A plant-based dietary score and attention deficit/hyperactivity disorder in Iranian children: A case-control study

Abstract

Objective: Attention-deficit hyperactivity disorder (ADHD) is the most prevalent neurodevelopmental disorder with a prevalence of 5 among children and adolescents worldwide. Plant foods have a protective effect against inflammation and oxidative stress which both are involved in psychiatric disorders pathophysiology including ADHD. Accordingly, we investigated the association between plant-based diet (PDI) and ADHD.Methods: This case-control study was conducted on 345children and adolescents 7-13 years old in Yazd, Iran. Subjects were categorized into the case (n = 113) and control groups (n = 232) based on matching age and sex. To diagnose ADHD, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSMIV-TR) was used. Food frequency questionnaire was used to measure food intake. The association of PDI with ADHD was examined by logistic regression.Results: Children in the highest quartile of PDI compared to the lowest quartile had a higher energy and macronutrient intake, calcium, zinc, iron, vitamin B12, B6, and folic acid. After adjusting for potential confounders, a significant decreasing trend in the odds of ADHD across increasing quartiles of the PDI (P-trend = 0.001) was observed. In addition, children in the fourth quartile of PDI had 68 lower odds of ADHD than the first quartile. This association remained significant after further adjustment for BMI (OR: 0.32;95 CI: 0.13-0.79; P for trend: 0.001).Conclusion: We found that PDI is associated with lower risk of ADHD in children. Cohort and clinical studies are necessary to approve our results.