飲食與注意力不足過動症的關係
有人懷疑注意力不足過動症與飲食存在關聯。關注的焦點主要為食品添加物、人工色素、含糖食物和衍生的食物過敏、食物不耐、和維他命、礦物質及Ω-3脂肪酸等營養素的缺乏[1]。整體來說,飲食並不會影響一個人的言行舉止到需要就醫的情形,而且飲食也不是絕大多數注意力不足過動症的成因。[2] 只有極少數人的言行舉止會受到食品添加物、人工色素、攝取過度的糖分、缺乏維生素礦物質與Ω-3脂肪酸的的影響。[2]
食品添加物與人工色素
迄今未有證據能證明「食品添加物與人工色素」會導致兒童出現食物不耐症和注意力不足過動症的症狀。[3]:452 雖然有些人工色素可能真的會誘發些本來就帶有食物不耐症和注意力不足過動症基因或體質的人之症狀,但這個結論的證據力被認為是薄弱的,因為那些文獻似乎存在「不中立(bias)」、「統計數據的樣本數不足」的問題。[1][4][5]
血糖控制
研究發現,讓ADHD患者改用無糖飲食,並不會顯著改善其ADHD的症狀;平常少吃含糖食物的人,改吃較多量的含醣食物後,也未出現ADHD的症狀。[6] 然而不排除仍有極少數的人對於糖較為敏感,畢竟多數研究所使用的含糖食物,其所含的糖分,都不至於到非常高的地步。[7]
精緻糖
有些人認為攝取糖分、甜食、人工香料(包含:阿斯巴甜)等會導致過動[8],不過一旦回顧那些曾經比較學齡兒童和學齡前兒童的對照實驗會發現,受試者即便將糖分攝取至遠高於正常範圍的程度,對受試者的「注意力」及「行為」並沒有產生影響[9],如果將實驗組成員(受試者)換成是「其父母對糖分敏感的兒童試驗者」,得到的結果也相同。[10]
除此之外,美國小兒科醫學會舉出一個研究顯示,數名被其父母認為對糖分有反應的(reactive)的男孩子,當攝取較多量的糖分時,反而會變得較不活躍。[11] 美國小兒科醫學會另表示,不同研究人員通過數項比對血糖的研究,都得到ADHD患者與非ADHD患者在生活中的糖分攝取量並無不同的結論[11][12]。據此,「美國小兒科醫學會」決定不建議患者透過任何「特別飲食」來治療ADHD。[11]
MedlinePlus則表示,精緻糖可能對孩子的活動量有些許 影響,MedlinePlus認為精緻糖和碳水化合物能快速進入血管中,使血糖迅速升高,這可能使得孩子變得較為活躍。[8]雖然MedlinePlus不認為攝取精緻糖與ADHD有直接關係,仍建議不要過量甚至建議節制精緻糖的攝取,並且以更健康的飲食型態取而代之。[8]
截至2019年7月,沒有任何科學證據顯示糖、或甜食(包括:糖分含量遠高於一般菜餚的食物)會影響人類的行為或導致ADHD[13] [11][8][14][15]。
魚油
有些研究指出,Ω-3脂肪酸在ADHD患者的血液中,含量較低。[16] 然而,「Ω-3脂肪酸在血液中的濃度是否會直接導致或改變ADHD的症狀」以及「ADHD患者中較低的Ω-3脂肪酸濃度之成因」,迄今仍不得而知。[16][17] 而「攝取Ω-3脂肪酸是否能改善ADHD的核心症狀」,學術界的研究至今仍未有結論。[18]
維生素與礦物質
補充維生素和礦物質(例如:維他命B群、維他命C、鐵、鎂及碘等)對於改善ADHD病情的功效,尚有待更多的實驗證明。[19][20][21][註 1] (页面存档备份,存于)</ref> 在美国,没有膳食补充剂被 FDA 批准用于治疗多动症。[23]
一些用于管理多动症症状的流行补充剂:
- 咖啡因 — 多动症与咖啡因摄入量增加有关,咖啡因对认知的刺激作用可能对多动症有一些好处。[24] 有限的证据表明,其治疗效果明显不如哌醋甲酯和右旋安非他命等标准治疗,但仍会产生类似或更大的副作用。[24][25]
- 尼古丁 — 多动症和尼古丁摄入之间的关联是众所周知的,有限的证据表明尼古丁可能有助于改善多动症的某些症状,尽管效果通常很小。[26][27][28]
- Omega-3 脂肪酸 — 2012 年 Cochrane 综述发现,几乎没有证据表明补充 omega-3 或其他多不饱和脂肪酸可以改善儿童或青少年的 ADHD 症状。[29]2011 年的一项荟萃分析发现了“小而显着的益处”,其益处“与目前可用的 ADHD 药物治疗的功效相比是适度的”。[30] 该评论得出结论,由于其“相对良性的副作用”,补充剂可能值得考虑作为与药物组合的增强治疗,但不作为主要治疗。[30] 大多数关于 Omega-3 脂肪酸的研究被认为质量很差,存在广泛的方法学缺陷。[29][30]
- 锌 – 尽管锌在 ADHD 中的作用尚未阐明,但有少量有限证据表明较低的组织锌水平可能与 ADHD 相关。[31] 在没有证明缺锌的情况下(在发展中国家以外很少见),不建议将补锌作为 ADHD 的治疗选择。
註解
- 攝取過多的維他命可能產生健康問題。[22]
文獻
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In some cases, a special diet of foods without artificial flavors or colors works for a child, because the family and the child interact in a different way when the child eliminates these foods. These changes, not the diet itself, may improve the behavior and activity level.
Refined (processed) sugars may have some effect on children's activity. Refined sugars and carbohydrates enter the bloodstream quickly. Therefore, they cause rapid changes in blood sugar levels. This may make a child become more active.
Several studies have shown a link between artificial colorings and hyperactivity. On the other hand, other studies do not show any effect. This issue is yet to be decided. - Kanarek, RB. . Nutrition reviews. 1994, 52 (5): 173–5. ISSN 0029-6643. PMID 8052458.
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Recommendations. There are many reasons to limit the sugar a child has other than the effect on activity level.
A diet high in sugar is a major cause of tooth decay.
High-sugar foods tend to have fewer vitamins and minerals. These foods may replace foods with more nutrition. High-sugar foods also have extra calories that can lead to obesity.
Some people have allergies to dyes and flavors. If a child has a diagnosed allergy, talk to a dietitian.
Add fiber to your child's diet to keep blood sugar levels more even. For breakfast, fiber is found in oatmeal, shredded wheat, berries, bananas, whole-grain pancakes. For lunch, fiber is found in whole-grain breads, peaches, grapes, and other fresh fruits.
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