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http://dx.doi.org/10.5720/kjcn.2018.23.5.397

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

An, Minji (Graduate School of Kyung Hee University)
An, Hyojin (Department of Food and Nutrition, Kyung Hee University)
Hwang, Hyo-Jeong (Department of Food and Nutrition, Sahmyook University)
Kwon, Ho-Jang (Department of Preventive Medicine, Dankook University College of Medicine)
Ha, Mina (Department of Preventive Medicine, Dankook University College of Medicine)
Hong, Yun-Chul (Department of Preventive Medicine, Seoul National University College of Medicine)
Hong, Soo-Jong (Department of Pediatrics, Childhood Asthma Atopy Center, Asan Medical Center, University of Ulsan College of Medicine)
Oh, Se-Young (Department of Food and Nutrition, Kyung Hee University)
Publication Information
Korean Journal of Community Nutrition / v.23, no.5, 2018 , pp. 397-410 More about this Journal
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.
Keywords
ADHD (attention deficit hyperactivity disorder); dietary patterns; dietary habits; food frequency questionnaire; linear or nonlinear association;
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