Evidence map›Paper›PMID 22176942›Full record

SynthesisJournal of the American Academy of Child and Adolescent Psychiatry2012

Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives.

Joel T Nigg, Kara Lewis, Tracy Edinger, Michael Falk

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of the American Academy of Child and Adolescent Psychiatry, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
76citing papers in PubMed, 6 pooled it
8.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

76 citing papers in PubMed, 6 syntheses or guidelines pooled it, 250 citations in OpenAlex.

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  17. Annual Research Review: Micronutrients and their role in the treatment of paediatric mental illness.Journal of child psychology and psychiatry, and allied disciplines · 2025
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16 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Joel T NiggOregon Health and Science University, Portland, OR, USA. niggj@ohsu.edu
Kara Lewis
Tracy Edinger
Michael Falk
Life Sciences Research Foundation · USOregon Health & Science University · US

Funding

NEUROPSYCHOLOGICAL AND FAMILIAL MARKERS FOR CHILD ADHDR01MH059105 · NIMH · OREGON HEALTH & SCIENCE UNIVERSITY · PI NIGG, JOEL T · 1999 to 2012
$3.3M
NIMH NIH HHS R01 MH059105
6 · The paper itself

Abstract

objectiveThe role of diet and of food colors in attention-deficit/hyperactivity disorder (ADHD) or its symptoms warrants updated quantitative meta-analysis, in light of recent divergent policy in Europe and the United States.

methodStudies were identified through a literature search using the PubMed, Cochrane Library, and PsycNET databases through February 2011. Twenty-four publications met inclusion criteria for synthetic food colors; 10 additional studies informed analysis of dietary restriction. A random-effects meta-analytic model generated summary effect sizes.

resultsRestriction diets reduced ADHD symptoms at an effect of g = 0.29 (95% CI, 0.07-0.53). For food colors, parent reports yielded an effect size of g = 0.18 (95% CI, 0.08-0.24; p = .0007), which decreased to 0.12 (95% CI, 0.01-0.23; p < .05) after adjustment for possible publication bias. The effect was reliable in studies restricted to food color additives (g = 0.21, 95% CI = 0.06-0.36) but did not survive correction for possible publication bias and was not reliable in studies confined to Food and Drug Administration-approved food colors. Teacher/observer reports yielded a nonsignificant effect of 0.07 (95% CI = -0.03 to 0.18; p = .14). However, high-quality studies confined to color additives yielded a reliable effect (g = 0.22, 95% CI = 0.10-0.41, p = .030) that survived correction. In psychometric tests of attention, the summary effect size was 0.27 (95% CI = 0.07-0.47; p = .007) and survived correction. An estimated 8% of children with ADHD may have symptoms related to synthetic food colors.

conclusionsA restriction diet benefits some children with ADHD. Effects of food colors were notable were but susceptible to publication bias or were derived from small, nongeneralizable samples. Renewed investigation of diet and ADHD is warranted.

Indexed as

AttentionAttention Deficit Disorder with HyperactivityFood Coloring AgentsHumansNeuropsychological TestsUnited StatesFood Coloring Agents

Identifiers

PMID22176942
PMCPMC4321798
OpenAlexW2141557060

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.