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Published on: June 12, 2020
Associations between dietary inflammatory index (DII) scores and attention deficit hyperactivity disorder (ADHD) in
Fatemeh Navab1,2,3, Khadijeh Abbasi1,2, Hajar Heidari1,2
1Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
A higher energy-adjusted dietary inflammatory index (E-DII) was associated with increased attention deficit hyperactivity disorder (ADHD) risk in Iranian children. This finding suggests diet may play a role in ADHD development.
Area of Science:
- Neurodevelopmental Disorders
- Nutritional Science
- Pediatric Health
Background:
- Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder with incompletely understood etiologies.
- Factors such as genetics, family history, nutrition, lifestyle, and inflammation are implicated in ADHD development.
- The Dietary Inflammatory Index (DII) quantifies the inflammatory potential of a diet.
Purpose of the Study:
- To investigate the association between the Dietary Inflammatory Index (DII) and the risk of ADHD in children.
- To determine if dietary inflammatory potential is linked to ADHD in a pediatric population.
Main Methods:
- A case-control study involving 500 Iranian children (200 with ADHD, 300 healthy controls) aged 4-12 years.
- Dietary intake assessed using 168-item Food Frequency Questionnaires (FFQs); Energy-adjusted DII (E-DII) scores calculated.
- Statistical analyses included ANCOVA and multivariable logistic regression, adjusting for age, gender, income, and BMI.
Main Results:
- The energy-adjusted dietary inflammatory index (E-DII) showed a significant direct association with ADHD risk.
- Odds ratios (ORs) for ADHD increased with higher E-DII scores across crude, Model 1, and Model 2 analyses (p < 0.05).
- Specifically, ORs ranged from 1.104 to 1.162, indicating a heightened risk with more pro-inflammatory diets.
Conclusions:
- Elevated E-DII scores are significantly associated with an increased risk of ADHD in Iranian children.
- Dietary patterns with higher inflammatory potential may contribute to ADHD development.
- Further research is warranted to confirm these findings and explore causal relationships, given the study's limitations.
Abstract:
Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders, yet its underlying mechanisms remain unclear. Genetic, family history, nutritional, lifestyle, and inflammatory factors are considered as contributing factors of ADHD. The dietary inflammatory index (DII) could be used to determine whether a diet has an inflammatory potential. Therefore, the purpose of this study was to find out if DII scores and ADHD were related. This study included 500 Iranian children aged 4-12 (200 ADHD cases and 300 healthy controls). Food frequency questionnaires (FFQs) consisting of 168 items were used to determine dietary intake. DII scores were calculated using data from D-FFQ. Energy-adjusted DII (E-DII) scores were calculated using standardized z-scores for each food item, following established protocols. Analysis of covariance (ANCOVA) assessed energy-adjusted dietary intake across DII tertiles. Multivariable logistic regression estimated ADHD odds ratios (ORs) and 95% confidence intervals (CIs) through two hierarchical models: Model 1 (adjusted for age, gender, income) and Model 2 (Model 1 + BMI). Statistical significance was set at p < 0.05, with analyses performed in SPSS version 21. Overall, 200 ADHD and 300 healthy children participated in this study. Energy-adjusted dietary inflammatory index (E-DII) was directly associated with ADHD risk in the crude model (OR = 1.104; 95% CI: 1.009, 1.208; p = 0.031). This result also remained significant in Model 1 (OR = 1.162; 95% CI: 1.050, 1.285; p = 0.004) and Model 2 (OR = 1.133; 95% CI: 1.021, 1.258; p = 0.019). We found that E-DII had a significant association with the risk of ADHD in Iranian children. Limitations include the case-control design, which precludes causal inference, and potential residual confounding from unmeasured factors. It will be necessary to conduct further studies to confirm these findings.
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