Recommendations on the nutritional treatment of attention deficit hyperactivity disorder (ADHD)

Published

2015-03-27

How to Cite

Ruiz-Lázaro, P. M., Garcia-Giral, M., Montañés-Rada, F., Gastaminza-Pérez, X., Mardomingo-Sanz, M. J., Pàmias, M., Morey, J., Ruiz-Sanz, F., Herreros, O., Ajoy, M., Ortíz-Guerra, J., Mojarro-Práxedes, D., Ferrin, M., Graell, M., Granada, O., Cantó-Díez, T., & Sasot-Llevadot, J. (2015). Recommendations on the nutritional treatment of attention deficit hyperactivity disorder (ADHD). Revista De Psiquiatría Infanto-Juvenil, 32(1), 49–54. Retrieved from https://aepnya.eu/index.php/revistaaepnya/article/view/113

Issue

Section

Orginial article

Authors

  • Pedro Manuel Ruiz-Lázaro Instituto Aragonés de Ciencias de la Salud I+CS
  • Marta Garcia-Giral Hospital Clínic de Barcelona
  • Francisco Montañés-Rada Hospital Universitario Alcorcón, Madrid
  • Xavier Gastaminza-Pérez Hospital Universitario Valle De Hebrón, Barcelona
  • María J. Mardomingo-Sanz Hospital Gregorio Marañón, Madrid
  • Montserrat Pàmias Hospital Parc Tauli, Sabadell
  • Jaume Morey IBSMIA
  • Francisco Ruiz-Sanz Hospital San Telmo, Palencia
  • Oscar Herreros Unidad de Gestión Clínica de Salud Mental del Hospital Universitario Virgen de las Nieves de Granada
  • Manuel Ajoy Fuerteventura
  • Juan Ortíz-Guerra Hospital San Juan de Dios, Barcelona
  • Dolores Mojarro-Práxedes Hospital Universitario Virgen de la Macarena, Sevilla
  • Mayte Ferrin CSM Estella
  • Montserrat Graell Hospital Niño Jesús, Madrid
  • Olvido Granada USMIJ Toledo
  • Tomás Cantó-Díez USMI San Vicente, Alicante
  • Jordi Sasot-Llevadot Centro Médico Teknon, Barcelona

Keywords:

ADHD, Iron, Nutrition, Omega-3 fatty acid, PUFAS, Treatment, Zinc

Abstract

In this article, the GEITDAH -the Spanish abbreviation of the Special Interest Group on Attention Deficit Hyperactivity Disorder (ADHD)- presents a consensus about nutritional treatment for ADHD reached by experts in the management of ADHD from all over Spain. The ADHD treatment should be multimodal. Nutritional treatment is supplementary and there is some begining evidence of modest efficacy. Dietary interventions can have little beneficial effects in ADHD symptomatology.
The controversial restricted elimination of food additives, preservatives, artificial food colours and refined sugar from diet is good studied. Present findings do not support to date the positive recommendation of its use as an appropriate treatment in ADHD. Neither do they support Acetyl-L Carnitine supplementation to augment methylphenidate. Iron and zinc should be supplemented in selected patients with know deficiencies.
Current findings from randomized trials are limited and have not consistently supported the generalized clinical use of PUFA supplements (omega-3 fatty acids) as a primary or supplementary treatment for children with ADHD.
However, it seems to reduce ADHD symptoms, at least in some children. And the benefits may be greater in a classroom setting than at home.

Downloads

Download data is not yet available.

Author Biography

Pedro Manuel Ruiz-Lázaro, Instituto Aragonés de Ciencias de la Salud I+CS

Hospital Clínico Universitario Lozano Blesa. Instituto Aragonés de Ciencias de la Salud I+CS. Zaragoza

Correspondencia:
Sección de Psiquiatría Infanto-Juvenil. HCU Lozano Blesa. Universidad de Zaragoza. Av. San Juan Bosco nº 15, 50009. Zaragoza. Instituto Aragonés de Ciencias de la Salud (Aragon Health Sciences Institite). e-mail: pmruiz@aragon.es

References

1. Montañés-Rada F, Gastaminza-Pérez X, Catalá MA, Ruiz-Sanz F, Ruiz-Lázaro PM, Herreros-Rodríguez O, et al; Grupo de Especial Interés en el TDAH (GEITDAH). Consenso del GEITDAH sobre el trastorno por déficit de atención/hiperactividad. Rev Neurol 2010; 51: 633-637.

2. Grupo de trabajo de la Guía de Práctica Clínica sobre el Trastorno por Déficit de Atención con Hiperactividad (TDAH) en Niños y Adolescentes. Fundació Sant Joan de Déu, coordinador. Guía de Práctica Clínica sobre el Trastorno por Déficit de Atención con Hiperactividad (TDAH) en Niños y Adolescentes. Plan de Calidad para el Sistema Nacional de Salud del Ministerio de Sanidad, Política Social e Igualdad. Agència d´Informació, Avaluació i Qualitat (AIAQS) de Cataluña; 2010. Guías de Práctica Clínica en el SNS: AATRM Nº 2007/18.

