Editor,—In the management section of his paper on attention deficit hyperactivity disorder (ADHD) which focuses mainly on medication,1 Hill gives the erroneous impression that managing hyperactivity by diet is difficult and ineffective: those who use it regularly to control ADHD know that this is not the case.

Standard diets are not helpful in the management of this disorder because the foods which provoke hyperactive behaviour are different for each child. Few parents succeed in identifying the foods which affect their child without help, but an elimination diet is effective in most cases. Deficiencies of omega 6 essential fatty acids are common in these children2 so, in addition to the calcium supplement given to all children avoiding milk, evening primrose oil, borage oil, and cofactors such as zinc, are also usually recommended. Under this …