[Prevention in attention deficit hyperactivity disorder]. / Prevencion en el trastorno por deficit de atencion/hiperactividad.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that begins at an early age and can be present until adulthood. Subjects with ADHD not only have symptoms such as inattention, impulsivity or hyperactivity but also have their social and emotional areas affected. In addition, they have an associated increased risk for presenting comorbilities with other psychiatric disorders, overshadowing the development. Considering ADHD as a evolutionary risk factor, prevention should be considered as a primary goal. Most preventive actions on ADHD have been focused on tertiary prevention. The present review aims to study the factors involved in the development of ADHD in order to form a prevention model beyond tertiary prevention. This research focuses on models of primary prevention (early detection of disease) and secondary prevention (to prevent or delay the disease), trying to incorporate them into daily practice. This study reviews risk factors that affect ADHD. Through actions aimed to pursue an early detection, development of the disorder could be improved, and by identifying population at risk, efforts could be concentrated on developing a true primary prevention (perinatal period and early childhood) that eventually could contribute to reduce the incidence of ADHD.

TITLE: Prevencion en el trastorno por deficit de atencion/hiperactividad.El trastorno por deficit de atencion/hiperactividad (TDAH) es un trastorno del neurodesarrollo que comienza en edades muy tempranas y que puede estar presente hasta la edad adulta. Los sujetos que padecen TDAH presentan sintomas como falta de atencion, impulsividad e hiperactividad, y se ven afectados en otras areas, como las sociales o emocionales. El TDAH asocia un riesgo aumentado para presentar comorbilidades con otros trastornos psiquiatricos, lo que ensombrece la evolucion. Teniendo en cuenta el TDAH como un factor de riesgo evolutivo, la prevencion deberia ser un objetivo principal. Mayoritariamente, las acciones preventivas en el TDAH se han centrado en la prevencion terciaria. La presente revision busca estudiar los factores que intervienen en el desarrollo del TDAH para poder conformar un modelo de prevencion mas alla de la prevencion terciaria. Se estudian modelos de prevencion secundaria (deteccion precoz de la enfermedad) y primaria (evitar o retrasar la enfermedad), intentando incorporarlos a la practica diaria. Se revisan los factores de riesgo que afectan al TDAH. Mediante acciones encaminadas a la deteccion precoz, se podria mejorar la evolucion del trastorno, y mediante la identificacion de poblaciones en riesgo, se pueden concentrar los esfuerzos en desarrollar una verdadera prevencion primaria (periodo perinatal y primeros años de vida), que a la larga podria contribuir en la reduccion de la incidencia del TDAH.

[Nutritional aspects of attention-deficit/hyperactive disorder]. / Aspectos nutricionales en el trastorno por déficit de atención/hiperactividad.

INTRODUCTION: Attention-deficit/hyperactive disorder (ADHD) has received in the past years a lot of attention from the paediatrician's specialties. Even though the studies of its etiopathology have advanced, mainly the ones related with genetics and neuroimaging, the final cause today is still unclear. DEVELOPMENT: It has been related to many factors such as diet, like some allergies to additives, toxicity to heavy metals and other toxic substances from the environment, due to low protein diets with a high carbohydrate content, unbalanced minerals, essential fatty acids and phospholipid deficit, amino acid deficits, thyroid disorders, and vitamin B complex disorders and phytochemicals. The way our lifestyle has changed in general and the diet in particular nowadays is being considered as a hypothesis for many disorders and health problems, but what about ADHD? One of the changes that we want to emphasize is related to vegetable fat and oils that dominate human consumption and the reduction income of fatty acids from the omega-3 family, including alpha-linolenic acid, eicosapentaenoic acid and docosapentaenoic acid. The fact is even worse when the amount of omega-6 increases and the ratio between both changes. CONCLUSIONS: It is a fact that these kinds of nutrients play an important role in the nervous system development. In this paper the essential fatty acids in neuropsychiatric disorders in general, ADHD in particular, is reviewed.

Aspectos nutricionales en el trastorno por déficit de atención/hiperactividad / Nutritional aspects of attention-deficit/hyperactive disorder

Introducción. El trastorno por déficit de atención/hiperactividad (TDAH) ha recibido en los últimos años gran atenciónpor parte de las especialidades pediátricas. A pesar de los avances en el conocimiento de su etiopatogenia, fundamentalmenterelacionados con la genética y la neuroimagen, su causa última todavía se desconoce. Desarrollo. El TDAH se ha relacionadocon multitud de factores, algunos concernientes a la dieta, como algunas alergias a aditivos, la toxicidad a metales pesadosy otros tóxicos ambientales, dietas bajas en proteínas con alto contenido en carbohidratos, desequilibrios minerales, déficitde ácidos grasos esenciales y fosfolípidos, déficit de aminoácidos, trastornos de tiroides y déficit del complejo vitamínico B y fitonutrientes.Los cambios en el estilo de vida en general y en la dieta se barajan como hipótesis de numerosos trastornos y problemasde salud, pero, ¿y para el TDAH? Uno de los cambios más destacables se da en las grasas vegetales y los aceites que hoydía dominan el consumo humano, ya que están desprovistos de lípidos de la familia de los ácidos grasos esenciales omega-3, comoácido alfa-linoleico, ácido eicosapentanoico y ácido docosahexanoico. Esto se ha podido agravar al aumentar las cantidadesde omega-6 y alterar la ratio entre ambos. Conclusiones. Está bien documentado que este tipo de nutrientes desempeña unpapel importante en el desarrollo, principalmente del sistema nervioso. Este trabajo revisa el papel de los ácidos grasos esencialesen los trastornos neuropsiquiátricos en general y en el TDAH en particular(AU)

Introduction. Attention-deficit/hyperactive disorder (ADHD) has received in the past years a lot of attention fromthe paediatrician’s specialties. Even though the studies of its etiopathology have advanced, mainly the ones related withgenetics and neuroimaging, the final cause today is still unclear. Development. It has been related to many factors such asdiet, like some allergies to additives, toxicity to heavy metals and other toxic substances from the environment, due to lowprotein diets with a high carbohydrate content, unbalanced minerals, essential fatty acids and phospholipid deficit, aminoacid deficits, thyroid disorders, and vitamin B complex disorders and phytochemicals. The way our lifestyle has changed ingeneral and the diet in particular nowadays is being considered as a hypothesis for many disorders and health problems, butwhat about ADHD? One of the changes that we want to emphasize is related to vegetable fat and oils that dominate humanconsumption and the reduction income of fatty acids from the omega-3 family, including alpha-linolenic acid,eicosapentaenoic acid and docosapentaenoic acid. The fact is even worse when the amount of omega-6 increases and the ratiobetween both changes. Conclusions. It is a fact that these kinds of nutrients play an important role in the nervous systemdevelopment. In this paper the essential fatty acids in neuropsychiatric disorders in general, ADHD in particular, is reviewed(AU)