A randomized controlled pilot study into the effects of a restricted elimination diet on family structure in families with ADHD and ODD

Abstract

Background: Behavioural improvements of children with attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) following a restricted elimination diet (RED), may be due to concurrent changes in family environment. Methods: Twenty-four children with ADHD, were randomized to either a 5-week RED intervention, or a control intervention consisting of healthy food advices in a pilot study. Results: No differences in family environment were found, neither at baseline nor when comparing the start and end measurements of both groups. Conclusions: In this pilot study, the effects of an RED on ADHD and ODD are not mediated by improvement of family environment in families motivated to follow an RED. Replication of this preliminary study in larger groups of children is advised. Key Practitioner Message:• Family environment in families of children with ADHD successfully adhering to a 5-week restricted elimination diet (RED), appears to be above average• In families adhering to a 5-week RED, family environment does not change due to the RED • The beneficial effects of an RED on ADHD and ODD are not mediated by concurrent changes in family environment• There is an inverse relationship between the number of ADHD and ODD symptoms and family relationships

Retrospective Outcome Monitoring of ADHD and Nutrition (ROMAN): The Effectiveness of the Few-Foods Diet in General Practice

“…It has been suggested that a stringent diet might affect family structure (22), thus underlying the behavioral improvements rather than the FFD. However, research has shown that the FFD did not affect family structure (23). Nevertheless, good family structure might be important to persevere in the FFD, especially in the reintroduction phase.…”

Is there a future for restricted elimination diets in ADHD clinical practice?

“…A second point of criticism was the nature of the control group, receiving non-obligatory healthy food advice. It cannot be ruled out for certain that non-dietary factors, such as increased (positive) attention towards the child and/or increased structure in the household, may have contributed to the positive outcomes in the dietary group, although no change in family structure was observed in these already highly organized households [22].…”

Abordagem nutrológica do transtorno do déficit de atenção e hiperatividade em crianças

“…• O nível de organização e o clima familiar devem também ser levados em consideração na fase de planejamento da RED. REDs tendem a ser mais bem-sucedidas em ambientes familiares motivados e positivos 44 . Além disso, uma vez que as REDs requerem um certo nível de preparação, se a família possui dificuldades em relação a organização e estrutura, pode ser necessário capacitar a família nestas habilidades antes de se implementar uma RED 15,16 .…”