ASSESSING THE EFFICACY OF THE FEW FOOD DIET (FFD) IN MANAGING SYMPTOMS OF ATTENTION DEFICIT AND HYPERACTIVITY DISORDER (ADHD )

Abstract Attention Deficit Hyperactivity Disorder (ADHD) is a severe neurodevelopmental disorder characterized by challenges in focus, energy regulation, impulsivity, and emotional management. Its high prevalence across childhood and adulthood, coupled with its profound impact on individuals' lives, positions ADHD as a focal point in psychiatric research. Fluctuations in symptom development based on the types of consumed food have long been suspected by doctors and parents. However, the exact triggers and mechanisms behind these changes have remained unclear. In 1985, Professor Egger suspected that these changes might be related to food allergies, leading him to design The Few-Food Diet (FFD) and conducted his studies. This dietary intervention aims to introduce a limited number of hypoallergenic foods for a 2-week time period. It serves as the first step in establishing an individualized diet for those who respond, followed by the gradual addition of potentially reactive foods. This innovative approach has emerged as a potential method for managing ADHD symptoms. Despite FFD's proven effectiveness in reducing ADHD symptoms, recent research has indicated that it is not related to food allergy reactions, therefore exact mechanism remains unclear. This systematic review thoroughly examines studies up to April 2023, with the aim of establishing a scientific conclusion about the FFD's effectiveness in managing ADHD. The studies are categorized into open randomized and controlled double-blinded trials, seeking to unveil FFD's potential as either a standalone or adjunctive therapy. In these studies, various scales of measurement are employed to quantitatively assess the severity of ADHD symptoms. Scales such as the ADHD Rating Scale (ARS), Abbreviated Conner Score (ACS), and CPRS-48 are utilized to meticulously examine the changes in ADHD symptoms before and after a two-week FFD intervention period. To understand whether these changes are statistically significant, p-values are calculated using the scores before and after the FFD diet intervention. Additionally, the ratio of individuals who respond to the FFD is determined; only individuals who show a reduction of 40 or more in ADHD symptom scores are categorized as responders. When evaluating the efficacy of FFD based on the conducted studies, it becomes evident that five of the open randomized studies strongly support the effectiveness of the FFD. Likewise, the results from the four controlled studies also confirm the positive impact of the FFD in alleviating symptoms of ADHD. These combined findings strongly emphasize the feasibility of FFD as an alternative or adjunctive therapy for ADHD. Considering the effectiveness range of 50% to 70%, it is clear that FFD is not a universally applicable method but holds significant potential for a substantial number of individuals, particularly when the challenges associated with medications are taken into account. By highlighting the potential of personalized dietary interventions, this research reshapes conventional approaches, broadening the scope of ADHD management strategies.