Adherence to lifestyle recommendations and ADHD: A population-based study of children aged 10-11 years
Loewen OK, Maximova K, Ekwaru JP, Asbridge M, Ohinmaa A, Veugelers PJ.
Psychosom Med. 2020 Feb 13.
Commentary* by Dr. Margaret Weiss: It seems as likely that ADHD impairs the capacity to comply with lifestyle recommendations, as that lifestyle is a risk factor for ADHD.
OBJECTIVE: The incidence of Attention-Deficit/Hyperactivity Disorder (ADHD) among children and youth is high and temporal increases have been paralleled by deteriorating lifestyles. Poor diet quality, physical inactivity, poor sleep habits, and sedentary behaviors have all been associated with ADHD. However, no earlier prospective study has examined the independent and combined importance of meeting established lifestyle recommendations in childhood for ADHD in adolescence. We examined the associations of adherence to lifestyle recommendations with the incidence of ADHD and the utilization of health services associated with ADHD.
Methods: Lifestyle survey among 10- and 11-year-old students (n=3,436) was linked to administrative health data. Associations between adherence to nine established lifestyle recommendations with ADHD diagnosis and number of physician visits for ADHD until age 14 were examined using Cox proportional hazard and negative binomial regression.
Results: Before age 14, 10.8% of students received an ADHD diagnosis. Meeting recommendations for vegetables & fruit, meat & alternatives, saturated fat, added sugar, and physical activity was associated with fewer ADHD diagnoses. Compared to children who met 1-3 recommendations, meeting 7-9 recommendations was associated with substantially lower incidence of ADHD and fewer physician visits related to ADHD (Hazard Ratio: 0.42 [95%CI: 0.28, 0.61]) (Rate Ratio:0.38 [95%CI 0.22,0.65]).
Conclusions: Lifestyle recommendations exist to benefit development and physical health. Their promotion comes at no harm and may have benefits for ADHD. Experimental evidence is needed to clarify the potential bidirectional relationship between ADHD and adverse health behaviors.
* Abstracts are selected for their clinical relevance by Dr. Margaret Weiss, Director of Clinical Research, Child Psychiatry, Cambridge Health Alliance, Harvard University. Her commentary reflects her own opinion. It is not approved or necessarily representative of the CADDRA board.