3. Ruiz-Lázaro PM, Argemí M. Tratamiento no farmacológico en el trastorno por déficit de atención con y sin hiperactividad (TDAH). Trabajo social y salud 2009; 62: 115-120.

4. Skokauskas N, McNicholas F, Masaud T, Frodl T. Complementary medicine for children and young people who have attention deficit hyperactivity disorder. Curr Opin Psychiatry. 2011; 24:291-300.

5. Millichap JG, Yee MM. The diet factor in attention-deficit/hyperactivity disorder. Pediatrics. 2012; 129: 330-337.

6. Martí LF. Effectiveness of nutritional interventions on the functioning of children with ADHD and/or ASD. An updated review of research evidence. Bol Asoc Med P R. 2010; 102: 31-42.

7. Hurt EA, Arnold LE, Lofthouse N. Dietary and nutritional treatments for attention-deficit/hyperactivity disorder: current research support and recommendations for practitioners. Curr Psychiatry Rep. 2011; 13: 323-332.

8. Wolraich MI, Wilson DB, White JW. The effect of sugar on behaviour or cognition in children: a meta-analysis. JAMA 1995; 274: 1617-1621.

9. Rojas NL, Chan E. Old and new controversies in the alternative treatment of Attention-Deficit Hyperactivity Disorder. Ment Retard Dev Disab Res Rev 2005; 11: 116-130.

10. Pelsser LM, Frankena K, Toorman J, Savelkoul HF, Dubois AE, Rodrigues R, Haagen TA, Rommelse NN, Buiterlaar JK. Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disosrder (INCA study): a randomised controlled trial. Lancet 2011; 377 (9764): 494-503.

11. Ghuman JK. Restricted elimination diet for ADHD: the INCA study. Lancet 2011; 377 (9764): 446-448.

12. Sonuga-Barke EJ, Brandeis D, Cortese S, Daley D, Ferrin M, Holtmann M, Stevenson J, Danckaerts M, van der Oord S, Döpfner M, Dittmann RW, Simonoff E, Zuddas A, Banaschewski T, Buitelaar J, Coghill D, Hollis C, Konofal E, Lecendreux M, Wong IC, Sergeant J; European ADHD Guidelines Group. Nonpharmacological interventions for ADHD: systematic review and metaanalyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry. 2013; 170: 275-289.

13. Lakhan SE, Vieira KF. Nutritional therapies for mental disorders. Nutrition Journal 2008; 7: 2: 1-8.

14. Abbasi SH, Heidari S, Mohammadi MR, Tabrizi M, Ghaleiha A, Akhondzadeh S. Acetyl-L Carnitine as an Adjunctive Therapy in the Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Placebo-Controlled Trial. Child Psychiatry Hum Dev 2011; 42: 367-375.

15. Orellana-Ayala CE. Nutrición y trastorno por déficit de atención/hiperactividad [carta]. Rev Neurol 2010; 50: 384.

16. Oner P, Oner O, Azik FM, Cop E, Munir KM. Ferritin and hyperactivity ratings in attention deficit hyperactivity disorder. Pediatr Int. 2012; 54: 688-692.

17. Soto-Insuga V, Calleja ML, Prados M, Castaño C, Losada R, Ruiz-Falcó ML. Utilidad del hierro en el tratamiento del trastorno por déficit de atención e hiperactividad. An Pediatr (Barc). 2013;79: 230-235.

18. Cortese S, Angriman M, Lecendreux M, Konofal E. Iron and attention deficit/hyperactivity disorder: What is the empirical evidence so far? A systematic review of the literature. Expert Rev Neurother. 2012; 12: 1227-1240.

19. Ghanizadeh A, Berk M. Zinc for treating of children and adolescents with attention-deficit hyperactivity disorder: a systematic review of randomized controlled clinical trials. Eur J Clin Nutr. 2013; 67: 122-124.

20. Zamora J, Velásquez A, Troncoso L, Barra P, Guajardo K, Castillo-Duran C. Zinc in the therapy of the attention-deficit/hyperactivity disorder in children. A preliminar randomized controlled trial. Arch Latinoam Nutr. 2011; 61: 242-6.

21. Vancassel S, Durand G, Barthelemy C, Lejeune B, Martineau J, Guilloteau D, et al. Plasma fatty acid levels in autistic children. Prostaglandins Leukot Essent Fatty Acids 2001; 65: 1-7.

22. Ruiz-Lázaro PM, GEITDAH. Ácidos grasos poliinsaturados (PUFAS) en el tratamiento del déficit de atención con y sin hiperactividad (TDAH) Rev Psiquiatr Infanto-Juv 2014; 31 (3). pp. 9-20.

23. Gow RV, Hibbeln JR, Parletta N. Current evidence and future directions for research with omega-3 fatty acids and attention deficit hyperactivity disorder. Curr Opin Clin Nutr Metab Care. 2015, Jan 8. [Epub ahead of print].

Most read articles by the same author(s)

<< < 1 2