Dietary, Nutrient Patterns and Blood Essential Elements in Chinese Children with ADHD
Abstract
:1. Introduction
2. Methods and Materials
2.1. Study Population and Recruitment
2.2. Data Collection
2.3. Dietary Assessment and Food Grouping
2.4. Blood Sampling and Analysis
2.5. Covariates
2.6. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
Abbreviations
ADHD | attention deficit hyperactivity disorder |
BMI | body mass index |
CIs | confidence intervals |
FFQ | food frequency questionnaire |
ORs | odds ratios |
PUFAs | polyunsaturated fatty acids |
SD | standard deviation |
24HR | 24 h diet recalls |
Appendix
Food or Food Groups | Food Items |
---|---|
Grains | rice, millet, yellow rice, corn |
Processed grains | bread, noodle, rice noodle, steamed roll |
Red meat | pork, pig trotters, beef, beef brisket, mutton, and other meat |
White meat | chicken, chicken paw, duck, duck feet, goose, and other poultry |
Organ meat | pork, beef and mutton liver; chicken and duck giblets |
Dairy products | cheese, margarine, yoghurt, skim and powder milk |
Deep water fish | ribbonfish, yellow croaker, cuttlefish, snailfish |
Freshwater fish | crucian carp, yellow catfish, silver carp, grass carp, rice field eel |
Shellfish | shrimp, crab, shellfish |
Fruits | banana, papaya, water melon, apple, honeydew, mango, pineapple, jackfruit, guava, orange |
Tuber crops | sweet potato, dry sweet potato, cassava |
Soya beans | soya bean, soya-bean milk, soya-bean flour, tofu, bean curd |
Other beans | mung bean, red bean, broad bean, and other kidney beans |
Root vegetables | carrot, white radish, turnip |
Fruiting vegetables | pepper, eggplant, cucumbers, tomato, white gourd, pumpkin, cucumber, sponge gourd, bitter melon, courgettes |
Leafy vegetables | cabbage, broccoli, greens, cauliflower, celery, water spinach, lettuces, spinach, chive, leek |
Tuber vegetables | asparagus lettuce, bamboo shoots, water chestnut, lotus root, yams, taro, ginger, garlic, onion |
Fungi and algae | mushroom family, seaweed |
Snacks | potato chips, bread, cake, biscuits, other starchy snacks, pork floss |
Fast food | convenience foods, frozen foods |
Ice cream | ice cream |
Drinks | cola, sprite, juices and juice drinks, vegetable juice drinks, milk drinks, chocolate soy milk, almond milk, tea beverage |
Animal fats | lard |
Vegetable oils | mixed oil, peanut oil, tea oil, olive oil, soybean oil, other edible oil |
Condiments | soy sauce, vinegar, broad bean butter, pepper sauce, preserved bean curd, pickles, pepper, wild pepper, chili powder, salt, monosodium glutamate, others |
Eggs | egg, duck’s egg, preserved egg, other eggs |
Nuts | walnut, cedar nut, hazelnut, peanut, seeds of sunflower, watermelon and pumpkin |
Sweets | candy, chocolate, preserved fruits, candied Chinese date |
References
- American Psychiatric Association. Diagnostic & Statistical Manual for Mental Disorders, 4th ed.; Text Revision (DSM-IV-R): Washington, DC, USA, 2000. [Google Scholar]
- Biederman, J.; Faraone, S.V. Attention-deficit hyperactivity disorder. Lancet 2005, 366, 237–248. [Google Scholar] [CrossRef]
- Satterfield, J.H.; Faller, K.J.; Crinella, F.M.; Schell, A.M.; Swanson, J.M.; Homer, L.D. A 30-year prospective follow-up study of hyperactive boys with conduct problems: Adult criminality. J. Am. Acad. Child Adolesc. Psychiatry 2007, 46, 601–610. [Google Scholar] [CrossRef] [PubMed]
- Pliszka, S.R. The neuropsychopharmacology of attentiondeficit/hyperactivity disorder. Biol. Psychiatry 2005, 57, 1385–1390. [Google Scholar] [CrossRef] [PubMed]
- Simonoff, E.; Taylor, E.; Baird, G.; Bernard, S.; Chadwick, O.; Liang, H.; Whitwell, S.; Riemer, K.; Sharma, K.; Sharma, S.P.; et al. Randomized controlled double-blind trial of optimal dose methylphenidate in children and adolescents with severe attention deficit hyperactivity disorder and intellectual disability. J. Child Psychol. Psychiatry 2013, 54, 527–535. [Google Scholar] [CrossRef] [PubMed]
