Lifestyle factors, diet and attention-deficit/hyperactivity disorder in Spanish children – an observational study

ABSTRACT

Background: The aetiology of Attention Deficit Hyperactivity Disorder (ADHD) continues to be debated, although several contributing factors have been acknowledged.

Objective: Assess the association between weight, birth attributes, exercise and sleep habits, dietary intake and adherence to a Mediterranean diet, and impulsive behaviour on Spanish ADHD children. Establish whether specific food groups (not just adherence to the Mediterranean diet) associate with impulsive behaviour.

Methods: This observational cross-sectional study included 57 ADHD children from Madrid (Spain). Demographic, clinical data, sleep, exercise and technology-use habits were obtained. Anthropometric measurements included height and weight. Adherence to the Mediterranean diet was assessed using the KIDMED test. Barratt Impulsivity Scale version-11c was used to assess impulsivity. Subjects were divided into three groups for analysis, according to their age (6–10 years, children; 11–13 years, pre-adolescents; 14–16 years, adolescents).

Results: There were clear associations between those who had higher BIS scores and who slept less at weekends (49.4 ± 10.16 vs. 43.8 ± 12.51), who adhered poorly to the Mediterranean diet (49.9 ± 11.72 vs. 41.6 ± 16.52), who used internet and technological devices for >3 h/day (45.5 ± 13.6 vs. 44.7 ± 12.11), who were born with >2.5 kg (46.1 ± 11.61 vs. 42.9 ± 15.29), who were delivered by caesarean (45.1 ± 12.78 vs. 44.7 ± 12.5) and who were not breastfed (45.0 ± 13.38 vs. 44.8 ± 12.39). Subjects exercising more than 3 days a week also scored slightly higher (45.4±14.02 vs. 44.6±11.85) in the BIS.

Conclusion: There is a need to follow up the link between ADHD and sleep onset difficulties, dietary patterns, technological habits, perinatal factors, breastfeeding and birth delivery mode.

KEYWORDS:

• Attention-deficit/hyperactivity disorder
• children
• breastfeeding
• delivery
• diet
• sleep
• exercise
• technology

Acknowledgments

We thank Hospital El Escorial (Madrid, Spain), Asociación A.P.D.E Sierra (Madrid, Spain) and New Roots Herbal Inc (Vaudreuil-Dorion, Quebec, Canada) for their expertise and assistance throughout the study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by New Roots Herbal Inc (Vaudreuil-Dorion, Quebec, Canada). The funder did not play any role in data collection, designing the study, analysing or interpreting the results, or reporting the findings.

Notes on contributors

Ismael San Mauro Martin

Ismael San Mauro Martin is Ph.D. in Biomedicine at Complutense University of Madrid. Clinical and scientific director of Research Centers in Nutrition and Health.

Sara Sanz Rojo

Sara Sanz Rojo Ph.D. is student in Biomedicine at Universidad Complutense de Madrid. Researcher at Research Centers in Nutrition and Health.

Elena Garicano Vilar

Elena Garicano Vilar is Ph.D. student in Food Technology at University College Cork, Ireland. Master in Novel Foods. Bachelor's in Human Nutrition and Dietetics. Research and data manager at Research Centers in Nutrition and Health.

Lourdes González Cosano

Lourdes González Cosano is Bachelor's in Human Nutrition and Dietetics. Researcher at Research Centers in Nutrition and Health.

Raquel Conty de la Campa

Raquel Conty de la Campa is Bachelor's in Human Nutrition and Dietetics. Researcher at Research Centers in Nutrition and Health.

Javier Andrés Blumenfeld Olivares

Javier Andrés Blumenfeld Olivares Doctor in Medicine, Universidad Complutense de Madrid. Deputy doctor at Pediatrics Unit in Hospital El Escorial.