Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder affecting children and adults. Recently, there has been growing interest in the potential role of diet in the management of ADHD symptoms. This narrative-based literature review describes the biological plausibility of the ketogenic diet (KD), examines studies looking at the role of the KD in the management of ADHD symptoms, and identifies key areas for future research. No randomized controlled trials (RCTs) were found that investigated children with a primary ADHD diagnosis who underwent verified nutritional ketosis. Current literature in this area derives from three primary sources—dietary pattern studies, observations in existing pediatric epilepsy cohorts, and animal studies—yet such research may not necessarily confirm whether subjects entered ketosis and often relies on activity-based outcome measures. To properly establish the potential function of the KD in the care of children with ADHD, scientific validation through carefully designed controlled trials conducted within strict ethical frameworks is essential.
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