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. 2023 Jun;26(6):572-581.
doi: 10.1080/1028415X.2022.2071805. Epub 2022 May 10.

Fruit and vegetable intake is inversely associated with severity of inattention in a pediatric population with ADHD symptoms: the MADDY Study

Lisa M Robinette  1 , Irene E Hatsu  1   2 , Jeanette M Johnstone  3   4 , Gabriella Tost  3   4 , Alisha M Bruton  3   4 , Brenda M Y Leung  5 , James B Odei  6 , Tonya Orchard  1 , Barbara L Gracious  7 , L Eugene Arnold  8   9
Affiliations

Fruit and vegetable intake is inversely associated with severity of inattention in a pediatric population with ADHD symptoms: the MADDY Study

Lisa M Robinette et al. Nutr Neurosci. 2023 Jun.

Abstract

Objectives: Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder with a U.S. pediatric prevalence of 8-10%. It presents with inattention and hyperactivity/impulsivity; frequently associated with emotional dysregulation (ED) symptoms common in Oppositional Defiant Disorder and Disruptive Mood Dysregulation Disorder. The etiology of ADHD is multi-factorial; symptom severity is associated with diet. This study examines the association of diet quality with ADHD and ED symptoms within a pediatric research cohort.

Methods: Baseline data were analyzed for 134 children aged 6-12 years with symptoms of ADHD and ED enrolled in an RCT of multinutrient supplementation. Diet quality was based on Healthy Eating Index-2015 (HEI-2015). ADHD and ED symptoms were assessed using Child and Adolescent Symptom Inventory-5 and Strengths and Difficulties Questionnaire. Linear regression models, adjusting for covariates when necessary, determined association.

Results: The mean HEI Total Score of 63.4 (SD = 8.8) was not significantly associated with any outcome symptoms. However, after adjusting for covariates, HEI component scores for total fruit intake (β = -0.158, p = .037) and total vegetable intake (β = -0.118, p = .004) were negatively associated with inattention.

Conclusions: The lack of association with total diet quality could be explained by the relatively good baseline diet quality and mild symptom severity in this sample, along with measurement error from dietary intake estimates and relatively small sample size. These findings suggest that dietary intake may impact inattention in children with ADHD and ED: those eating less fruits and vegetables were likely to have more severe symptoms of inattention. Causality is not established by this cross-sectional analysis.

Keywords: ADHD; Dietary quality; Healthy Eating Index; children; disruptive mood dysregulation disorder; emotional dysregulation; inattention; mental health; oppositional defiant disorder.

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Conflict of interest statement

Disclosure Statement

Dr. Arnold has received research funding from Forest, Lilly, Noven, Shire, Supernus, Roche, and YoungLiving (as well as NIH and Autism Speaks); has consulted with Pfizer, Tris Pharma, and Waypoint; and been on advisory boards for Arbor, Ironshore, Otsuka, Pfizer, Roche, Seaside Therapeutics, Shire. Dr. Gracious has been or is a consultant to Johnson and Johnson, Astra Zeneca, and Novo Nordisc. She also received research funding through the Jeffrey Research Fellowship, The Ohio State University Department of Psychiatry and Behavioural Health, and Nationwide Children’s Hospital Department of Behavioural Health and Psychiatry, and The Research Institute at Nationwide Children’s Hospital. This research was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare affiliated entity. The views expressed in this publication represent those of the author(s) and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities. The other authors declare that the research was conducted without any conflict of interest.

Figures

Figure 1.
Figure 1.
Mean HEI-2015 component scores as a percent of the recommendation for study sample versus the national average for children aged 6-11 (23). ^HEI moderation component. Higher scores represent lower consumption of that component. *Mean score is significantly better than national average (p≤ 0.05). For moderation components, this sample consumed less of the component than national average. **Mean score is significantly worse than national average (p≤ 0.05). For moderation components, this sample consumed more of the component than national average.
See this image and copyright information in PMC

References

    1. Thomas R, Sanders S, Doust J, Beller E, Glasziou P. Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics. 2015;135(4):e994–e1001. - PubMed
    1. Danielson ML, Bitsko RH, Ghandour RM, Holbrook JR, Kogan MD, Blumberg SJ. Prevalence of parent-reported ADHD diagnosis and associated treatment among US children and adolescents, 2016. Journal of Clinical Child & Adolescent Psychology. 2018;47(2):199–212. - PMC - PubMed
    1. American Psychological Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: 2013.
    1. Faraone SV, Rostain AL, Blader J, Busch B, Childress AC, Connor DF, Newcorn JH. Practitioner Review: Emotional dysregulation in attention-deficit/hyperactivity disorder–implications for clinical recognition and intervention. Journal of Child Psychology and Psychiatry. 2019;60(2):133–150. - PubMed
    1. Lange KW, Hauser J, Lange KM, Makulska-Gertruda E, Nakamura Y, Reissmann A, Sakaue Y, Takano T, Takeuchi Y. The role of nutritional supplements in the treatment of ADHD: what the evidence says. Current Psychiatry Reports. 2017;19(2):8. - PubMed