Medication and Treatment Reviews

Elimination Diet

How to identify food sensitivities that may impact ADHD symptoms.

What is it?

In an elimination diet, an individual removes one or more foods from his or her diet for a period of time in order to identify food sensitivities that may impact ADHD symptoms. Certain foods — like wheat, dairy, nuts, soy, or artificial food dyes — are thought to cause adverse reactions in some people, triggering periods of inattention, hyperactivity, or erratic emotions. This is called a food sensitivity, which differs from a food allergy; an allergy can be detected through a skin or blood test, whereas a food sensitivity cannot. The best way to identify a food sensitivity, experts say, is through an elimination diet.

How does an elimination diet work?

Elimination diets require strict discipline, and can be done independently or with the help of a professional. There are three main types of elimination diets:

  1. The “oligoantigenic” or “few foods” diet: This diet is most often used in research studies, as it consists of a very small number of foods and is difficult for individuals to maintain on their own. Most foods are eliminated, except those least likely to cause any problems: rice, meat, vegetables, pears, and water. In order to avoid nutritional deficiencies, patients should only try this diet with the help of a professional.
  2. The multiple-food elimination diet: This diet removes the foods that most commonly cause a reaction. Most versions eliminate dairy products, wheat, corn, soy, eggs, nuts, citrus, and artificial colors and flavors.
  3. The single-food elimination diet: This diet only removes one or two foods at a time.

An elimination diet is simple in theory. Start by removing the potential trigger food or foods from your or your child’s diet for three weeks. After three weeks, slowly add the food back into the diet, and note if you observe a change in behavior. If your child is calm when eggs are removed from diet, for instance, but becomes hyperactive after you reintroduce them, he may have a food sensitivity.

Since elimination diets can be difficult to maintain — especially during tumultuous periods of your life, like the beginning of the school year — you may have to repeat the process a few times to see results or come to a conclusion on a certain food. And keep in mind that not every behavioral change is linked to food: you may feel unfocused because of a lack of sleep the previous night — not because you ate gluten. Consistency and patience are the keys to seeing results from elimination diets.

Who is an elimination diet for?

Anyone can try an elimination diet. There are no reports of adverse side effects associated with elimination diets. Anyone concerned about nutrition should consult their doctor before starting an elimination diet, however.

How much does it cost?

Costs of elimination diets vary, depending on which food(s) you eliminate and which foods you purchase instead.

What studies have been done on elimination diets?

A 2011 study, published in The Lancet, found that children with ADHD who were placed on strict diets similar to the oligoantigenic elimination diet saw a 64 percent improvement in their ADHD symptoms after five weeks, while children who ate a normal “healthy” diet saw no change. However, some experts have criticized this research as not being sufficiently blinded. Other double-blind studies — including one published in 1997, but with most published in the late 70s and early 80s — concluded that as many as 30 percent of children with ADHD responded positively to elimination diets. Unfortunately, more recent research on the subject has been sparse.

Where can I learn more?

Sandy Newmark, M.D., wrote an in-depth article on elimination diets called “Testing for Food Sensitivities.” You can also learn more about food allergies and sensitivities at www.foodallergy.org. To consult a registered dietician to help you implement an elimination diet, go to www.eatright.org/find-an-expert.

Sources:

https://www.additudemag.com/adhd/article/9807.html
https://www.additudemag.com/slideshow/180/slide-1.html
http://thelancet.com/journals/lancet/article/PIIS0140-6736(10)62227-1/abstract
https://www.ncbi.nlm.nih.gov/pubmed/2909977
https://www.ncbi.nlm.nih.gov/pubmed/353681
https://www.ncbi.nlm.nih.gov/pubmed/9257090

6 reviews

  1. We tried an elimination diet when my son was first diagnosed at 4 years old. Did it for about 6-8 months. We did not notice a difference in his behavior. If anything, it made it worse because he HATED having to give up certain foods and didn’t understand why he couldn’t eat what everyone else was eating @ home & school and that caused major tantrums.

    Also, it’s pretty much a part-time job to plan, shop and prepare these kinds of meals. If you work a full-time job it’s virtually impossible to keep up with all of it.

    You’ll have to take your own food for him to everything—birthday parties, school functions, camps, church activities, etc. if you want him to have any kind of social life.

    The amount of time, energy & money spent doing this FAR outweighed any benefits that we saw.

    I’ve heard that other people had great success with it; we didn’t.

