Trialling a microbiome-targeted dietary intervention in children with ADHD—the rationale and a non-randomised feasibility study.

Journal article


Lawrence, K., Myrissa, K., Toribio-Mateas, M., Minini, L. and Gregory, A. (2022). Trialling a microbiome-targeted dietary intervention in children with ADHD—the rationale and a non-randomised feasibility study. Pilot and Feasibility Studies. 8 (108). https://doi.org/10.1186/s40814-022-01058-4
AuthorsLawrence, K., Myrissa, K., Toribio-Mateas, M., Minini, L. and Gregory, A.
Abstract

Background
Dietary interventions have been previously explored in children with ADHD. Elimination diets and supplementation can produce beneficial behaviour changes, but little is known about the mechanisms mediating change. We propose that these interventions may work, in part, by causing changes in the gut microbiota. A microbiome-targeted dietary intervention was developed, and its feasibility assessed.

Methods
A non-randomised feasibility study was conducted on nine non-medicated children with ADHD, aged 8–13 years (mean 10.39 years), using a prospective one-group pre-test/post-test design. Participants were recruited from ADHD support groups in London and took part in the 6-week microbiome-targeted dietary intervention, which was specifically designed to impact the composition of gut bacteria. Children were assessed pre- and post-intervention on measures of ADHD symptomatology, cognition, sleep, gut function and stool-sample microbiome analysis. The primary aim was to assess the study completion rate, with secondary aims assessing adherence, adverse events (aiming for no severe and minimal), acceptability and suitability of outcome measures.

Results
Recruitment proved to be challenging and despite targeting 230 participants directly through support groups, and many more through social media, nine families (of the planned 10) signed up for the trial. The completion rate for the study was excellent at 100%. Exploration of secondary aims revealed that (1) adherence to each aspect of the dietary protocol was very good; (2) two mild adverse events were reported; (3) parents rated the treatment as having good acceptability; (4) data collection and outcome measures were broadly feasible for use in an RCT with a few suggestions recommended; (5) descriptive data for outcome measures is presented and suggests that further exploration of gut microbiota, ADHD symptoms and sleep would be helpful in future research.

Conclusions
This study provides preliminary evidence for the feasibility of a microbiome-targeted dietary intervention in children with ADHD. Recruitment was challenging, but the diet itself was well-tolerated and adherence was very good. Families wishing to trial this diet may find it an acceptable intervention. However, recruitment, even for this small pilot study, was challenging. Because of the difficulty experienced recruiting participants, future randomised controlled trials may wish to adopt a simpler dietary approach which requires less parental time and engagement, in order to recruit the number of participants required to make meaningful statistical interpretations of efficacy.

KeywordsGut microbiome; ADHD; Kefir; Gut-brain axis
Year2022
JournalPilot and Feasibility Studies
Journal citation8 (108)
PublisherSpringer
ISSN2055-5784
Digital Object Identifier (DOI)https://doi.org/10.1186/s40814-022-01058-4
Web address (URL)https://pilotfeasibilitystudies.biomedcentral.com/articles/10.1186/s40814-022-01058-4
Publication dates
Print23 May 2022
Publication process dates
Accepted03 May 2022
Deposited27 May 2022
Publisher's version
License
File Access Level
Open
Supplemental file
License
File Access Level
Open
Permalink -

https://openresearch.lsbu.ac.uk/item/8zz2q

Download files


Publisher's version
s40814-022-01058-4.pdf
License: CC BY 4.0
File access level: Open

  • 22
    total views
  • 7
    total downloads
  • 0
    views this month
  • 0
    downloads this month

Export as

Related outputs

Integrated multi-omics of the gut microbiome: assessing the beneficial effects of fermented foods to human health
Bester, A., Toribio-Mateas, M., Mileva, K. and Gaoua, N. (2022). Integrated multi-omics of the gut microbiome: assessing the beneficial effects of fermented foods to human health. Exploring Human Host-Microbiome Interactions in Health and Disease. Hinxton, Cambridge 05 - 07 Dec 2018 Wellcome Connecting Science Courses and Conferences. https://doi.org/10.13140/RG.2.2.10244.58246
Reference values for intake of 6 types of soluble and insoluble fibre in healthy UK inhabitants based on the UK Biobank data.
Shevlyakov, A., Nikogosov, D., Stewart, Leigh-Ann and Toribio-Mateas, M. (2021). Reference values for intake of 6 types of soluble and insoluble fibre in healthy UK inhabitants based on the UK Biobank data. Public health nutrition. https://doi.org/10.1017/S1368980021002524
Diet and the microbiome in precision medicine
Toribio-Mateas, M. and Bester, A. (2021). Diet and the microbiome in precision medicine. in: Faintuch, Joel and Faintuch, Salomao (ed.) Precision Medicine for Investigators, Practitioners and Providers Academic Press. pp. 445-452
Impact of Plant-Based Meat Alternatives on the Gut Microbiota of Consumers: A Real-World Study
Toribio-Mateas, M., Bester, A. and Klimenko, N. (2021). Impact of Plant-Based Meat Alternatives on the Gut Microbiota of Consumers: A Real-World Study. Foods (Basel, Switzerland). 10 (9), p. 2040. https://doi.org/10.3390/foods10092040
Neuroprotection, Aging, and the Gut–Brain Axis
Toribio-Mateas, M. (2019). Neuroprotection, Aging, and the Gut–Brain Axis. in: Bakhru, Aruna (ed.) Nutrition and Integrative Medicine: A Primer for Clinicians CRC Press - Taylor and Francis Group. pp. 177-196
Harnessing the Power of Microbiome Assessment Tools as Part of Neuroprotective Nutrition and Lifestyle Medicine Interventions
Toribio-Mateas, M (2018). Harnessing the Power of Microbiome Assessment Tools as Part of Neuroprotective Nutrition and Lifestyle Medicine Interventions. Microorganisms. 6 (2), pp. 35-35. https://doi.org/10.3390/microorganisms6020035