Diet
Above, we referred to a series of recently published metaanalyses
of non-pharmacological interventions for the treatment
of ADHD. Sonuga-Barke and colleagues (2013) reported
that effect sizes for all interventions dropped to nonsignificance
in analyses of outcomes from probably blinded
assessors, with the exception of two dietary interventions (free
fatty acid supplementation and restricted food colouring). This
could therefore be taken as evidence that dietary interventions
offer the most promise for the future of non-pharmacological
interventions for ADHD. However, NICE guidelines do not
currently recommend the use of dietary interventions. Metaanalyses
have shown that restricted food colouring diets and
omega-3 supplementation are effective in reducing ADHD
symptoms, yet effect sizes are small and study inclusion is
often restricted to families where parents have reported an
adverse link between food and their child’s behaviour (Bloch &
Qawasmi 2011; Nigg et al. 2012). The methodological quality of
some dietary intervention studies has also be questioned (Nigg
et al. 2012). Restrictive diets are likely to be difficult and expensive
for parents to implement, particularly in families facing
other psychosocial adversities. Where parents report a link
between food and drink consumption and their child’s behaviour,
they should be encouraged to keep a food diary and clinicians
should consider possible referral to a dietician where
necessary (NICE 2008).