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As many as seven percent of children worldwide and 10% in the United States have Attention Deficit Hyperactivity Disorder (ADHD). And while the exact etiology of it is still unknown, research into what affects the symptoms – typically chronic patterns of inattention and hyperactivity – is continuing to grow rapidly.
Globally, there has been growing evidence to suggest that a Western dietary pattern and diets high in added sugars are associated with ADHD, which makes sense! By now, many of us have heard the warnings to steer clear of red dye 40 and sugary foods – but how much of what we hear is myth vs. reality? In this latest study published in Nutritional Neuroscience, researchers conclude that the higher fruit and vegetable intake, the lower the severity of ADHD symptoms.
The StudyIn the study titled Fruit and vegetable intake is inversely associated with severity of inattention in a pediatric population with ADHD symptoms: the MADDY Study, researchers sought to find if symptom severity in ADHD is associated with diet. The study examined the association of diet quality with ADHD and Emotional Dysregulation (ED) in 134 children aged six to twelve years old.
The quality of their diet was based on the Healthy Eating Index-2015 and symptoms were assessed using the Child and Adolescent Symptom Inventory-5 and Strengths and Difficulties Questionnaire. The study was an eight-week long, randomized, double-blind placebo-controlled trial that used Hardy’s Daily Essential Nutrients, a 40+ active ingredient micronutrient supplement, to treat symptoms of ADHD and ED.
In the end, the HEI component scores for total fruit and vegetable intake were both negatively associated with inattention – suggesting that dietary intake may impact inattention in children with ADHD and ED.
Assessing Behaviors and Backgrounds
Parents completed the CASI-5 and Strengths and Difficulties Questionnaire at their baseline visit to fully assess the participating children's behaviors. This included questions about symptoms of ADHD (inattention and hyperactivity/impulsivity) as well as Likert-style questions about emotional dysregulation symptoms (such as if they’re feeling irritated, experiencing positive or negative emotions inappropriately, etc).
Researchers also took sociodemographic characteristics into account. Of the 134 children in the study, 71% were male, and approximately 79% were white. Over half of the sample (57%) had family income greater than $80,000 a year.
The paper found that overall diet quality as measured by HEI-2015 was not associated with ADHD symptoms of inattention or hyperactivity, or emotional dysregulation. Interestingly, this contrasts with several non-U.S. studies that used a priori-defined diet qualities.
How can this be explained? Researchers believe it comes down to a difference in traditional western diets vs. other diets around the globe, such as Dutch, German, Mediterranean, etc.
These diets “may measure dietary factors expected to affect ADHD more directly than the HEI-2015, such as distinct measures of consumption of foods such as seafood, nuts, and seeds, since these foods are typically high in omega-3 fatty acids, iron, zinc, and magnesium.”
This means for future studies, research should take advantage of larger sample populations in the U.S. and Canada to further examine the relationship between ADHD and Western dietary patterns, of which there are currently only a few.
In contrast to overall diet quality, as measured by the HEI, not being associated with ADHD symptoms nor emotional dysregulation severity in this cohort of children, researchers found that: “Increased intake of fruits and vegetables was inversely associated with severity of inattention...These findings are important because they suggest that dietary intake is associated with symptoms of inattention in children with ADHD and emotional dysregulation: those eating less fruits and vegetables were likely to have more severe inattention.”
To read the full paper, click here.