The associations between maternal and child diet quality and child ADHD - findings from a large Norwegian pregnancy cohort study.


Journal

BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559

Informations de publication

Date de publication:
08 03 2021
Historique:
received: 09 10 2020
accepted: 21 02 2021
entrez: 9 3 2021
pubmed: 10 3 2021
medline: 27 4 2021
Statut: epublish

Résumé

Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder. Effective long-term treatment options are limited, which warrants increased focus on potential modifiable risk factors. The aim of this study was to investigate associations between maternal diet quality during pregnancy and child diet quality and child ADHD symptoms and ADHD diagnosis. This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa). We assessed maternal diet quality with the Prenatal Diet Quality Index (PDQI) and Ultra-Processed Food Index (UPFI) around mid-gestation, and child diet quality using the Diet Quality Index (CDQI) at 3 years. ADHD symptoms were assessed at child age 8 years using the Parent Rating Scale for Disruptive Behaviour Disorders. ADHD diagnoses were retrieved from the Norwegian Patient Registry. In total, 77,768 mother-child pairs were eligible for studying ADHD diagnoses and 37,787 for ADHD symptoms. Means (SD) for the PDQI, UPFI and CDQI were 83.1 (9.3), 31.8 (9.7) and 60.3 (10.6), respectively. Mean (SD) ADHD symptom score was 8.4 (7.1) and ADHD diagnosis prevalence was 2.9% (male to female ratio 2.6:1). For one SD increase in maternal diet index scores, we saw a change in mean (percent) ADHD symptom score of - 0.28 (- 3.3%) (CI: - 0.41, - 0.14 (- 4.8, - 1.6%)) for PDQI scores and 0.25 (+ 3.0%) (CI: 0.13, 0.38 (1.5, 4.5%)) for UPFI scores. A one SD increase in PDQI score was associated with a relative risk of ADHD diagnosis of 0.87 (CI: 0.79, 0.97). We found no reliable associations with either outcomes for the CDQI, and no reliable change in risk of ADHD diagnosis for the UPFI. We provide evidence that overall maternal diet quality during pregnancy is associated with a small decrease in ADHD symptom score at 8 years and lower risk for ADHD diagnosis, with more robust findings for the latter outcome. Consumption of ultra-processed foods was only associated with increased ADHD symptom score of similar magnitude as for overall maternal diet quality, and we found no associations between child diet quality and either outcome. No causal inferences should be made based on these results, due to potential unmeasured confounding.

Sections du résumé

BACKGROUND
Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder. Effective long-term treatment options are limited, which warrants increased focus on potential modifiable risk factors. The aim of this study was to investigate associations between maternal diet quality during pregnancy and child diet quality and child ADHD symptoms and ADHD diagnosis.
METHODS
This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa). We assessed maternal diet quality with the Prenatal Diet Quality Index (PDQI) and Ultra-Processed Food Index (UPFI) around mid-gestation, and child diet quality using the Diet Quality Index (CDQI) at 3 years. ADHD symptoms were assessed at child age 8 years using the Parent Rating Scale for Disruptive Behaviour Disorders. ADHD diagnoses were retrieved from the Norwegian Patient Registry.
RESULTS
In total, 77,768 mother-child pairs were eligible for studying ADHD diagnoses and 37,787 for ADHD symptoms. Means (SD) for the PDQI, UPFI and CDQI were 83.1 (9.3), 31.8 (9.7) and 60.3 (10.6), respectively. Mean (SD) ADHD symptom score was 8.4 (7.1) and ADHD diagnosis prevalence was 2.9% (male to female ratio 2.6:1). For one SD increase in maternal diet index scores, we saw a change in mean (percent) ADHD symptom score of - 0.28 (- 3.3%) (CI: - 0.41, - 0.14 (- 4.8, - 1.6%)) for PDQI scores and 0.25 (+ 3.0%) (CI: 0.13, 0.38 (1.5, 4.5%)) for UPFI scores. A one SD increase in PDQI score was associated with a relative risk of ADHD diagnosis of 0.87 (CI: 0.79, 0.97). We found no reliable associations with either outcomes for the CDQI, and no reliable change in risk of ADHD diagnosis for the UPFI.
CONCLUSIONS
We provide evidence that overall maternal diet quality during pregnancy is associated with a small decrease in ADHD symptom score at 8 years and lower risk for ADHD diagnosis, with more robust findings for the latter outcome. Consumption of ultra-processed foods was only associated with increased ADHD symptom score of similar magnitude as for overall maternal diet quality, and we found no associations between child diet quality and either outcome. No causal inferences should be made based on these results, due to potential unmeasured confounding.

Identifiants

pubmed: 33685413
doi: 10.1186/s12888-021-03130-4
pii: 10.1186/s12888-021-03130-4
pmc: PMC7941947
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

139

Subventions

Organisme : Norges Forskningsråd
ID : 251072/F20

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Auteurs

Tiril Cecilie Borge (TC)

Department of Child Health and Development, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, 0213, Oslo, Norway. tibo@fhi.no.

Guido Biele (G)

Department of Child Health and Development, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, 0213, Oslo, Norway.

Eleni Papadopoulou (E)

Department of Environmental Health, Section of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, 0213, Oslo, Norway.

Lene Frost Andersen (LF)

Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, P.O. Box 1046, Blindern, 0317, Oslo, Norway.

Felice Jacka (F)

Food & Mood Centre, IMPACT, Deakin University, Geelong, VIC, Australia.
Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia.
Black Dog Institute, Randwick, NSW, Australia.
James Cook University, Townsville, Qld, Australia.

Merete Eggesbø (M)

Department of Environmental Health, Section of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, 0213, Oslo, Norway.

Ida Henriette Caspersen (IH)

Department of Environmental Health, Section of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, 0213, Oslo, Norway.

Heidi Aase (H)

Department of Child Health and Development, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, 0213, Oslo, Norway.

Helle Margrete Meltzer (HM)

Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, 0213, Oslo, Norway.

Anne Lise Brantsæter (AL)

Department of Environmental Health, Section of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, P.O. Box 222, Skøyen, 0213, Oslo, Norway.

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