Major clinical implications of adequate nutrition in children and adolescents with attention-deficit/hyperactivity disorder: a concise systematic review

Introduction: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inappropriate levels of impulsive behavior, hyperactivity, and/or inattention, with a worldwide prevalence estimated at around 7% in childhood and adolescence, and around 3 % in adulthood, with a higher prevalence in boys than in girls. Objective: It was to present the main clinical implications of adequate nutrition in children and adolescents with attention-deficit/hyperactivity disorder. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from January to March 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 84 articles were found, 21 articles were evaluated, and 14 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 19 studies with a high risk of bias and 30 studies that did not meet GRADE. Most studies showed homogeneity in their results, with X2=62.8%>50%. Intake of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) fatty acids daily for 8 weeks is associated with less impulsive behavior in children with ADHD. Dietary supplementation with omega-3 fatty acids reduces ADHD symptoms in both individuals with ADHD and typically developing children. A Mediterranean diet may improve BIS results, although our results are not conclusive in this population. The daily intake of calories and nutrients in patients taking methylphenidate is generally lower than in a healthy population of similar age. Co-supplementation of vitamin D and magnesium over 8 weeks may improve behavioral function and mental health in children with ADHD.