A trial in the Netherlands followed 165 children aged 5 to 12 with a DSM-5 ADHD diagnosis for one year. Children were randomly assigned to start with either a strict elimination diet or a healthy diet for five weeks, and both groups could add or switch to usual care after that. A separate group of 58 children who got usual care only was used as a comparison, but they were not randomly assigned. The diets were run with ongoing help from a dietician.
After one year, more children who started with the healthy diet showed at least partial improvement in ADHD and behavior problems than those who started with the elimination diet (64% compared with 47%). Teachers reported slightly larger drops in hyperactivity and behavior problems in the healthy diet group, though the effect was small. Fewer children in the diet groups were taking stimulant medication than in the usual care group (45% and 38% versus 78%). Children on the elimination diet were more likely to develop sleep problems and needed more dietician visits. The authors suggest that starting with the healthy diet, rather than the more intensive elimination diet, is a low key and feasible option for families considering a dietary treatment, with the choice to add or switch to usual care later.
The numbers Stats and what the terms mean
The statistics behind the plain-language claims above.
- Huberts-Bosch, 2024: teacher-rated hyperactivity and behavior problems, healthy diet compared with elimination diet, Cohen's d = 0.30 and 0.29.
What the terms mean:
- d is an effect size. Roughly, 0.2 is small, 0.5 is moderate and 0.8 is large. A minus sign shows the direction of the change, not its size.
Source: Huberts‐Bosch A, Bierens M, Rucklidge J, et al.. Effects of an elimination diet and a healthy diet in children with Attention‐Deficit/Hyperactivity Disorder: 1‐Year prospective follow‐up of a two‐arm randomized, controlled study (TRACE study). JCPP Advances (2024). doi:10.1002/jcv2.12257