High intake of macronutrients ups ADHD risk in children

26 Feb 2024 bởiStephen Padilla
High intake of macronutrients ups ADHD risk in children

Children who have lower intakes of vitamins and mineral and higher intakes of macronutrients are more likely to have attention deficit hyperactivity disorder (ADHD), suggests an Egypt study.

“These findings can inform parents, caregivers, policy- and decision-makers, media, and food industry about the importance of healthy food consumption and good-quality dietary intake in early prevention of ADHD,” the investigators said.

A total of 146 children with ADHD, 141 control siblings, and 146 community controls were included in this study. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) criteria were used to confirm ADHD diagnosis, following the assessment by the long-form Conner’s Scale.

The investigators assessed dietary intakes using a semi-quantitative food frequency questionnaire and identified nutrient patterns using the principal component analysis (PCA).

Based on the results, children with ADHD were found to have a significantly higher mean total energy intake than community controls and siblings (8,867.9 vs 4,481.9 and 7,308.2 KJ, respectively; p<0.001). [Eur J Clin Nutr 2024;78:64-71]

The PCA extracted four nutrient patterns, which explained 75.9 percent of the total variance. Lower tertiles of “predominantly calcium-phosphorus; pattern 1” (ptrend=0.002) and “predominantly-vitamins; pattern 3” (ptrend=0.005) significantly correlated with a higher likelihood of developing ADHD relative to community controls.

The same associations were seen in “predominantly-vitamins” (ptrend<0.001) and “predominantly zinc-iron; pattern 2” (ptrend<0.001) when compared with siblings. On the other hand, higher tertiles of “macronutrients; pattern 4” appeared to increase the odds of ADHD relative to either community controls or siblings (ptrend=0.017 and ptrend<0.001, respectively).

“This study revealed that ADHD children had significantly higher daily total energy, and energy-adjusted intakes of carbohydrates and sodium, compared to controls,” the investigators said. “However, they had significantly low energy-adjusted daily intake of water and all other micro- and macronutrients.”

Of note, majority of the participating children in the three cohorts were males, firstborns, and living in urban areas with nuclear families. Such characteristics were similar to those described in previous studies that examined children with an ADHD diagnosis. [Egypt J Commun Med 2017;35:1-6; Egypt Int J Fam Med 2014;2014:257369; Sci J Public Health 2015;3:274-280; Acta Sci Nutr Health 2020;4:01-6]

“The linkage between macro- and micronutrient to ADHD in children could be explained by nutrient deficiencies due to attentional demands and medication effects,” the investigators said. “ADHD is caused by neurotransmitters dopamine and norepinephrine, which are influenced by iron, zinc, and copper.”

Low levels of zinc in patients with ADHD had an impact on attention scores but not hyperactivity. Moreover, low serum ferritin showed an association with severe ADHD symptoms. [Int J Pediatr 2010;2010:767318; Nutrients 2014;6:1539-1553; BMC Pediatr 2022;22:1-9; Nutrients 2016;8:352]

“Further prospective studies are needed to ascertain the causal relationship between nutrient patterns and ADHD development, while randomized control trials are needed with focus on caregiver education and tailored nutritional regimens for improved mental health,” the investigators said.