Swanson, Nolan, and Pelham scale (SNAP-IV), and the Strengths and Difficulties Questionnaire (SDQ). Although there is only one study with DASH in ADHD, it is reasonable to think it could be beneficial to these patients because of its known health benefits [ 93 , 94 , 95 , 96 , 97 , 98 , 99 ].…”

“…Moreover, dietary patterns may influence the risk of ADHD, since patterns described as “Junk-food”, “Processed”, “Snack”, “Sweet”, and “Western-like” have been positively associated with this pathology [ 5 , 6 , 8 ]. On the other hand, healthy eating patterns, such as the Mediterranean diet, Dietary Approaches to Stop Hypertension (DASH), and vegetarian diets, filled with vegetables and fruits and rich in micronutrients, have been inversely associated with the risk of ADHD [ 7 , 9 ]. Furthermore, since diet plays an important role in children’s health and development, school food environment policies may improve targeted dietary behaviors and therefore be a critical tool to promote healthy diets in children [ 10 ].…”

The association between dietary polyphenol intake and attention-deficit hyperactivity disorder: a case-control study

“…Also, a vegetarian dietary pattern rich in all types of vegetables, fruits, beans, and grains was negatively associated with ADHD [ 20 , 21 ]. Other dietary patterns rich in polyphenols, such as the Mediterranean diet and the Dash diet, were negatively correlated with ADHD and improved ADHD symptoms [ 22 , 23 ]. A cross-sectional study showed that low adherence to the Mediterranean diet may contribute to the development of ADHD [ 8 ].…”

Nutrition in the Management of ADHD: A Review of Recent Research

“…Several components of the dietary approaches to stop hypertension diet, such as high amounts of fruits, vegetables, low-fat dairy products, and vitamin C and low amounts of simple sugars, have been suggested to improve ADHD symptoms. A randomized controlled trial investigated the effect of this diet administered for 12 weeks to 80 children with ADHD aged 6 to 12 years [ 68 ]. Following adjustment for confounders, various measures determined by the abbreviated 10-item Conners’ scale, 18-item Swanson, Nolan and Pelham scale and the strengths and difficulties questionnaire, parent-, teacher- and child-reported hyperactivity, emotional symptoms, teacher-reported conduct problems, peer relationship problems, and prosocial behaviors were significantly improved in the dietary approaches to stop hypertension group compared to the control group [ 68 ].…”