The work of Dr Wen-Harn Pan and colleage at Academia Sinica, National Taiwan University, Chang-Kung Medical Centre, and Chung Hua University of Medical Technology explored comorbidities, biomarkers, and dietary and nutritional biochemistry profiles associated with Attention Deficit Hyperactivity Disorder (ADHD) with the ultimate aim to understand its complex aetiology and improve diagnosis, prevention, and management.
This study is one of very few to examine the relationship between ADHD and allergies, in combination with indicators of inflammation and immune responses, and to explore the potential inter-relationships among diet, and nutritional biochemistry.
ADHD is becoming more prevalent among children and it can have substantial impact on children and their families. Dr Pan and her colleagues recruited 216 children diagnosed with ADHD, and 216 children without ADHD who were matched in terms of similarities in age, sex, height, and weight form 31 schools in Taiwan. The participants were elementary students and a diagnosis of ADHD was confirmed by a child psychologist.
The international Study of Asthma and Allergies in Childhood questionnaire was used to measure allergic symptoms. Dietary intake of the participants was assessed using a food frequency questionnaire (FFQ). Fasting venous blood was collected and analysed for complete blood count, white blood cell differential count, immunoglobin (Ig) E level, serotonin level, and nutritional biochemistry.
The interdisciplinary team identified low levels of haemoglobin, serotonin, but high levels of eosinophils, IgE as being associated with ADHD. At the same time, symptoms of both rhinitis and eczema were significantly associated with increased risk of ADHD. It is likely that the immune response resulting form allergic diseases may affect the central nervous system and therefore children may be more likely to develop or aggravate neurological disorders.
The study also found that the greater number of comorbidities the child had, the greater the change they would be diagnosed with ADHD. Children with signs of allergy were two times as likely to have ADHD, and the presence of found and more abnormal clinical biochemistry items was associated with 6 – 7-fold increase in the risk of having ADHD. Therefore, ADHD’s aetiology could be multi-dimensional, or the risk factors have shared aetiology with ADHD.
From the study, children with ADHD were found to significantly lower serum levels of essential nutrition such as vitamin B12 and B6, but higher levels of serum saturated fatty acids compared to the negative control. This shows that poor nutritional biochemistry profiles link the association between unhealthy dietary patterns and ADHD. Which may be a predecessor of the poor nutritional biochemistry status, therefore, providing evidence that managing diet and nutritional conditions should be considered to improve ADHD symptoms in children.
With better understanding of these associations, there may be potential to modify some of these risk factors and improve the quality of life for children diagnosed with ADHD. These findings by Dr Pan and her team will provide important evidence in devising comprehensive diagnostic, treatment strategies, and management for allergy and diet associated ADHD. [APBN]
Wang, L. J., Yu, Y. H., Fu, M. L., Yeh, W. T., Hsu, J. L., Yang, Y. H., … Pan, W. H. (2018). Attention deficit-hyperactivity disorder is associated with allergic symptoms and low levels of hemoglobin and serotonin. Scientific reports, 8(1), 10229. doi:10.1038/s41598-018-28702-5
Wang, L. J., Yu, Y. H., Fu, M. L., Yeh, W. T., Hsu, J. L., Yang, Y. H., … Pan, W. H. (2019). Dietary Profiles, Nutritional Biochemistry Status, and Attention-deficit/hyperactivity Disorder: Path Analysis for a Case-control Study (P18-106-19). Current Developments in Nutrition, 3(Suppl 1), nzz039.P18-106-19. doi:10.1093/cdn/nzz039.P18-106-19