Tiril Cecilie Borge1, Guido Biele2, Eleni Papadopoulou3, Lene Frost Andersen4, Felice Jacka5,6,7,8, Merete Eggesbø3, Ida Henriette Caspersen3, Heidi Aase2, Helle Margrete Meltzer9, Anne Lise Brantsæter3. 1. Department of Child Health and Development, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, 0213, Oslo, Norway. tibo@fhi.no. 2. Department of Child Health and Development, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, 0213, Oslo, Norway. 3. Department of Environmental Health, Section of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, 0213, Oslo, Norway. 4. Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046, Blindern, 0317, Oslo, Norway. 5. Food & Mood Centre, IMPACT, Deakin University, Geelong, VIC, Australia. 6. Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia. 7. Black Dog Institute, Randwick, NSW, Australia. 8. James Cook University, Townsville, Qld, Australia. 9. Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, 0213, Oslo, Norway.
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.
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 childADHD 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.
Authors: Ronald C Kessler; Lenard Adler; Minnie Ames; Olga Demler; Steve Faraone; Eva Hiripi; Mary J Howes; Robert Jin; Kristina Secnik; Thomas Spencer; T Bedirhan Ustun; Ellen E Walters Journal: Psychol Med Date: 2005-02 Impact factor: 7.723
Authors: Nicola C Savill; Jan K Buitelaar; Ernie Anand; Kathleen Ann Day; Tamás Treuer; Himanshu P Upadhyaya; David Coghill Journal: CNS Drugs Date: 2015-02 Impact factor: 5.749
Authors: Joni Reef; Sofia Diamantopoulou; Inge van Meurs; Frank C Verhulst; Jan van der Ende Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2010-10-10 Impact factor: 4.328
Authors: Ai-Ru Chia; Ling-Wei Chen; Jun Shi Lai; Chun Hong Wong; Nithya Neelakantan; Rob Martinus van Dam; Mary Foong-Fong Chong Journal: Adv Nutr Date: 2019-07-01 Impact factor: 8.701
Authors: Priscila Gomes de Oliveira; Juliana Morais de Sousa; Débora Gabriela Fernandes Assunção; Elias Kelvin Severiano de Araujo; Danielle Soares Bezerra; Juliana Fernandes Dos Santos Dametto; Karla Danielly da Silva Ribeiro Journal: Front Nutr Date: 2022-05-13
Authors: Liv Grimstvedt Kvalvik; Kari Klungsøyr; Jannicke Igland; Ida Henriette Caspersen; Anne Lise Brantsæter; Berit Skretting Solberg; Catharina Hartman; Lizanne Johanna Stephanie Schweren; Henrik Larsson; Lin Li; Ingeborg Forthun; Stefan Johansson; Alejandro Arias Vasquez; Jan Haavik Journal: Eur J Nutr Date: 2022-01-23 Impact factor: 4.865