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Nutritional complexity in children with ADHD related morbidities in China: A cross-sectional study
Li-Xiao Shen1,2, Feng Li1,2, Min-Bo Xue1
1Developmental and Behavioral Pediatric Department & Child Primary Care Department, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Insights
Children with attention deficit/hyperactivity disorder (ADHD) show higher rates of stunted growth and overweight/obesity compared to non-ADHD peers. Poor sleep quality is a significant risk factor, particularly for stunted growth in ADHD children.
Area of Science:
- Pediatric Health
- Nutritional Science
- Neurodevelopmental Disorders
Background:
- Attention deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children.
- Nutritional status and general health are crucial for child development.
- Previous research has indicated potential links between ADHD and various health issues, but comprehensive nutritional assessments are needed.
Purpose of the Study:
- To evaluate the general and nutritional health status of children diagnosed with ADHD.
- To identify specific nutritional challenges and health problems in children with ADHD.
- To explore the relationship between ADHD and anthropometric classifications such as underweight, stunted growth, and overweight/obesity.
Main Methods:
- Utilized data from the National Multicenter Sleep Research Database, including 23,791 school-aged children from 9 Chinese cities.
- Compared children with ADHD (n=808) against a non-ADHD group using specialist diagnoses from 2005.
- Applied national anthropometric growth standards to classify children and employed binary logistic regression to analyze risk factors, including preterm birth, sleep quality, and prior diseases.
Main Results:
- Children with ADHD exhibited significantly higher prevalences of stunting (9.8% vs 5.9%) and overweight/obesity (32.6% vs 29.6%) compared to non-ADHD children.
- ADHD boys were more frequently underweight (7.5% vs 5.3%), a difference not observed in girls.
- Risk factors for ADHD included premature birth, allergic diseases, otitis media, tonsillar/adenoid hypertrophy, gastroesophageal reflux, and sleep disorders, with poor sleep quality interacting with ADHD for stunted growth.
Conclusions:
- Children with ADHD present with complex and compromised nutritional health, necessitating focused clinical nutrition interventions.
- The findings underscore the importance of addressing nutritional needs, especially during the critical 'first 1000 days' of life.
- Specific health issues identified in ADHD children highlight the need for integrated care addressing both neurodevelopmental and nutritional aspects.
Background And Objectives:
To assess the general and nutritional health of children with attention deficit/ hyperactivity disorder (ADHD).
Methods And Study Design:
The National Multicenter Sleep Research Database for 23791 school-age children in grades 1-6 from 9 cities in China was accessed. Children with a specialist diagnosis of ADHD or not (non-ADHD) in 2005 were studied. National anthropometric growth standards for children aged 2-18 years classified children as underweight, wasted, stunted (short stature presumed nutritional), or overweight/obesity. Independent variables were preterm birth, sleep quality and prior disease and ADHD was the dependent variable. Binary logistic regression models were developed along with interaction analyses for associated disorder or disease on overweight/obesity, and stunted.
Results:
Some 18731 records were analyzed for 808 children with ADHD. The comparative prevalences for ADHD with non-ADHD children were stunted 9.8% vs 5.9% (p<0.001) and overweight/ obesity (32.6% vs 29.6%, p=0.002) respectively. ADHD boys were more often underweight (7.5% vs 5.3%, p=0.027), but not in girls. ADHD likelihood Odds Ratios, ORs (with 95%CI) were for premature birth 1.838, (1.393-2.423), allergic diseases 1.915 (1.526-2.399), otitis media 1.54 (1.118- 2.146), tonsillar or adenoid hypertrophy1.662 (1.348-2.050), gastroesophageal reflux 3.008(1.792-1.792-5.049), and sleep disorder 2.201(1.847-2.623) were ADHD risk factors. Only poor sleep quality and ADHD exhibited an interaction for stunted with OR=0.409 (0.233-0.719).
Conclusions:
Compromised and complex nutritional health in ADHD children challenges clinical nutrition with a range of health problems, albeit coherent with the needed nutritional emphasis in the 'first 1000 days'.
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