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Effects of food on physical and sleep complaints in children with ADHD: a randomised controlled pilot study.

Pelsser LM, Frankena K, Buitelaar JK, Rommelse NN - Eur. J. Pediatr. (2010)

Bottom Line: Specific complaints that were significantly reduced were in three domains: headaches or bellyaches, unusual thirst or unusual perspiration, and sleep complaints.A positive correlation existed between the reduction of physical and behavioural symptoms (p < 0.01).The reduction did not differ between children with or without an atopic constitution (p = 0.7).

View Article: PubMed Central - PubMed

Affiliation: ADHD Research Centre, Liviuslaan 49, 5624 JE Eindhoven, The Netherlands. lmjpelsser@adhdresearchcentre.nl

ABSTRACT
Attention deficit/hyperactivity disorder (ADHD), a common behavioural disorder in children, may be associated with comorbid physical and sleep complaints. Dietary intervention studies have shown convincing evidence of efficacy in reducing ADHD symptoms in children. In this pilot study, we investigated the effects of an elimination diet on physical and sleep complaints in children with ADHD. A group of 27 children (3.8-8.5 years old), who all met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for ADHD, were assigned randomly to either a diet group (15/27) or a control group (12/27). The diet group followed a 5-week elimination diet; the control group adhered to their normal diet. Parents of both groups had to keep an extended diary and had to monitor the behaviour and the physical and sleep complaints of their child conscientiously. The primary endpoint was the clinical response, i.e. a decrease of physical and sleep complaints, at the end of the trial, based on parent ratings on a Physical Complaints Questionnaire. The number of physical and sleep complaints was significantly decreased in the diet group compared to the control group (p < 0.001), with a reduction in the diet group of 77% (p < 0.001, effect size = 2.0) and in the control group of 17% (p = 0.08, effect size = 0.2). Specific complaints that were significantly reduced were in three domains: headaches or bellyaches, unusual thirst or unusual perspiration, and sleep complaints. The reduction of complaints seemed to occur independently of the behavioural changes (p = 0.1). However, the power of this comparison was low. A positive correlation existed between the reduction of physical and behavioural symptoms (p < 0.01). The reduction did not differ between children with or without an atopic constitution (p = 0.7). An elimination diet may be an effective instrument to reduce physical complaints in children with ADHD, but more research is needed to determine the effects of food on (functional) somatic symptoms in children with and without ADHD. This trial was registered as an International Standard Randomised Controlled Trial, ISRCTN47247160.

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Flow diagram of subject participation throughout the day
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Fig1: Flow diagram of subject participation throughout the day

Mentions: Participants were selected from a sample of 79 Dutch children who were referred to the Dutch ADHD Research Centre in Eindhoven, specialised in scientific research on food and ADHD. Children were included if (1) they were between 3 and 8 years old; (2) they met the criteria for ADHD, as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition for ADHD Combined Type or Predominantly Hyperactive-Impulsive Type [1]; (3) their behavioural problems were present before the age of 4 or (4) they were medication naïve. Children were excluded if (1) they were diagnosed with Autism Spectrum Disorder or with ADHD Predominantly Inattentive Type [28], (2) they were pre- or dysmature at birth [30, 40] or (3) the mother had been smoking during pregnancy. A total of 43 children of the 79 failed to meet the criteria, and nine refused to participate. As a result, 27 children entered the study between January and July 2006 and were randomly allocated to the diet group (15) or the control group (12; Fig. 1). Twenty-four children, 13 in the diet group and 11 in the control group, completed the study. At the start of the trial, there was no difference between the number of physical complaints or the severity of ADHD symptoms in diet group and control group (Table 1).Fig. 1


Effects of food on physical and sleep complaints in children with ADHD: a randomised controlled pilot study.

Pelsser LM, Frankena K, Buitelaar JK, Rommelse NN - Eur. J. Pediatr. (2010)

Flow diagram of subject participation throughout the day
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2908441&req=5

Fig1: Flow diagram of subject participation throughout the day
Mentions: Participants were selected from a sample of 79 Dutch children who were referred to the Dutch ADHD Research Centre in Eindhoven, specialised in scientific research on food and ADHD. Children were included if (1) they were between 3 and 8 years old; (2) they met the criteria for ADHD, as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition for ADHD Combined Type or Predominantly Hyperactive-Impulsive Type [1]; (3) their behavioural problems were present before the age of 4 or (4) they were medication naïve. Children were excluded if (1) they were diagnosed with Autism Spectrum Disorder or with ADHD Predominantly Inattentive Type [28], (2) they were pre- or dysmature at birth [30, 40] or (3) the mother had been smoking during pregnancy. A total of 43 children of the 79 failed to meet the criteria, and nine refused to participate. As a result, 27 children entered the study between January and July 2006 and were randomly allocated to the diet group (15) or the control group (12; Fig. 1). Twenty-four children, 13 in the diet group and 11 in the control group, completed the study. At the start of the trial, there was no difference between the number of physical complaints or the severity of ADHD symptoms in diet group and control group (Table 1).Fig. 1

Bottom Line: Specific complaints that were significantly reduced were in three domains: headaches or bellyaches, unusual thirst or unusual perspiration, and sleep complaints.A positive correlation existed between the reduction of physical and behavioural symptoms (p < 0.01).The reduction did not differ between children with or without an atopic constitution (p = 0.7).

View Article: PubMed Central - PubMed

Affiliation: ADHD Research Centre, Liviuslaan 49, 5624 JE Eindhoven, The Netherlands. lmjpelsser@adhdresearchcentre.nl

ABSTRACT
Attention deficit/hyperactivity disorder (ADHD), a common behavioural disorder in children, may be associated with comorbid physical and sleep complaints. Dietary intervention studies have shown convincing evidence of efficacy in reducing ADHD symptoms in children. In this pilot study, we investigated the effects of an elimination diet on physical and sleep complaints in children with ADHD. A group of 27 children (3.8-8.5 years old), who all met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for ADHD, were assigned randomly to either a diet group (15/27) or a control group (12/27). The diet group followed a 5-week elimination diet; the control group adhered to their normal diet. Parents of both groups had to keep an extended diary and had to monitor the behaviour and the physical and sleep complaints of their child conscientiously. The primary endpoint was the clinical response, i.e. a decrease of physical and sleep complaints, at the end of the trial, based on parent ratings on a Physical Complaints Questionnaire. The number of physical and sleep complaints was significantly decreased in the diet group compared to the control group (p < 0.001), with a reduction in the diet group of 77% (p < 0.001, effect size = 2.0) and in the control group of 17% (p = 0.08, effect size = 0.2). Specific complaints that were significantly reduced were in three domains: headaches or bellyaches, unusual thirst or unusual perspiration, and sleep complaints. The reduction of complaints seemed to occur independently of the behavioural changes (p = 0.1). However, the power of this comparison was low. A positive correlation existed between the reduction of physical and behavioural symptoms (p < 0.01). The reduction did not differ between children with or without an atopic constitution (p = 0.7). An elimination diet may be an effective instrument to reduce physical complaints in children with ADHD, but more research is needed to determine the effects of food on (functional) somatic symptoms in children with and without ADHD. This trial was registered as an International Standard Randomised Controlled Trial, ISRCTN47247160.

Show MeSH
Related in: MedlinePlus