Gonçalves Bárbara Peter, Martins-Silva Thais, Bierhals Isabel, Murray Joseph, Domingues Marlos R, Hallal Pedro C, Tovo-Rodrigues Luciana, Bertoldi Andréa Dâmaso
Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Human Development and Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil.
Int J Obes (Lond). 2025 Mar 27. doi: 10.1038/s41366-025-01745-1.
Attention deficit hyperactivity disorder (ADHD) has been linked to excessive weight; however, the underlying mechanisms of this association are not well understood. To date, the bidirectional associations between ADHD and nutritional status in childhood have been explored in a limited number of studies, with particularly few of those incorporating body composition data. This study aims to evaluate the associations of ADHD symptoms, nutritional status, and body composition in childhood.
We analyzed data from 3940 children from the 2015 Pelotas (Brazil) Birth Cohort at 4 and 6-7 years of age. Linear regression was performed to evaluate the association between ADHD symptoms and nutritional status (weight, height, and body mass index [BMI]) at ages 4 and 6-7, as well as body composition, specifically fat mass (FF) and fat-free mass (FFM) at ages 6-7. Moreover, a cross-lagged panel model (CLPM) analysis between ADHD symptoms and BMI was performed to explore the bidirectional associations.
ADHD symptoms were associated with increased height (β 0.01, 95%CI 0.001, 0.026) and FFM (β 0.02, 95%CI 0.008-0.035) at age 4, and increased BMI (β0.02, 95%IC 0.002, 0.038), weight (β 0. 02, 95%CI 0.005, 0.039), height (β 0.01, 95%CI 0.000, 0.024), and FFM (β 0.02, 95%CI 0.012, 0.040) at ages 6-7. Although the CLPM indicated a small effect suggesting a bidirectional relationship between ADHD symptoms and BMI, the observed associations were not statistically significant: ADHD scores at age 4 predicting BMI z-scores at ages 6-7 (β 0.003; 95% CI: -0.026, 0.020), and BMI z-scores at age 4 predicting ADHD scores at ages 6-7 (β 0.013; 95% CI: -0.018, 0.044).
Children with higher ADHD symptoms showed increased growth in weight, height, and BMI. The observed increase in weight and BMI was attributed to greater FFM in these children.
注意力缺陷多动障碍（ADHD）与超重有关；然而，这种关联的潜在机制尚未完全明确。迄今为止，仅有少数研究探讨了儿童期ADHD与营养状况之间的双向关联，其中纳入身体成分数据的研究尤为少见。本研究旨在评估儿童期ADHD症状、营养状况和身体成分之间的关联。
我们分析了来自2015年佩洛塔斯（巴西）出生队列中3940名4岁以及6 - 7岁儿童的数据。采用线性回归评估4岁和6 - 7岁时ADHD症状与营养状况（体重、身高和体重指数[BMI]）之间的关联，以及6 - 7岁时身体成分，特别是脂肪量（FF）和去脂体重（FFM）之间的关联。此外，对ADHD症状和BMI进行交叉滞后面板模型（CLPM）分析，以探讨双向关联。
4岁时，ADHD症状与身高增加（β 0.01，95%可信区间0.001，0.026）和FFM增加（β 0.02，95%可信区间0.008 - 0.035）相关；6 - 7岁时，与BMI增加（β0.02，95%可信区间0.002，0.038）、体重增加（β 0. 02，95%可信区间0.005，0.039）、身高增加（β 0.01，95%可信区间0.000，0.024）和FFM增加（β 0.02，95%可信区间0.012，0.040）相关。尽管CLPM显示出ADHD症状与BMI之间存在双向关系的微弱效应，但观察到的关联无统计学意义：4岁时的ADHD得分预测6 - 7岁时的BMI z评分（β 0.003；95%可信区间： - 0.026，0.020），以及4岁时的BMI z评分预测6 - 7岁时的ADHD得分（β 0.013；95%可信区间： - 0.018，0.044）。
ADHD症状较重的儿童体重、身高和BMI增长较快。观察到的体重和BMI增加归因于这些儿童更大的FFM。
