Multinutrients Decrease Oxidative Stress in Children With ADHD: Mediation/Moderation Analysis of Randomized...

Area of Science:

• Nutritional Psychiatry
• Biochemistry
• Pediatric Neurology

Background:

• Attention-Deficit/Hyperactivity Disorder (ADHD) is linked to oxidative stress (OS), potentially due to nutrient deficiencies.
• Previous trials showed multinutrient supplements improved ADHD symptoms.
• The impact of multinutrients on antioxidant status and OS in ADHD remains unclear.

Purpose of the Study:

• To compare changes in antioxidant (AO) and OS biomarkers after 8-week multinutrient supplementation versus placebo in children with ADHD.
• To assess if baseline AO/OS biomarkers and their changes moderate or mediate treatment response.

Main Methods:

• Analysis of plasma samples from the Micronutrients for ADHD in Youth (MADDY) RCT.
• Measurement of glutathione peroxidase (GPx), glutathione reductase (GR), oxidative stress index (OSI), reactive oxygen metabolites (ROM), and biological antioxidant potential (BAP) at baseline and 8 weeks.
• Statistical comparison using t-tests/Mann-Whitney U-test and logistic regression for mediation/moderation analysis.

Main Results:

• Seventy-seven children (9.9 ± 1.7 years, 71% male) were analyzed.
• Multinutrient treatment significantly decreased ROM compared to placebo after 8 weeks (p=0.017).
• No significant differences were found in OSI, BAP, GPx, or GR between groups; baseline biomarkers did not moderate response, and changes in OSI/ROM showed non-significant trends toward mediation.

Conclusions:

• Eight weeks of multinutrient supplementation reduced ROM in children with ADHD, indicating a potential decrease in oxidative stress.
• While antioxidant status did not change significantly, the preliminary findings suggest a link between reduced OS and symptom improvement, meriting further research into OS in ADHD pathogenesis.