The associations between maternal and child diet quality and child ADHD – findings from a large Norwegian pregnancy cohort study

Abstract

Background Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder. Effective long-term treatment options are limited, which warrants increased focus on potential modifiable risk factors. The aim of this study was to investigate associations between maternal diet quality during pregnancy and child diet quality and child ADHD symptoms and ADHD diagnosis. Methods This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa). We assessed maternal diet quality with the Prenatal Diet Quality Index (PDQI) and Ultra-Processed Food Index (UPFI) around mid-gestation, and child diet quality using the Diet Quality Index (CDQI) at 3 years. ADHD symptoms were assessed at child age 8 years using the Parent Rating Scale for Disruptive Behaviour Disorders. ADHD diagnoses were retrieved from the Norwegian Patient Registry. Results In total, 77,768 mother-child pairs were eligible for studying ADHD diagnoses and 37,787 for ADHD symptoms. Means (SD) for the PDQI, UPFI and CDQI were 83.1 (9.3), 31.8 (9.7) and 60.3 (10.6), respectively. Mean (SD) ADHD symptom score was 8.4 (7.1) and ADHD diagnosis prevalence was 2.9% (male to female ratio 2.6:1). For one SD increase in maternal diet index scores, we saw a change in mean (percent) ADHD symptom score of − 0.28 (− 3.3%) (CI: − 0.41, − 0.14 (− 4.8, − 1.6%)) for PDQI scores and 0.25 (+ 3.0%) (CI: 0.13, 0.38 (1.5, 4.5%)) for UPFI scores. A one SD increase in PDQI score was associated with a relative risk of ADHD diagnosis of 0.87 (CI: 0.79, 0.97). We found no reliable associations with either outcomes for the CDQI, and no reliable change in risk of ADHD diagnosis for the UPFI. Conclusions We provide evidence that overall maternal diet quality during pregnancy is associated with a small decrease in ADHD symptom score at 8 years and lower risk for ADHD diagnosis, with more robust findings for the latter outcome. Consumption of ultra-processed foods was only associated with increased ADHD symptom score of similar magnitude as for overall maternal diet quality, and we found no associations between child diet quality and either outcome. No causal inferences should be made based on these results, due to potential unmeasured confounding.

Association of sweetened carbonated beverage consumption during pregnancy and ADHD symptoms in the offspring: a study from the Norwegian Mother, Father and Child Cohort Study (MoBa)

“…We found no evident associations between other not-carbonated sweet drinks and offspring ADHD, and our results might reflect that women who consume carbonated sweet drinks report ADHD symptoms differently than women who do not consume carbonated drinks. Our findings are also compatible with a recent study from the MoBa cohort that found higher overall maternal diet quality to be associated with slightly lower ADHD symptom scores and risk of ADHD diagnoses in offspring aged 8 years [ 13 ]. The maternal diet quality was assessed using a composite index where added sugar was one of the components.…”

“…So far, such possibilities have been less studied in relation to ADHD. A recent study from the Norwegian Mother and Child Cohort Study, however, found that overall maternal diet quality and lower intake of ultra-processed foods were weakly associated with the child’s ADHD symptoms at 8 years of age [ 13 ].…”

Do Children with Attention-Deficit/Hyperactivity Disorder Follow a Different Dietary Pattern than That of Their Control Peers?

“…Association was found between ADHD, and the mother’s altered nutritional and metabolic status [ 8 ]. In contrast, a healthy diet without ultraprocessed products [ 9 ] and a diet with a low inflammatory index (DII) during pregnancy [ 10 ] are associated with a lower incidence of ADHD in offspring.…”

Adherence to a healthy and potentially sustainable Nordic diet is associated with child development in The Norwegian Mother, Father and Child Cohort Study (MoBa)

“…Previous studies in MoBa have shown that maternal diet quality described by various measures of a healthy diet, is associated with a decrease in ADHD symptoms and diagnosis at 8 years [ 39 ], and that higher maternal intake of unhealthy foods during pregnancy predict emotional problems among children at the age of five [ 40 ]. However, our study is, to our knowledge, one of few that has explored associations between both maternal and child dietary patterns and child communication and motor development at multiple timepoints.…”