Attention deficit is a very common disease especially in childhood, but it is a disease that usually progresses with hyperactivity disorder. Attention deficit is a disorder that compels children in many areas, from their social life to their quality of life. Children with attention deficit disorder experience problems such as learning disorders, depression, internalizing, and behavioral deterioration, and it is very important to evaluate these behaviors. During the treatment process, attention should not be directed only to the symptoms of attention deficit. >Attention deficit usually continues with hyperactivity disorder and the disease begins to show symptoms before the age of 7 in children (Koca & Altuntaş, 2020). These symptoms are not suitable for normal development and continue as age-appropriate mobility, impulsivity, and lack of attention span (Koca & Altuntaş, 2020).
Children with attention deficit have some symptom criteria. These symptom criteria are called DSM-IV criteria (Öner et al., 2003). Inattention symptoms must persist and be followed for at least six months. These symptoms are given below (Deniz, 2008).
• Usually cannot pay attention to details, makes careless mistakes in homework or activities.
• Distracts attention in tasks or games played.
• Often does not seem to listen when spoken to.
• Usually avoids tasks that require mental effort and does not like to do these tasks.
• Activities or tasks He often loses things for himself. (Toys, pencils, books, school assignments)
• Often does not follow directions and cannot complete schoolwork and minor tasks.
• Distracts quickly due to external stimuli.
• Often experiences forgetfulness (Deniz, 2008).
Nutrition Therapy in Attention Deficit Disease
According to studies conducted for ADHD, three patients diagnosed with ADHD The number of children has increased with an upward trend over the years, hence the need for effective non-medical interventions to reduce symptomology (Reddy et al., 2018). Medication is also used for children with ADHD, but drug therapy may not be beneficial in all children and may cause concerns about the side effects of drugs when it is considered to be used for a long time. Therefore, it is more appropriate to apply diet therapy to reduce symptoms. (Heilskov Rytter et al., 2015). Nutritional status in ADHD patients tends to worsen with long-term treatment due to pharmacological drugs, suggesting that it is necessary to know the dietary intake of these patients during treatment (Durá-Travé and Gallinas-Victoriano, 2014). Pharmacological treatment may be beneficial in ADHD, but many affected individuals continue to have difficulties in cognitive functions despite medical treatment, and up to 30% do not respond to pharmacological treatment (Bikic et al., 2015). Inadequate medical compliance and the long-term effects of treatment make it necessary to explore non-pharmacological and complementary therapies for ADHD. Identifying health-related behavioral risk factors, including diet quality, physical development, and sedentary activities in ADHD, is very important for improving cognitive health (Wu et al., 2016). Dietary patterns of calorie and food intake should be evaluated in patients diagnosed with ADHD, and nutritional intervention strategies should be designed in these patients (Durá-Travé and Gallinas-Victoriano, 2014). An unhealthy diet pattern characterized as a diet high in sugar, salt, and saturated and total fat while low in sugar has been associated with increased ADHD symptoms (Wu et al., 2016). In children with attention deficit and hyperactivity disorder, vegetable proteins such as soy, quinoa and beans provide benefits in blood sugar control and meat products in terms of avoidance of chemical and hormone additives (Burstedde et al., 2010). Various diets are recommended to reduce attention deficit symptoms. According to these diets, sugar restriction, additives and preservatives Substance-free food products should be used and fatty acid supplements should be available (Millichap and Yee, 2012). Considering children with ADHD, it would be more accurate to apply diet practices in two ways. The first is to follow an elimination diet, and the second is to interfere with certain foods that increase harmful food intake (Heilskov Rytter et al., 2015).
Elimination Diets
Elimination diet was first used to treat food allergies (Ly et al., 2017) Elimination diet can be considered as an alternative dietary strategy and It is a diet model that aims to experimentally eliminate the food allergens that are most likely to trigger allergies, independent of the allergy test, after these foods are removed from the diet, and the situation is evaluated by making a decision (Molina-Infante et al., 2014). Elimination diets vary in different ways according to the frequency and the eliminated food (Ly et al., 2017). According to the elimination diet, some foods are removed from the diet and the situation is evaluated (Heilskov Rytter et al., 2015).
Children with ADHD may show behavioral changes when exposed to certain foodstuffs, these are artificial food colorings, additives and sugars (Heilskov Rytter et al., 2015). According to the elimination diet, refined carbohydrates, sugars, foods containing additives and processed foods should be completely excluded from the diet (Burstedde et al., 2010). Diets that exclude food additives and oligoantigentic diets are applied in ADHD (Ly et al., 2017). Organic fruits, vegetables and meat of free-range animals should be consumed as much as possible in attention deficit and hyperactivity disorder (Burstedde et al., 2010).
