Healthy nutritional habits should be encouraged in all children independently of the existence or non-existence of neurodevelopmental disorders

Different dietary approaches have been attempted for the treatment of attention-deficit/hyperactivity disorder and autism, but only three of them have been subjected to clinical trials: education in healthy nutritional habits, supplementation and elimination diets. On the other hand, for multiple reasons, the number of people who adopt vegetarian and gluten-free diets (GFD) increases daily. More recently, a new entity, non-celiac gluten sensitivity (NCGS), with a still evolving definition and clinical spectrum, has been described. Although, the benefits of GFD are clearly supported in this condition as well as in celiac disease, in the last two decades, GFD has expanded to a wider population. In this review, we will attempt to clarify, according to the existing evidence, which are the myths and facts of these diets. © 2016 S. Karger AG, Basel Published online: June 30, 2016 Sylvia Cruchet, MD Gastroenterología y Nutrición Pediátrica Comunicaciones y RR.PP., Nutrition and Food Technology Institute (INTA) University of Chile , Av. El Líbano 5524, Macul , Santiago (Chile) E-Mail scruchet @ inta.uchile.cl © 2016 S. Karger AG, Basel 0250–6807/16/0685–0043$39.50/0 www.karger.com/anm Key Messages • Healthy and balanced nutrition should be encouraged in children with attention-deficit/hyperactivity disorder (ADHD) and autism. In children with ADHD, dietetic restriction of sugar, sweeteners and elimination of colorants/preservatives improve behavioral and attention performance. Other specific elimination diets should only be recommended to children with demonstrated food allergy. Supplementation with omega-3 fatty acids improves behavior. • A glutenand casein-free diet does not have strong evidence supporting its indication in the management of autism. An exclusion diet is only indicated in children with demonstrated milk and/or wheat allergy. Macroand micronutrient deficiencies have been described in children under this diet, and health professional supervision should be encouraged. • A new entity, non-celiac gluten sensitivity, with a still evolving definition and clinical spectrum, has been described. The benefits of a gluten-free diet (GFD) are clearly supported in these conditions. Until now, no long-term complication has been described in patients not adhering strictly to this diet. • GFD without health professional supervision has risks of vitamin (mainly B vitamins and folic acid) and micronutrient (especially iron and zinc) deficiencies as well as lower fiber intake. • Subjects on a vegetarian diet, especially vegans, are at risk of vitamin B 12 deficiency if they are not adequately supplemented. • A vegetarian diet is a feasible alternative if implemented with supervision by a specialist, especially during vulnerable periods of life. D ow nl oa de d by : 54 .7 0. 40 .1 1 11 /2 6/ 20 17 1 2: 56 :1 5 P M