Korean J Community Nutr.  2018 Oct;23(5):397-410. 10.5720/kjcn.2018.23.5.397.

Dietary Factors Associated with Attention Deficit Hyperactivity Disorder (ADHD) in School-aged Children

Affiliations
  • 1Graduate School of Kyung Hee University, Seoul, Korea, Student.
  • 2Department of Food and Nutrition, Kyung Hee University, Seoul, Korea, Researcher.
  • 3Department of Food and Nutrition, Sahmyook University, Seoul, Korea, Professor.
  • 4Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea, Professor.
  • 5Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea, Professor.
  • 6Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, Professor.
  • 7Department of Food and Nutrition, Kyung Hee University, Seoul, Korea, Professor. seyoung@khu.ac.kr

Abstract

OBJECTIVES: An association between dietary patterns and mental health in children has been suggested in a series of studies, yet detailed analyses of dietary patterns and their effects on ADHD (attention deficit hyperactivity disorder) are limited.
METHODS
We included 4569 children who had dietary intake data as part of the CHEER (Children's Health and Environmental Research) study conducted nationwide from 2005 to 2010. We assessed ADHD (Attention Deficit Hyperactivity Disorder) by the DuPaul's ADHD Rating Scales and dietary intake by a semi-quantitative food frequency questionnaire. Using intake data, we constructed five dietary patterns: “Plant foods & fish,”“Sweets,”“Meat & fish,”“Fruits & dairy products,” and “Wheat based.”
RESULTS
The overall proportion of ADHD was 12.3%. Boys (17.8%) showed a higher rate of ADHD than girls (6.5%). The total intake of calories (85 kcal) and plant fat (2g) in the ADHD group was significantly higher than that of the normal group. ADHD was significantly negatively associated with dietary habits such as having breakfast and meal frequency, and positively associated with eating speed, unbalanced diet, overeating, and rice consumption. Regarding dietary patterns, the “Sweets” category was relevant to high ADHD risk (OR 1.59, 95% CI: 1.18, 2.15 for Q5 vs. Q1) in a linear relationship. An inverse, non-linear association was found between “Fruits & dairy products” and ADHD (OR 0.55, 95% CI: 0.39, 0.76 for Q4 vs. Q1).
CONCLUSIONS
Our study confirms both positive and negative associations between diet and ADHD in elementary school age children. Moreover, linear or nonlinear associations between diet and ADHD draw attention to the possible threshold role of nutrients. Further studies may consider characteristics of diet in more detail to develop better intervention or management in terms of diet and health.

Keyword

ADHD (attention deficit hyperactivity disorder); dietary patterns; dietary habits; food frequency questionnaire; linear or nonlinear association
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