Abstract
BACKGROUND: As an adjuvant for medication, dietary changes focused on specific nutrients have been proposed to prevent or reduce attention-deficit/hyperactivity disorder (ADHD) symptoms. However, whether an overall healthy dietary pattern is associated with ADHD symptom severity during childhood remains unclear. Furthermore, it is not clear what the direction of this association is. OBJECTIVES: We aimed to examine the association between dietary patterns and ADHD symptoms in school-aged children. In addition, we aimed to identify the temporal direction of this association-that is, whether dietary patterns predict ADHD symptoms or vice versa. METHODS: We analyzed data from 3680 children participating in the Generation R Study, a prospective cohort in Rotterdam, Netherlands. ADHD symptoms were assessed with parent-report questionnaires at ages 6 and 10 y using the Child Behavior Checklist. Dietary intake was assessed at the age of 8 y with a validated food-frequency questionnaire. We computed a diet quality score reflecting adherence to dietary guidelines. We examined bidirectional associations of diet quality with ADHD symptom scores using multivariable linear regression analysis and cross-lagged modeling. RESULTS: Linear regressions showed that more ADHD symptoms at age 6 y were associated with a lower diet quality score at age 8 y (SD score = -0.08; 95% CI: -0.11, -0.05) but that diet quality at age 8 y was not associated with ADHD symptoms at age 10 y. Cross-lagged models confirmed a unidirectional relation from ADHD symptoms to diet quality but not vice versa. Associations did not differ by overweight status or between boys and girls. CONCLUSION: Our study suggests that children with more ADHD symptoms may be at higher risk of an unhealthy diet but that overall diet quality does not affect ADHD risk.
| Original language | English |
|---|---|
| Pages (from-to) | 642-648 |
| Number of pages | 7 |
| Journal | The Journal of nutrition |
| Volume | 149 |
| Issue number | 4 |
| Early online date | 27 Mar 2019 |
| DOIs | |
| Publication status | Published - Apr 2019 |
Funding
The Generation R Study is made possible by financial support from Erasmus Medical Center Rotterdam, Erasmus University Rotterdam (EUR), and the Netherlands Organization for Health Research and Development (ZonMw) “Geestkracht” program (no. 10.000.1003). TV received additional funding from Nestlé Nutrition (Nestec Ltd.) and the Thrasher Research Fund. PWJ was funded by the Dutch Diabetes Foundation (no. 2013.81.1664). The funders had no role in design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript. Author disclosures: AM, PWJ, ANN, AB, CMR, and TV, no conflicts of interest. Supplemental Tables 1–4 and Supplemental Figures 1 and 2 are available from the “Supplementary data” link in the online posting of the article and from the same link in the online table of contents at https://academic.oup.com/jn/. The Generation R Study is conducted by the Erasmus Medical Center in close collaboration with the School of Law and the Faculty of Social Sciences at the Erasmus University, Rotterdam; the Municipal Health Service, Rotterdam area; and the Stichting Trombosedienst and Artsenlaboratorium Rijnmond (Star-MDC), Rotterdam. Address correspondence to TV (e-mail: [email protected]). Abbreviations used: ADHD, attention-deficit/hyperactivity disorder; CBCL, Child Behavior Checklist; SCB, sugar-containing beverage; SDS, SD score.
| Funders | Funder number |
|---|---|
| Dutch Diabetes Foundation | 2013.81.1664 |
| Erasmus Medical Center Rotterdam | |
| Nestec Ltd. | |
| Netherlands Organization for Health Research and Development | |
| Thrasher Research Fund | |
| ZonMw | 10.000.1003 |
| Erasmus Universiteit Rotterdam |
Keywords
- ADHD symptoms
- attention-deficit/hyperactivity disorder
- causality
- children
- dietary pattern
- directionality