Wang Liang-Jen, Yu Ya-Hui, Fu Ming-Ling, Yeh Wen-Ting, Hsu Jung-Lung, Yang Yao-Hsu, Yang Hui-Ting, Huang Shih-Yi, Wei Ien-Lan, Chen Wei J, Chiang Bor-Luen, Pan Wen-Harn
Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan.
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 10617, Taiwan.
J Clin Med. 2019 May 18;8(5):709. doi: 10.3390/jcm8050709.
This study aims to investigate dietary and nutritional biochemistry profiles of attention-deficit/hyperactivity disorder (ADHD) and to explore their potential relationship by path analysis. We enrolled 216 children with ADHD and 216 age-, height- and gender-matched controls from 31 elementary schools in Taiwan. Dietary intake of the participants was assessed using a food frequency questionnaire (FFQ). Fasting blood samples were collected to determine the serum levels of multiple nutritional markers. Moreover, we employed a structural equation model (SEM) to link diet, nutritional markers and ADHD. Compared to healthy control, ADHD children had significantly lower serum levels of vitamin B12, folate, vitamin B6, ferritin concentration, and monounsaturated fatty acids (MUFA), but higher levels of serum saturated fatty acids (SFA), n-6/n-3 fatty acid ratio, and inorganic phosphorous concentration. Children with ADHD had more intake of nutrient-poor foods such as high sugar and high fat foods, and had less intake of vegetable, fruit, protein-rich foods than their counterpart. SEM analysis showed that the poor nutritional biochemistry profiles linked the association between unhealthy dietary patterns and ADHD. In conclusion, an unhealthy dietary pattern may be a predecessor of the poor nutritional biochemistry status, and managing diet and nutrition conditions should be considered to improve ADHD symptoms in children.
本研究旨在调查注意力缺陷多动障碍（ADHD）的饮食和营养生物化学特征，并通过路径分析探索它们之间的潜在关系。我们从台湾31所小学招募了216名患有ADHD的儿童和216名年龄、身高和性别匹配的对照组儿童。使用食物频率问卷（FFQ）评估参与者的饮食摄入量。采集空腹血样以测定多种营养标志物的血清水平。此外，我们采用结构方程模型（SEM）来关联饮食、营养标志物和ADHD。与健康对照组相比，ADHD儿童的血清维生素B12、叶酸、维生素B6、铁蛋白浓度和单不饱和脂肪酸（MUFA）水平显著较低，但血清饱和脂肪酸（SFA）、n-6/n-3脂肪酸比值和无机磷浓度较高。患有ADHD的儿童摄入高糖、高脂肪等营养匮乏食物较多，而蔬菜、水果、富含蛋白质食物的摄入量比对照组少。SEM分析表明，不良的营养生物化学特征与不健康饮食模式和ADHD之间的关联有关。总之，不健康的饮食模式可能是营养生物化学状态不佳的先兆，应考虑通过管理饮食和营养状况来改善儿童的ADHD症状。
