Effects of High-Protein Diet on Weight and Height Growth in Children with Attention Deficit Hyperactivity Disorder Receiving Ritalin: a Randomized Clinical Trial

Background: Children with Attention-Deficit/Hyperactivity Disorder (ADHD) who take Ritalin may be faced with appetite reduction and weight loss. Herein, we aimed to evaluate the effects of a high-protein diet on weight and height growth in children with ADHD receiving Ritalin. Methods: In this randomized controlled trial, performed during 2016-2018 in Tehran, 50 children with ADHD treated with Ritalin were randomly assigned to the high-protein diet (HPD) group (35% of the total calories intake from protein) or the control group receiving a standard diet (STD) (15% of the total calories from protein). The height and weight were measured in the standard mode and three-day food record was completed at baseline. The measurements were repeated on a monthly basis for 5 months. We used independent sample t-test to analyze the data. The study protocol was registered in the Iranian Registry of Clinical Trials with the code of IRCT2014062116465N4. Results: A total of 40 children and adolescents (19 in HPD and 21 in STD) completed the study. Baseline characteristics between the trial arms were equal. After 5 months, the protein intake of HPD group was significantly higher based on a seven-day food record. In girls’ subgroup, after 5 months, the mean difference concerning height, weight, and BMI change in HPD group compared to the control group were respectively +0.5 cm (P =0.41), -2.5 kg (P=0.04), and -1.6 kg/m2 (P=0.01) while in boys’ subgroup, they were +0.4 cm (P=0.59),+0.3 kg (P =0.37), and+0.02 kg/m2 (P=0.51). Conclusion: Girls responded differently to the HPD. The BMI in the girls decreased significantly after 5 months of HPD consumption as a result of weight loss. This effect was not observed in the boys. This may be due to different patterns of growth and puberty in the two genders