Food and Behaviour Research

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'Few-foods' diet could be recipe for easing ADHD symptoms

Cara Murez

children eating

63% of the kids had a least a 40% decrease in ADHD symptoms after the 'few-foods diet' in this study

FAB RESEARCH COMMENT:

Controlled clinical trials have repeatedly shown that a 'few foods' diet can significantly reduce ADHD symptoms in around 60% of children with this condition, with systematic reviews showing this to be the single most effective dietary treatment for ADHD. 

This kind of diet is sometimes known as an 'oligoantigenic diet' - because it includes only foods that are thought unlikely to trigger allergic or other adverse food reactions.  It therefore excludes all ultra-processed foods and drinks, along with any others containing artificial food additives - because some of these alone (particularly artificial food colourings) have been shown in placebo-controlled trials to have adverse effects on behaviour in both ADHD and non-ADHD children.

This new study - invoving 79 boys with ADHD - had no placebo control group, as it's primary aim was to use brain imaging to investigate possible mechanisms by which a few-foods diet could improve behaviour. 

In 50 of these children (63%), ADHD symptoms fell by more than 40% following the few foods diet.

Brain imaging showed that these behavioural changes were linked with increased activation in a brain region known to be important for attention, cognition and memory, as well as being central to the network of brain regions that are activated during 'resting' consciousness.

These findings may help to explain, and add to, a large body of existing evidence showing that a 'few foods' diet can improve attention and behaviour in many children with ADHD.

It is now over 20 years since some of the UK's leading psychiatrists and specialists in ADHD published an auditable clinical treatment protocol, acknowledging the effectiveness of dietary modifications for some children (having carried out controlled clinical trials themselves). See


Unfortunately, dietary treatment options are still not widely used or recommended - but following a few-foods diet is not easy, and professional support is usually needed to ensure that this provides all essential nutrients, and to supervise the gradual re-introduction of a wider variety of foods.  

Meanwhile, however, simply reducing if not eliminating ultra-processed 'junk' foods and drinks would by itself have benefits for the physical and mental health of all children - not just those with ADHD.  So this is something that all parents, schools and other organisations responsible for feeding children could start by doing.   


For the underlying research please see:


See also:

04/01/2022 - Medical Xpress

New research suggests that short-term nutritional intervention, which tests whether certain foods are a trigger for ADHD symptoms through the process of elimination, might make a difference.

ADHD can result in inattentiveness, hyperactivity and impulsiveness, and nutrition can play a part in managing symptoms, the European researchers said.

In the case of this study, the most stringent diets consisted of rice, turkey, vegetables (cabbage, beets, cauliflower, sprouts, lettuce), pears, olive oil, ghee (clarified butter), salt and drinks with added calcium and water. During the first two weeks of the diet, other foods were added, including lamb, butter and small portions of wheat, corn, potatoes, some fruits and honey.

The authors explained the eating plan eventually results in a personalized diet excluding only those foods the patient reacts to, which could be food with allergens or any everyday food. Other studies have shown children often react to more than one food.

"This knowledge underlines the importance of applying a [few-foods diet] as a standardized intervention in further research into the effect of food on ADHD," wrote authors Saartje Hontelez and Tim Stobernack, from Wageningen University and Research in the Netherlands, and their colleagues.

The study included 79 boys between the ages of 8 and 10 who had ADHD. Parents completed the ADHD Rating Scale before and after the boys switched to the few-foods diet for several weeks. Researchers also did MRI brain scans before and after the diet.

The team found that 63% of the kids had a least a 40% decrease in ADHD symptoms after the few-foods diet. Some of the symptoms they looked at included:

  • avoiding assignments or having trouble wrapping up details of a project,
  • interrupting,
  • being distracted by other things or people,
  • having trouble remembering appointments or obligations.

In addition to seeing an easing of symptoms, the researchers reported that a whole-brain analysis showed an association between ADHD symptom improvements and increased activation in a brain region associated with visuospatial processing.

ADHD experts in the United States weighed in on the challenges of such a restrictive eating plan.

"The improvement in ADHD symptoms is commensurate with that reported in previous studies of [the few-foods diet], which have indicated a robust effect size," said Mary Solanto, professor of pediatrics and psychiatry at Cohen Children's Medical Center in New Hyde Park, N.Y.

Solanto noted the study's lack of a control group and said it did not reach its primary aim of discovering the critical biomarkers of this behavior improvement.

The diet is also lengthy and arduous for parents and children, she added, and may not be feasible in general practice.

"Further study of potentially critical biomarkers may enable quicker, more direct identification and elimination of offending foods," Solanto said.

She noted that the results of this study are consistent with a previous review of six meta-analyses of the few-foods diet in revealing a robust effect in reducing the core symptoms of ADHD.

Stimulant and non-stimulant medications, behavior therapy and the combination of the two remain the treatments of choice for ADHD, Solanto said.

The study suggested that prescribed drugs are not effective 24 hours per day and can cause sleeping problems, decreased appetite, headache and stomachache, so finding alternative treatments is important.

The findings were published recently in the journal Scientific Reports.

Carey Heller, a psychologist from Maryland who works with people who have ADHD, said he always feels skeptical about studies that consider diet for treating ADHD.

"Eating as healthy as possible for most people is going to make things at least somewhat better, but I think … when there's a focus on this diet or that diet for ADHD sometimes it creates this false understanding of what causes ADHD, or that diet can be a proven mechanism for treatment without anything else," he said.

Still, how parents help manage their child's ADHD and their environment can impact their symptoms, Heller said.

Best practices include behavioral treatment, such as psychotherapy or ADHD coaching, paired with medication, he said. Behavioral treatments can help some gain important tools for managing their symptoms, Heller said.

He suggested that parents have good communication with their child's health care provider, always talking before starting a new treatment or approach.

"Everyone's different in terms of what's best for them," Heller said.