With regard to attention-deficit hyperactivity disorder (ADHD) treatment without stimulants (Item 125-8), I advise parents to eliminate all junk food, fast food, and processed food from their child’s diet. Kids are typically fast oxidizers, and foods with with artificial coloring, flavoring, and preservatives stimulate hyperactivity. Children need a diet high in protein and (good) fat. Of course I also encourage more fruits and vegetables. The use of fish-oil supplements high in docosahexaenoic acid has made a huge difference in many of my patients with ADHD. Behavior modification should also be addressed. If more information is needed, hair analysis can reveal mineral patterns (e.g., high copper) that stimulate neurotransmitters. This can be corrected with nutritional supplements.
—KERRY SAUSER, ARNP, ND, Atlantic, Iowa

There is a wonderful review of ADHD treatments in which the quality of the evidence is judged as well as the results of the studies (J Child Adolesc Psychopharmacol. 2008;18:413-447). The authors rated the evidence of efficacy of additive-free and few-foods diets at Level B. This means there has been a significant difference on an ADHD outcome variable in at least one randomized controlled trial (RCT), two or more RCTs with mixed results, or one series of single-case design experiments with randomization and control or placebo groups. There does not appear to be clear evidence yet for omega-3 fatty acids (although certainly good for health in general) or other specific nutritional supplements.—Julee B. Waldrop, MS, PNP (130-11)