ADHD Medication & Treatment

Elimination Diet

How to identify food sensitivities that may impact ADHD symptoms.

What is an elimination diet?

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:

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.
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.
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 an elimination diet 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 about elimination diets?

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.