  2. Unfortunately, we had the exact same experience/lack of results as did ANMom. In a desperate bid to avoid medications, we’ve been willing to try everything under the sun, and had read very encouraging things about this, but it didn’t work for us, though it has for others, so I would definitely give it a go. We did the gluten-free casein-free diet, and pretty much eat organic and preservative/additive-free foods anyways. My son (7 years-old) also felt very frustrated with the restrictions of the GFCF diet, and it was crazy time-consuming and expensive for my husband and I, who both work full time and also have a 2 year-old. I will say, however, that it was enlightening to learn how pervasive gluten is, and we’ve definitely added a lot of GF products into our diet, especially since they are becoming more readily available and mainstream. I thought GFCF was pretty manageable if you had time to cook everything fresh (we did a lot of tacos, pasta, fish, etc), but school lunches & just being out & about were really difficult. GF is pretty easy to do, but CF isn’t. We’re now trying Synaptol, a homeopathic medicine, and he’s been on it for a couple of weeks, but I haven’t seen any improvement. Keeping my fingers crossed, still.

  3. I also had a similar experience with an elimination diet when my daughter was first diagnosed. She was seven and we discovered her “triggers” to be sugar, colouring, and dairy (big surprise). She felt utterly deprived! With lots of coaxing, we hung in for about 6 months. At that point we decided to do a two week trial of meds. The difference was like a miracle! The clincher was when her reading teacher approached me to say that she wasn’t sure what happened but reading had suddenly “clicked”. We have never looked back and have never regretted our decision.

    We still pay attention to diet, high protein breakfast, no “treats” during the school day, but we are by no means vigilant. We had to find the happy medium for our family. We had to find small powerful changes that felt reasonable to her and to us. That’s what worked for us anyway.

    We also supplement with omega 3 to try to keep her med dosage lower.

  4. I have Crohns and probably Attention Problems but my son has been diagnosed with ADHD and just recently with Dyslexia.

    My intestinal issues have led to many other problems but since I started the Specific Carbohydrate Diet (by Elaine Gottschall, http://www.breakingtheviciouscycle.info/)
    I have been seeing a huge difference in my brain function: concentration and memory.

    We started our son on a bit of this diet (as we have a hard time removing all grains, milk, sugars and carbs but have managed to cut back a lot). We have also added omega 3, digestive enzymes, probiotics and multivitamins called FOCUS. In doing these little things, our son has managed to make a big breakthrough in his learning and his reading and writing skills along with his concentration have improved tremendously. His teacher even asking if we had changed or raised his medication as in class, he was a lot more on task, on time with the others and really doing well. We strongly believe in this diet and the positive effects of it. In learning recently that our son is also dyslexic, we are going to implement a lot more of this diet and see what the effects on his learning will be. We strongly recommend you read the book and follow as much as you can. Your child will benefit from it 100%.

  5. We tried a gluten-free diet with our son, and over 30 days, he was 80% less likely to get in trouble at school than the previous 6 months.

    So, we are sticking to gluten-free as much as possible on school days, especially for breakfast & lunch. It doesn’t solve all his symptoms, but he does behave “better” at school.

  6. My 9 year-old son with ADHD is on an elimination diet (and no meds) and it is working really well for him. So well that you can tell when he cheats, it’s very apparent. I would say that the effects are not as strong as when he was on meds, but fairly close, and with no side effects. Before meds he was wild at home and very inattentive at school. So inattentive that by the end of first grade he hadn’t completed enough work to go on to second grade. He wasn’t dumb, he just couldn’t sit still long enough to get work done and learn. Second time around for first grade we medicated him and by October he had progressed so far that they bumped back up to second grade where he belonged. But the rollercoaster of emotional side-effects, the all-nighters when he couldn’t sleep due to his meds, the lack of weight gain and then the weight loss, the midnight hallucinations, the unexplained hives, the variety of drugs we tried, his lack of sparkle and personality, all this crap just got to be too much for us all. We gave him a medication vacation over the summer break and tried the elimination diet to help save our sanity over break with him off meds. It worked so well we never went back to meds. Now on the diet all the side effects are gone, he has gained a ton of weight (in a good way), and his symptoms are controlled so well that several people have thought that he was still on meds. He is also keeping up with his grade level work and even did above average on his standardized testing. For us we get the best results when we avoid the things he is sensitive to (we had food sensitivity testing done by a naturopath). For him it is gluten first and foremost, that gets the biggest reaction. But other things that affect him are milk, soy, dyes, and artificial ingredients—just to a lesser extent.

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