Dietary patterns in childhood tied to behaviour problems in adolescence

Boys who adhere to a diet rich in animal protein in middle childhood are less likely to externalize problems and become aggressive during adolescence, while adherence to the traditional/starch dietary pattern is associated with attention problems among girls, according to a study in Colombia.

“Adherence to other dietary patterns in middle childhood was not related to behavioural problems in adolescence,” the researchers said.

This cohort study included mothers of 385 children aged 5 to 12 years, who completed a food frequency questionnaire (FFQ) on their children’s usual intake at enrolment. The researchers identified four dietary patterns through principal component analysis of the FFQ: animal protein, snacking, cheaper protein, and traditional/starch.

After a median follow-up of 6 years, adolescent children reported behaviour problems using the standardized questionnaire Youth Self Report. The researchers then performed multivariable linear regression to compare the continuous distributions of externalizing and internalizing behaviour problems and their subscales across quartiles of adherence to the four dietary patterns.

Boys in the highest quartile of adherence to the animal protein dietary pattern during middle childhood demonstrated an adjusted 5.5-units lower (95 percent confidence interval [CI], ‒9.5 to ‒1.5) mean total externalizing problems score relative to those in the lowest quartile (p_trend=0.008). Adherence to the animal protein pattern was also inversely associated with aggressive behaviour externalizing subscale in a dose‒response manner (p_trend=0.009). [Eur J Clin Nutr 2021;75:1809-1818]

In addition, girls in the highest quartile of adherence to the traditional/starch dietary pattern showed a mean attention problem score 2.1-units higher than those in the lowest quartile (95 percent CI, 0.6‒3.6; p_trend=0.004).

No associations were found between adherence to other dietary patterns and externalizing problems in boys or girls. There were also no associations with internalizing problems seen.

“The inverse association seen in our study between adherence to the animal protein pattern and externalizing behaviour problems in boys may be partly explained through increased intake of micronutrients critical for neurobehavioural development that exist in animal foods in highly bioavailable form,” the researchers said.

Vitamin B12 and iron could be significant since they have been associated with mood and child brain development, respectively. [Pharmacopsychiatry 2015;48:141-144; J Nutr Biochem 2014;25:1101-1107]

“We previously found that low serostatus biomarkers of these micronutrients in middle childhood were related to externalizing behaviour problems in boys from the same study population,” the researchers noted. [J Nutr 2018;148:760-770]

Furthermore, animal food consumption was found to influence behavioural development through increased protein intake. Exposure to early postnatal protein deficiency in rodents and monkeys led to more aggressive and socially abnormal behaviour. [Behav Biol 1975;14:325-333; Physiol Behav 2005;85:246-251]

“We did not find an association between adherence to the animal protein pattern and behaviour problems among girls. The mechanisms that could explain sex differences in these relations are unclear,” the researchers said.

“Additional longitudinal studies are warranted elsewhere in Latin America to examine whether this association replicates in comparable settings,” they added.