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用于管理注意力缺陷多动障碍(ADHD)的饮食干预和补充剂:疗效及建议的系统评价

Dietary Interventions and Supplements for Managing Attention-Deficit/Hyperactivity Disorder (ADHD): A Systematic Review of Efficacy and Recommendations.

作者信息

Abhishek Fnu, Gugnani Jaikirat Singh, Kaur Harkamalpreet, Damera Abhiram Rao, Mane Rohan, Sekhri Arushi, Singh Gurpreet, Kaur Gurnoor

机构信息

Medicine, Government Medical College, Amritsar, Amritsar, IND.

Nephrology, Government Medical College, Amritsar, Amritsar, IND.

出版信息

Cureus. 2024 Sep 20;16(9):e69804. doi: 10.7759/cureus.69804. eCollection 2024 Sep.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) significantly impacts children's neurological development, behaviour, and overall well-being, affecting academic performance and social interactions. This systematic review investigates the effectiveness of dietary interventions (DASH (Dietary Approaches to Stop Hypertension) diet, Vitamin D3 supplementation, magnesium, and impact of artificial food colors and marine oils) and supplements alongside standard pharmacotherapy in managing ADHD symptoms. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, we extensively searched various databases for studies published from 2016 to 2022. Out of an initial pool of 7873 records, 14 randomized controlled trials met our inclusion criteria following rigorous screening. Our findings suggest that gluten-free diets may alleviate ADHD symptoms despite negative celiac serology, highlighting the role of non-celiac gluten sensitivity. Moreover, vitamin and mineral supplements like vitamin D and magnesium showed varying degrees of effectiveness in improving behavioural and emotional symptoms. Innovative treatments, such as combining saffron with methylphenidate and using marine oil extracts, also demonstrated potential in enhancing behaviours associated with ADHD. The review underscores the importance of dietary approaches, such as the DASH diet and specific exclusions (e.g., a few foods diet and an oligoantigenic diet), in managing symptoms by addressing nutritional factors. Studies on probiotics and interventions targeting gut microbiota composition yielded mixed results, necessitating further exploration. Limitations include study diversity and short-term outcome assessments, cautioning against broad generalizations. Integrating personalized dietary assessments and interventions into ADHD treatment strategies could optimize therapeutic outcomes and potentially reduce reliance on pharmacotherapy alone. In summary, this systematic review highlights the potential benefits of dietary modifications and supplements in managing ADHD symptoms. Future research should prioritize long-term efficacy, interactions with conventional medications, and personalized dietary approaches to refine ADHD treatment strategies.

摘要

注意力缺陷多动障碍(ADHD)对儿童的神经发育、行为及整体幸福感有显著影响,会影响学业成绩和社交互动。本系统评价研究了饮食干预(DASH(防治高血压饮食)饮食、补充维生素D3、镁,以及人工食用色素和海洋油的影响)和补充剂与标准药物治疗相结合对ADHD症状的管理效果。我们遵循系统评价和Meta分析的首选报告项目(PRISMA)2020指南,广泛检索了2016年至2022年发表的各类数据库中的研究。在最初的7873条记录中,经过严格筛选,有14项随机对照试验符合我们的纳入标准。我们的研究结果表明,无麸质饮食可能减轻ADHD症状,尽管乳糜泻血清学检查结果为阴性,这凸显了非乳糜泻麸质敏感性的作用。此外,维生素D和镁等维生素和矿物质补充剂在改善行为和情绪症状方面显示出不同程度的效果。藏红花与哌甲酯联合使用以及使用海洋油提取物等创新治疗方法,在改善与ADHD相关的行为方面也显示出潜力。该评价强调了饮食方法的重要性,如DASH饮食和特定排除法(如几种食物饮食和低抗原饮食),通过解决营养因素来管理症状。关于益生菌和针对肠道微生物群组成的干预措施的研究结果不一,需要进一步探索。局限性包括研究的多样性和短期结果评估,因此要谨慎做出广泛的概括。将个性化饮食评估和干预措施纳入ADHD治疗策略中,可以优化治疗效果,并有可能减少对单一药物治疗的依赖。总之,本系统评价强调了饮食调整和补充剂在管理ADHD症状方面的潜在益处。未来的研究应优先关注长期疗效、与传统药物的相互作用以及个性化饮食方法,以完善ADHD治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8108/11491108/5f43c015d1df/cureus-0016-00000069804-i01.jpg

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