Dietary Profiles, Nutritional Biochemistry Status, and Attention-Deficit/Hyperactivity Disorder: Path Analysis for a Case-Control Study

Abstract

This study aims to investigate dietary and nutritional biochemistry profiles of attention-deficit/hyperactivity disorder (ADHD) and to explore their potential relationship by path analysis. We enrolled 216 children with ADHD and 216 age-, height- and gender-matched controls from 31 elementary schools in Taiwan. Dietary intake of the participants was assessed using a food frequency questionnaire (FFQ). Fasting blood samples were collected to determine the serum levels of multiple nutritional markers. Moreover, we employed a structural equation model (SEM) to link diet, nutritional markers and ADHD. Compared to healthy control, ADHD children had significantly lower serum levels of vitamin B12, folate, vitamin B6, ferritin concentration, and monounsaturated fatty acids (MUFA), but higher levels of serum saturated fatty acids (SFA), n-6/n-3 fatty acid ratio, and inorganic phosphorous concentration. Children with ADHD had more intake of nutrient-poor foods such as high sugar and high fat foods, and had less intake of vegetable, fruit, protein-rich foods than their counterpart. SEM analysis showed that the poor nutritional biochemistry profiles linked the association between unhealthy dietary patterns and ADHD. In conclusion, an unhealthy dietary pattern may be a predecessor of the poor nutritional biochemistry status, and managing diet and nutrition conditions should be considered to improve ADHD symptoms in children.

Relationship between the diet and psychiatric diseases such as depression, anxiety and attention-deficit hyperactivity disorder (ADHD)

“…Vitamin D plays a special role among them, the deficiency of which not only increases the risk of the above mental states but also is more often found in children with ADHD compared to the control group [40]. Such children have a predisposition to an unhealthy diet full of fried food, sweets, sweetened drinks, and instant soups, which can be associated with these children's results such as lower levels of vitamin B12, folic acid and vitamin B, monounsaturated fatty acids, and higher saturated and polyunsaturated fatty acids [38].…”

“…Of course, the diets used by these children in a dependent way influenced the results of the levels of vitamins, minerals and fats that they tested. Thanks to these results, a significant and negatively correlated relationship was determined between: monounsaturated fatty acids / saturated fatty acids ratio, B vitamins and minerals, and the diagnosis of ADHD [38].…”

“…As for minerals, reduced values relative to the control group were observed with ferritin, and higher with inorganic phosphorous (Pi). Recent -fats have shown that children with ADHD had lower levels of monounsaturated fatty acids, and higher saturated and polyunsaturated fatty acids [38].…”

“…When it comes to the diet of Taiwanese children with ADHD and control group, the first group had significantly lower consumption of vegetables, fruits, meat, milk (regular and soy), fish and eggs, while consuming more than the control group of poorly nutritious eating such like fried food, ice cream, candies, chocolates, sweetened drinks, and instant soups. Also the preferences of children suffering from ADHD pointed to unhealthy food [38]. Of course, the diets used by these children in a dependent way influenced the results of the levels of vitamins, minerals and fats that they tested.…”

Micronutrients and Diets in the Treatment of Attention-Deficit/Hyperactivity Disorder: Chances and Pitfalls

“…As early as the 1920s, a possible association between food and hyperkinetic behavior was suggested (10). Children with ADHD and healthy controls appear to have different dietary patterns (11)(12)(13). Growing evidence suggests that nutrients, diet, and other lifestyle factors may play a role in the pathophysiology and management of mental disorders (14), including ADHD (15, 16).Major dietary compounds proposed to be helpful in the treatment of ADHD include micronutrients, such as minerals and vitamins, and polyunsaturated fatty acids (PUFAs).…”