Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial

Pelsser, Lidy; Frankena, K.; Toorman, Jan; Savelkoul, H.F.J.; Dubois, Anthony; Pereira, Rob Rodrigues; Haagen, Ton A; Rommelse, Nanda; Buitelaar, Jan K.

doi:10.1016/s0140-6736(10)62227-1

Cited by 172 publications

(178 citation statements)

References 32 publications

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“…The role of food in ADHD has been investigated since 1985 in several restricted elimination diet (RED) studies. A restricted elimination diet is commonly used to identify food intolerance and involves a temporary (2-5 weeks) total change of diet, in which the patient is only allowed to eat a few different hypoallergenic foods (including rice, turkey, lettuce, pears, and water) [9][10][11][12][13][14][15][16][17]. The rationale for this diet is that a patient may show adverse reactions to any foods.…”

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confidence: 99%

“…In the Netherlands, three randomized controlled trials (RCTs) have been conducted over the last 10 years [13][14][15]. The elimination diet applied in these studies is based on the few foods diet, but is somewhat more extensive: rice, turkey, lamb, a range of vegetables, pear, rice milk with added calcium and water.…”

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confidence: 99%

“…The latest conducted Dutch RCT applying a RED was published in The Lancet [15] and was both applauded as N. Rommelse (&) Á J. Buitelaar Nijmegen, Netherlands e-mail: N.Lambregts-Rommelse@psy.umcn.nl well as criticized in scientific and public media [19][20][21]. It is thus far the largest study conducted of this kind, in ADHD patients not selected for an atopic constitution or presence/absence of comorbidities, and with a rigorous attempt to investigate possible immunological mechanisms underlying response to RED.…”

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confidence: 99%

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

Rommelse¹,

Buitelaar²

2013

Eur Child Adolesc Psychiatry

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confidence: 99%

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confidence: 99%

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confidence: 99%

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

Rommelse¹,

Buitelaar²

2013

Eur Child Adolesc Psychiatry

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“…The diet starts with the elimination of most foods, usually allowing two types of meat, two sources of CHOs (originally rice and potato), two vegetables, two fruits, oil, and water. A number of poorly controlled reports show that within 1-5 weeks of following such a diet some children exhibited fewer ADHD symptoms (40,(80)(81)(82)(83)(84)(85)(86)(87). However, the lack of methodologies that can eliminate bias makes the results questionable.…”

Section: Diet and Treatment Of Adhdmentioning

confidence: 99%

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2017

Cereal Foods World

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“…However, as described by Ly et al in this issue [16], it remains inconclusive whether elimination diets are effective as a clinical treatment for children with ASD and ADHD, since the long-term effects (and hence, feasibility in daily life) have not been studied. Furthermore, although several studies using most proximal assessment demonstrated large effects of elimination diets in children with ADHD [16,17], an overall small effect of this diet was shown by other studies using probably blinded assessments [14].…”

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confidence: 99%

Editorial focused issue ‘The role of nutrition in child and adolescent onset mental disorders’

Lambregts-Rommelse

2017

Eur Child Adolesc Psychiatry

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the plasticity of the brain at this early age; structural and/ or functional damage may persist after repletion [1]. The central effect of nutrient deficiency or supplementation is dependent on the requirement of the central nervous system for a nutrient in specific metabolic pathways and structural components. A specific nutrient may promote normal brain development at one time point and be toxic at another. Furthermore, different concentrations of nutrients may be required during development. Concentrations of several nutrients are tightly regulated (e.g., iron) with aberrant brain development ensuing from both a deficiency and an excess. Important nutrients during late fetal and early neonatal life include protein, zinc, iron, copper, choline, and polyunsaturated fatty acids (PUFA; 1).Prenatal exposure to an 'unhealthy diet' has been associated with ADHD symptoms, further linked to altered epigenetic modification of blood-derived DNA [2]. The study by Daraki et al. in this issue [3] illustrates how low maternal serum vitamin D concentrations during the first trimester were related to behavioral difficulties, especially ADHDlike symptoms, at preschool age in the child. As vitamin D amounts of the developing fetus are dependent on maternal stores, maternal vitamin D deficiency is of great concern for its consequences in the offspring. Maternal vitamin D performs a number of biological functions that are fundamental to early brain development [4], including proliferation and differentiation of brain cells [5], regulation of axonal growth [6], calcium signaling within the brain, and neurotrophic and neuroprotective actions [6]. These results may suggest that appropriate supplementation of vitamin D during pregnancy may reduce the incidence of behavioral difficulties and ADHD-like symptoms later in life in the offspring.The systematic review by Föcker et al. in this issue [7] illustrates that based on the results from 25 cross-sectional studies and 8 longitudinal studies, vitamin D seems to play a Childhood neurodevelopmental and psychiatric disorders are known to be complex conditions of multifactorial aetiology, involving both genetic and environmental determinants. There is a rapidly growing awareness that mental symptoms and psychiatric disorders are linked to nutrition. This focused issue of European Child+Adolescent Psychiatry will present a state-of-the-art overview of the topic of nutrition and child and adolescent psychiatric disorders, with the aim of moving this highly promising field forward by formulating a research agenda and to inform clinicians regarding the currently available therapeutic and preventive options.Food intake affects brain development and function in all age groups, starting from the phase in utero in terms of cognitive processes, mood, and brain performance. Accordingly, nutritional deficiencies can result in a vast array of age-dependent clinical symptoms, which affect the function of the central nervous system. Nutritional insults can have a particularly strong effect on the deve...

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Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial

Cited by 172 publications

References 32 publications

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

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

Full Issue PDF

Editorial focused issue ‘The role of nutrition in child and adolescent onset mental disorders’

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