*Article* **Individual Behavioral Reactions in the Context of Food Sensitivities in Children with Attention-Deficit/Hyperactivity Disorder before and after an Oligoantigenic Diet**

**Elena Yorgidis †, Lisa Beiner †, Nicola Blazynski †, Katja Schneider-Momm, Hans-Willi Clement, Reinhold Rauh , Eberhard Schulz, Christina Clement \*,‡ and Christian Fleischhaker \*,‡**

> Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, Medical Center—University of Freiburg, D-79104 Freiburg, Germany; elena.yorgidis@gmx.de (E.Y.); lisa.beiner@uniklinik-freiburg.de (L.B.); n.blazynski@gmail.com (N.B.); katja.schneider-momm@uniklinik-freiburg.de (K.S.-M.); hans-willi.clement@uniklinik-freiburg.de (H.-W.C.);

reinhold.rauh@uniklinik-freiburg.de (R.R.); profeberhardschulz@gmx.de (E.S.)

**\*** Correspondence: christina.clement@uniklinik-freiburg.de (C.C.);

christian.fleischhaker@uniklinik-freiburg.de (C.F.); Tel.: +49-761-270-68620 (C.F.); Fax: +49-761-270-69490 (C.F.) † The authors contributed equally to this work.

‡ These authors share senior authorship.

**Abstract:** The influence of food intake on behavior problems of children with Attention-Deficit/ Hyperactivity Disorder (ADHD) was already described in the early 20th century. Eliminating food components by using the Oligoantigenic Diet (OD) leads to reduction of ADHD symptoms for more than two-thirds of patients. The aim of our study was to reveal how to identify foods having an impact on ADHD symptomatology. Therefore, 28 children with ADHD participating in this uncontrolled, open trial were examined before and after a restricted elimination diet. They kept a daily 24-h recall nutrition and behavior journal and filled out the abbreviated Conners' scale (ACS) to identify foods which increased ADHD symptoms. The study was completed by 16 children (13 m/3 f). After four weeks of elimination diet the individual food sensitivities were identified in a reintroduction phase. A repetitive increase of ADHD symptoms by at least two points in ACS after food introduction hints at food sensitivity. Twenty-seven food sensitivity reactions were identified. Most of the participants were sensitive to more than one food. Food intolerances could not be identified without preceding OD. The combination of OD and subsequent food challenge appears as a valid method to identify individual food sensitivity in ADHD.

**Keywords:** adolescents; attention-deficit/hyperactivity disorder; behavior; child; diet; elimination; food intolerance; nutrition; Oligoantigenic Diet