Artificial Food Coloring and Other Additives
Attention deficit in children is a problem that arises with the combination of factors such as mental problems, genetic transmission, environmental factors and nutrition, and the most important factors are environmental factors and nutrition (Büyükdere and Ayaz, 2016). It has been observed that children with ADHD show hypersensitivity to additives and cause atomic symptoms (Burstedde et al., 2010).
Additive and color additives, especially in school-age children It is seen that the symptoms are significantly reduced when a nutritious food diet is made. According to studies, it has been reported that hyperactivity disorder is caused by the consumption of some nutrients and food additives (Büyükdere and Ayaz, 2016).
Sugar and Artificial Sweeteners
Attention Excessive consumption of refined carbohydrates and sugar in children with deficiency and hyperactivity disorder may negatively affect learning ability, and there are studies showing that there is a direct link in increasing aggressive and restless behaviors in children (Burstedde et al., 2010). Lifestyle behaviors such as nutritional quality, lack of physical activity and inactivity have been examined, and various studies have shown that unhealthy eating models also increase the risk of ADHD (Wu et al., 2016). Artificial food dyes, colours, sweeteners, fruits and vegetables containing natural salicylates should be excluded from the diet (Heilskov Rytter et al., 2015). If positive results are observed on hyperactivity symptoms by removing these foods from the diet, this diet should be continued (Heilskov Rytter et al., 2015).
Several Foods Diet
A few foods diet is a strict diet type that lasts 2-4 weeks, which includes foods with very low allergen effects (Şanlıer, 2020). It is one of the dietary approaches applied for attention deficit and hyperactivity disorder and is referred to as a few food approaches, in fact, it is a restricted elimination diet. In a study, it was revealed that several food diets showed improvement towards 50% improvement in children (Burstedde et al., 2010).
GAPS Diet
GAPS's If we look at its expansion, it is intestinal and psychology syndrome and is a natural treatment method (Çıkıllı et al, 2019). The GAPS diet is a diet applied to eliminate the toxic fog structure on the brain and to run the brain as it should (Çıkıllı et al, 2019). In this diet, it is aimed to purify the person from toxins (Çıkıllı et al, 2019). In order to cleanse the patient from toxins, it is necessary to clean and heal the digestive tract as the first way, and then to purify the rest of the body from toxins (Çıkıllı et al, 2019). GAPS diet 3 a� It consists of stages, the first of which is the introductory diet, the second is the full GAPS diet and the exit from the GAPS diet (Çıkıllı et al, 2019).
Nutrition Principles in Children with ADHD
Diet Previous studies on the effect of factors on ADHD have shown that supplements of certain foods or nutrients (eg, omega-3 fatty acids, zinc, magnesium) should be taken and harmful foods (eg sugar) should be restricted or eliminated (Wu et al., 2016).
According to the diet listed by PubMed, it is recommended to switch from a western diet to a healthy diet. Additive-free and oligoantigenic/elimination diets are time consuming, so the emphasis is on applying this management in selected patients only. Iron and zinc supplements should be made in patients with deficiency. In addition, omega-3 support is of great importance in treatment. In addition to all these, nutrition education should be given to parents and children on what should be considered in order to establish a healthy diet (Millichap & Yee, 2012).
Therapeutic Dietary Interventions
Parents who are concerned about the side effects and long-term use of pharmacological treatment have turned to alternative treatment methods. Complementary and alternative medicine (CAM) offers parents a variety of treatment options, including dietary changes, nutritional supplements, herbal remedies (Burstedde et al., 2010). Two different diet models have been determined for attention deficit and hyperactivity disorder. These are the 'western' and 'healthy' diet patterns. While the Western diet model is associated with the definition of attention deficit, the healthy diet model is not associated with the definition of disease. According to the Western diet model; It contains higher total fat, saturated fat, refined sugar and sodium, and is deficient in n-3 fatty acids, fiber and folate. This diet model allows the consumption of snack foods rich in fat content and causes an increase in obesity (Şanlıer, 2019). It has been studied that probiotic therapy in children with ADHD is beneficial for atopic conditions such as eczema in children, and may also be useful for hypersensitivity in ADHD responses as an immune mediator (Burstedde et al., 2010)
It is also essential in nutrition.
Read: 0
