As you may have seen there are hundreds of sites, blogs, posts, tweets, talks and thoughts on ADHD and ADHD treatment. It can be so overwhelming for patients and families, even as specialists we are constantly digging through to find what is truly medical and evidence based vs opinion and exaggeration of incomplete studies. CHADD has an incredible list of resources on their site for both medical and alternative based treatments that we recommend every family look at. There is quite a bit of information and we wanted to take a moment and look at a hot topic that comes up a great deal with our families and that is Nutrition. One of our providers, Jade Wright, PA-C has shared the following:
Nutrition has been a growing field of research as it relates to ADHD and treatment. With the tremendous flood of information available at our fingertips, it’s easy to become overwhelmed and confused with conflicting stories. Here at Focus, we strive to remain up-to-date on the latest research available regarding the ADHD diagnosis and treatment, and provide that information to the community in the most helpful way possible. However, Focus clinics only promote evidence based approaches. When deciding on whether or not a recent study is valid, we rely on the statistical information gathered and published. We try not to get sidetracked by embedded opinions.
A quick recap from a recent article that had made statements on ADHD and nutrition alternatives which referenced a medical study however did not share a copy of the actual study for review (this is based on this article, we don’t have a copy of the actual study data for review). What we know to date, based on prior studies is that nutrition (including candy, food dyes, etc.) is not the cause of ADHD and elimination diets are not part of evidence based treatment for the disorder. HOWEVER, good nutrition is important for learning and attention; in fact, a healthy balanced diet is recommended for everyone, regardless of disease state. Elimination diets have not been scientifically proven to improve outcomes in ADHD patients. The article offers limited information regarding the actual study data. It states that 50 children were included, with the ADHD diagnosis, and placed on a restricted diet. However, we don’t know other exclusion/inclusion factors (were the children tested for food allergies prior to entry to the study, or was entry based solely on the ADHD diagnosis?). Look for evidence and facts beyond numbers and statements in an article or essay and see who their sources are. CHADD recommends, as do we, do another online search for those listed as the resources to find out more about their credentials and many times their motivations.
The author of the article we are using as an example is clearly trying to promote his book, which we should add that we neither support or oppose. However, the author offers a more important take away message, that we should emphasize a proper diagnosis. We couldn’t agree more with that idea! Many conditions have similar symptoms that may be misinterpreted or misdiagnosed as ADHD. ADHD is neurobiological disorder; it’s not caused by bad parenting, low intelligence, or foods. Certainly, a patient could have both ADHD and a food allergy!
Here are some tips for evaluating studies and complementary treatments:
1. Is it a “good” study (double-blind placebo controlled studies that have been published in peer-reviewed journals)
2. How is it promoted (be cautious of drastic claims that it will “work for everyone” or is a “miracle” cure)
3. Be cautious of claims that someone else in the medical community is unfairly attacking the idea or particular treatment or suppressing the “groundbreaking” news
We hope these guidelines are helpful to you and your family; we at Focus are committed to helping you come to a CORRECT and ACCURATE diagnosis. We see individuals who come to us and have been both OVER and UNDER diagnosed and we understand just how difficult your journey may have been; we are committed to providing you with an evidence based, medical diagnosis which includes a detailed, thorough and standardized encounter and comprehensive diagnosis and treatment plan. See more from Dr. Jay Wiley, our founding Physician here.
The following terms are important in understanding treatment interventions:
- Medical/medication management of ADHD refers to the treatment of ADHD using medication, under the supervision of a medical professional. See What We Know #3, “Managing Medication for Children and Adolescents with ADHD,” for more information.
- Psychosocial treatment of ADHD refers to treatment that targets the psychological and social aspects of ADHD. See What We Know #7, “Psychosocial Treatment for Children and Adolescents with ADHD,” for more information.
- Alternative treatment is any treatment — other than prescription medication or standard psychosocial/behavioral treatments — that claims to treat the symptoms of ADHD with an equally or more effective outcome. Prescription medication and standard psychosocial/behavioral treatments have been “extensively and well reviewed in the extant literature, with undoubted efficacy.”1
- Complementary interventions are not alternatives to multimodal treatment, but have been found by some families to improve the treatment of ADHD symptoms or related symptoms.
- Controversial treatments are interventions with no known published science supporting them and no legitimate claim to effectiveness.
Before actually using any of these interventions, families and individuals are encouraged to consult with their medical doctors. Some of these interventions are targeted to children with very discreet medical problems. A good medical history and a thorough physical examination should check for signs and symptoms of such conditions as thyroid dysfunction, allergic history, food intolerance, dietary imbalance and deficiency, and general medical problems that may mimic symptoms of ADHD.
1. Arnold, L.E. (2002). Treatment Alternatives for Attention-Deficit/Hyperactivity Disorder. In P.J. Jensen, & J. Cooper (Eds.), Attention-Deficit/Hyperactivity Disorder: State of the Science and Best Practices. Kingston, NJ: Civic Research Institute.