Systematic review: Mediterranean diet adherence and health outcomes in children and adolescents with ADHD and OCTD

Background Mediterranean diet (MD) is linked to improved health outcomes in children and adolescents. While prior research suggests that individual components of the MD, such as omega-3 fatty acids, may improve cognitive function and behavior in individuals with special educational needs (SEN), it is not known the association between adhering to MD and the symptomatology of SEN. Aim To systematically identify and evaluate the association between adherence to the MD and the diagnosis, symptomatology, and/or well-being of children and adolescents diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive-Compulsive Tics Disorder (OCTD), conditions classified as SEN. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a literature search was carried out on MEDLINE, Scopus, and Web of Science, from February to June 2024. Studies were included according to the following criteria: studies written in English or Portuguese; participants ≤19 years old; evaluation of MD using specific scores; and SEN diagnosis and/or symptomatology/well-being. This systematic review was also registered at PROSPERO as CRD42024527230. Results Six studies were included, investigating two specific conditions within the SEN umbrella: ADHD (five studies) and OCTD (one study). Studies found that higher adherence to the MD was associated with reduced symptoms of OCTD and ADHD. Also, a lower likelihood of ADHD diagnosis or having ADHD was associated with children and adolescents adhering more to MD. Conclusion This systematic review suggests that higher adherence to the MD is linked to lower prevalence and symptom severity of ADHD and OCTD in children and adolescents with SEN. However, future research is needed to confirm these results.