62e60d0f2d58ddfa0e76c0d22c31b8da pmc_34836314.pdf 562dd3616d7575b42ae4894ad569ce0bc19b1fed pmc_34836314.pdf 0e9f7fe6338255b1e448c4ff210bc97bc4bfd6091b0f42444e9c586ab8838ff4 pmc_34836314.pdf Title: The Role of Iron and Zinc in the Treatment of ADHD among Children and Adolescents: A Systematic Review of Randomized Clinical Trials Subject: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder common from childhood to adulthood, affecting 5% to 12% among the general population in developed countries. Potential etiological factors have been identified, including genetic causes, environmental elements and epigenetic components. Nutrition is currently considered an influencing factor, and several studies have explored the contribution of restriction and dietary supplements in ADHD treatments. Iron is an essential cofactor required for a number of functions, such as transport of oxygen, immune function, cellular respiration, neurotransmitter metabolism (dopamine production), and DNA synthesis. Zinc is also an essential trace element, required for cellular functions related to the metabolism of neurotransmitters, melatonin, and prostaglandins. Epidemiological studies have found that iron and zinc deficiencies are common nutritional deficits worldwide, with important roles on neurologic functions (poor memory, inattentiveness, and impulsiveness), finicky appetite, and mood changes (sadness and irritability). Altered levels of iron and zinc have been related with the aggravation and progression of ADHD. Objective: This is a systematic review focused on the contribution of iron and zinc in the progression of ADHD among children and adolescents, and how therapies including these elements are tolerated along with its effectiveness (according to PRISMA guidelines). Method: The scientific literature was screened for randomized controlled trials published between January 2000 to July 2021. The databases consulted were Medline, PsycINFO, Web of Science, and Google Scholar. Two independent reviewers screened studies, extracted data, and assessed quality and risk of bias (CONSORT, NICE, and Cochrane checklists used). Conclusion: Nine studies met the eligibility criteria and were selected. Evidence was obtained regarding the contribution of iron-zinc supplementation in the treatment of ADHD among young individuals. The discussion was focused on how the deficits of these elements contribute to affectation on multiple ADHD correlates, and potential mechanisms explaining the mediational pathways. Evidence also suggested that treating ADHD with diet interventions might be particularly useful for specific subgroups of children and adolescents, but further investigations of the effects of these diet interventions are needed. Keywords: ADHD; zinc; iron; treatment; children Author: Roser Granero, Alfred Pardo-Garrido, Ivonne Lorena Carpio-Toro, Andrés Alexis Ramírez-Coronel, Pedro Carlos Martínez-Suárez and Geovanny Genaro Reivan-Ortiz Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue Nov 16 13:28:27 2021 CET ModDate: Tue Nov 16 13:35:08 2021 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 20 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 510166 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- OPZDHV+VnURWPalladioL Type 1 Custom yes yes no 10 0 VALDCW+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 GTVGTW+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 SATJCU+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 IOJCNK+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 HGMNRX+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 36 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 58 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 62 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 66 0 IYELBM+CMSY10 Type 1 Builtin yes yes no 81 0 ONMPDK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 96 0 ONMPEL+PalatinoLinotype TrueType WinAnsi yes yes no 99 0 ONMPEN+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 102 0 ICBUDW+URWPalladioL-BoldItal Type 1 Custom yes yes no 109 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2022-03-22 02:32:04 CET RepresentationInformation: pmc_34836314.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2022-01-10 08:09:57 CET Size: 510166 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 448 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Children: Item: Title: Procedure Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Inclusion and Exclusion Criteria Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Research and Selection of Studies Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Study Quality Assessment Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Children: Item: Title: Descriptive for the Selected Studies Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Assessment of the Methodological Quality, Adherence and Competence Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Assessment of the Risk of Bias of the Included Studies Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Efficacy of Zinc for ADHD Treatment Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: Efficacy of Iron for ADHD Treatment Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: Efficacy of Including Simultaneously Iron and Zinc for ADHD Treatment Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Item: Title: Tolerability Analyses Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77f99a05 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@63440df3 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@3aeaafa6 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@76a3e297 Info: Title: The Role of Iron and Zinc in the Treatment of ADHD among Children and Adolescents: A Systematic Review of Randomized Clinical Trials Author: Roser Granero, Alfred Pardo-Garrido, Ivonne Lorena Carpio-Toro, Andrés Alexis Ramírez-Coronel, Pedro Carlos Martínez-Suárez and Geovanny Genaro Reivan-Ortiz Subject: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder common from childhood to adulthood, affecting 5% to 12% among the general population in developed countries. Potential etiological factors have been identified, including genetic causes, environmental elements and epigenetic components. Nutrition is currently considered an influencing factor, and several studies have explored the contribution of restriction and dietary supplements in ADHD treatments. Iron is an essential cofactor required for a number of functions, such as transport of oxygen, immune function, cellular respiration, neurotransmitter metabolism (dopamine production), and DNA synthesis. Zinc is also an essential trace element, required for cellular functions related to the metabolism of neurotransmitters, melatonin, and prostaglandins. Epidemiological studies have found that iron and zinc deficiencies are common nutritional deficits worldwide, with important roles on neurologic functions (poor memory, inattentiveness, and impulsiveness), finicky appetite, and mood changes (sadness and irritability). Altered levels of iron and zinc have been related with the aggravation and progression of ADHD. Objective: This is a systematic review focused on the contribution of iron and zinc in the progression of ADHD among children and adolescents, and how therapies including these elements are tolerated along with its effectiveness (according to PRISMA guidelines). Method: The scientific literature was screened for randomized controlled trials published between January 2000 to July 2021. The databases consulted were Medline, PsycINFO, Web of Science, and Google Scholar. Two independent reviewers screened studies, extracted data, and assessed quality and risk of bias (CONSORT, NICE, and Cochrane checklists used). Conclusion: Nine studies met the eligibility criteria and were selected. Evidence was obtained regarding the contribution of iron-zinc supplementation in the treatment of ADHD among young individuals. The discussion was focused on how the deficits of these elements contribute to affectation on multiple ADHD correlates, and potential mechanisms explaining the mediational pathways. Evidence also suggested that treating ADHD with diet interventions might be particularly useful for specific subgroups of children and adolescents, but further investigations of the effects of these diet interventions are needed. 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465, 674 Annotation: Subtype: Link Rect: 277, 640, 314, 651 Annotation: Subtype: Link Rect: 59, 607, 97, 617 Annotation: Subtype: Link Rect: 353, 571, 390, 582 Annotation: Subtype: Link Rect: 344, 537, 381, 548 Annotation: Subtype: Link Rect: 370, 514, 408, 525 Annotation: Subtype: Link Rect: 185, 491, 223, 502 Annotation: Subtype: Link Rect: 59, 457, 97, 467 Annotation: Subtype: Link Rect: 208, 400, 246, 410 Annotation: Subtype: Link Rect: 393, 376, 430, 387 Annotation: Subtype: Link Rect: 390, 353, 428, 364 Annotation: Subtype: Link Rect: 161, 331, 198, 341 Annotation: Subtype: Link Rect: 59, 296, 97, 306 Checksum: ef0774d8 Type: CRC32 Checksum: 62e60d0f2d58ddfa0e76c0d22c31b8da Type: MD5 Checksum: 562dd3616d7575b42ae4894ad569ce0bc19b1fed Type: SHA-1