Journal of Childhood & Developmental Disorders

Description

One of the psychiatric conditions that affect children the most frequently is attention-deficit/hyperactivity disorder (ADHD). Symptoms vary from patient to patient and are caused by a combination of genetic and environmental factors. The standard pharmaceutical treatment does not work for all children with ADHD: Some people experience side effects, and children's long-term effects on the drugs are a concern. As a result, diet changes have been studied for decades as a means of alleviating ADHD symptoms in children.

The theory behind so-called elimination diets, in which certain foods are eliminated from a child's diet, is that certain foods may cause behavioral changes in some children. There are three types of intervention studies: sugar, "Few Foods Diets," and artificial colorants and other additives in food The 1970s marked the beginning of research into artificial food colorants and other additives. The Kaiser Permanente diet, also known as the K-P diet or the Feingold diet, was thought to alleviate symptoms in children with "hyperactivity" or "minimal brain dysfunction" by eliminating natural salicylates and artificial food colorants. Parents who report that their children become "hyperactive" after eating a lot of sugar have focused their attention on the possibility that sugar and artificial sweeteners are to blame. Norepinephrine, which is involved in the symptoms of ADHD, is synthesized from the amino acid precursors, phenylalanine, tyrosine, and tryptophan. A few observational studies have found that sugar consumption was associated with ADHD symptoms in children and adolescents. As a result, it has been suggested that children with ADHD might benefit from amino acid supplements. Aspartame, an artificial sweetener, contains phenylalanine, which has been linked to an increase in ADHD symptoms in children.

It has been suggested that some children with ADHD may be sensitive to other foods, in addition to sugar and artificial food colorants, and that these particular foods may vary from child to child. Only a few foods are excluded from the Few Foods Diet for a time. Two types of meat, two sources of carbohydrates, two vegetables, two fruits, oil, and water typically make up the diet. If children improve after a few weeks on this diet, they are considered "diet sensitive." If this is the case, foods are slowly and carefully reintroduced to see which foods cause the child to react. After that, the child may be given random blinded challenges in which the foods the child was found to react to were disguised in other foods or capsules. The overarching goal is to determine the foods that should be avoided in each particular circumstance and, as a result, create an individual diet for future use.

The aim, search strategy, inclusion and exclusion criteria, as well as the approaches taken to evaluate the studies, were all outlined in a predefined but unpublished protocol that was followed during the review.

Prevalence of ADHD

The most reliable method for determining an intervention's safety, efficacy, and effectiveness is still randomized controlled trials (RCTs). For treatment evaluations to be free of bias, rigorous trial design and analyses have become increasingly important over the past few decades. The Cochrane Risk of Bias tool and GRADE criteria have been used to evaluate individual trials' potential bias and the quality of the evidence as a whole, respectively. Because of the different ways in which these tools have been used, different review groups have come to different conclusions about the quality of the evidence as a whole and how it should be interpreted. The manner in which thresholds are established (for instance, the number of "uncertain" items required for a study to be rated as "high risk") or different approaches to evaluating the impact of potential conflicts of interest are common causes of these variations. In contrast to considerations for pharmacological interventions, researchers' involvement in the creation and evaluation of non-pharmacological interventions has not been taken into account as a potential area of bias until recently. The National Institute for Healthcare and Excellence (NICE) in the United Kingdom recently rated the overall quality of evidence for pharmacological interventions as low to moderate and for non-pharmacological approaches as low. It is important to note that the level of evidence assessed for pharmacological interventions is comparable to that of some standard treatments for significant somatic disorders.

Multi-Disciplinary Collaboration

In children and adolescents, ADHD is the most common neurodevelopmental disorder. Even though the symptoms of ADHD vary in severity, many people who suffer from the condition suffer from persistent symptoms and significant impairment as a result of their primary disorder and/or co-occurring symptoms. As a result, it is crucial to accurately identify ADHD and implement effective interventions. For a variety of pharmacological and, for non-core symptoms, some non-pharmacological treatments, there is a lot of evidence, at least in the short term. There is also a lot of agreement among different national guidelines from societies with different rates of acceptance, identification, and healthcare organization. However, just like in many other areas of healthcare, a lot of the research that went into these guidelines has significant methodological issues. Clinicians should be aware of these issues and how they could make it harder to interpret the evidence. Clinicians should have faith that ADHD medications are safe, effective, and well-tolerated despite these methodological concerns. Parent training is a valuable addition, primarily for the purpose of reducing additional behavioral issues and enhancing parent-child relationships. There is less high-quality evidence for neuromodulation, including neurofeedback and cognitive training, so these should not be used as first-line treatments for core symptoms at this time.

Psychoeducation and a shared, agreed-upon management plan that takes into account individual treatment priorities and preferences are at the foundation of ADHD management, which should be viewed as a partnership with patients and their parents. In contrast to clinical settings, where standard care is provided through one-on-one patient-clinician relationships, schools and other third-party settings have a lot to offer a more comprehensive approach. In addition to determining which accommodations are most effective at assisting patients and their family’s access and engage with care, future research will need to evaluate the usefulness of digital methods for monitoring outcomes and delivering psychological interventions.