- Sharma, A.; Couture, J. A review of the pathophysiology, etiology, and treatment of attention-deficit hyperactivity disorder (ADHD). Ann. Pharmacother. 2014, 48, 209–225. [Google Scholar] [CrossRef] [PubMed]
- Greenhill, L.L.; Muniz, R.; Ball, R.R.; Levine, A.; Pestreich, L.; Jiang, H. Efficacy and safety of dexmethylphenidate extended-release capsules in children with attention-deficit/hyperactivity disorder. J. Am. Acad. Child Adolesc. Psychiatry 2006, 45, 817–823. [Google Scholar] [CrossRef] [PubMed]
- Findling, R.L.; Turnbow, J.; Burnside, J.; Melmed, R.; Civil, R.; Li, Y. A randomized, double-blind, multicenter, parallel-group, placebo-controlled, dose-optimization study of the methylphenidate transdermal system for the treatment of ADHD in adolescents. CNS Spectr. 2010, 15, 419–430. [Google Scholar] [PubMed]
- Millichap, J.G. Etiologic classification of attention-deficit/hyperactivity disorder. Pediatrics 2008, 121, e358–e365. [Google Scholar] [CrossRef] [PubMed]
- Millichap, J.G.; Yee, M.M. The diet factor in attention-deficit/hyperactivity disorder. Pediatrics 2012, 129, 330–337. [Google Scholar] [CrossRef] [PubMed]
- Kruesi, M.J.; Rapoport, J.L.; Cummings, E.M.; Berg, C.J.; Ismond, D.R.; Flament, M.; Yarrow, M.; Zahn-Waxler, C. Effects of sugar and aspartame on aggression and activity in children. Am. J. Psychiatry 1987, 144, 1487–1490. [Google Scholar] [PubMed]
- Stevenson, J.; Sonuga-Barke, E.; McCann, D.; Grimshaw, K.; Parker, K.M.; Rose-Zerilli, M.J.; Holloway, J.W.; Warner, J.O. The role of histamine degradation gene polymorphisms in moderating the effects of food additives on children’s ADHD symptoms. Am. J. Psychiatry 2010, 167, 1108–1115. [Google Scholar] [CrossRef] [PubMed]
- Pelsser, L.M.; Frankena, K.; Toorman, J.; Savelkoul, H.F.; Dubois, A.E.; Pereira, R.R.; Haagen, T.A.; Rommelse, N.N.; Buitelaar, J.K. Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): A randomised controlled trial. Lancet 2011, 377, 494–503. [Google Scholar] [CrossRef]
- Ng, K.H.; Meyer, B.J.; Reece, L.; Sinn, N. Dietary PUFA intakes in children with attention-deficit/hyperactivity disorder symptoms. Br. J. Nutr. 2009, 102, 1635–1641. [Google Scholar] [CrossRef] [PubMed]
- Bilici, M.; Yildirim, F.; Kandil, S.; Bekaroğlu, M.; Yildirmiş, S.; Değer, O.; Ulgen, M.; Yildiran, A.; Aksu, H. Double-blind, placebo-controlled study of zinc sulfate in the treatment of attention deficit hyperactivity disorder. Prog. Neuropsychopharmacol. Biol. Psychiatry 2004, 28, 181–190. [Google Scholar] [CrossRef] [PubMed]
- Konofal, E.; Lecendreux, M.; Deron, J.; Marchand, M.; Cortese, S.; Zaïm, M.; Mouren, M.C.; Arnulf, I. Effects of iron supplementation on attention deficit hyperactivity disorder in children. Pediatr. Neurol. 2008, 38, 20–26. [Google Scholar] [CrossRef] [PubMed]
- Jacobs, D.R., Jr.; Steffen, L.M. Nutrients, foods, and dietary patterns as exposures in research: A framework for food synergy. Am. J. Clin. Nutr. 2003, 78, 508S–513S. [Google Scholar] [PubMed]
- Howard, A.L.; Robinson, M.; Smith, G.J.; Ambrosini, G.L.; Piek, J.P.; Oddy, W.H. ADHD is associated with a “Western” dietary pattern in adolescents. J. Atten. Disord. 2011, 15, 403–411. [Google Scholar] [CrossRef] [PubMed]
- Azadbakht, L.; Esmaillzadeh, A. Dietary patterns and attention deficit hyperactivity disorder among Iranian children. Nutrition 2012, 28, 242–249. [Google Scholar] [CrossRef] [PubMed]
- Woo, H.D.; Kim, D.W.; Hong, Y.S.; Kim, Y.M.; Seo, J.H.; Choe, B.M.; Park, J.H.; Kang, J.W.; Yoo, J.H.; Chueh, H.W.; et al. Dietary patterns in children with attention deficit/hyperactivity disorder (ADHD). Nutrients 2014, 6, 1539–1553. [Google Scholar] [CrossRef] [PubMed]
- Shahar, D.; Shai, I.; Vardi, H.; Brener-Azrad, A.; Fraser, D. Development of a semi-quantitative Food Frequency Questionnaire (FFQ) to assess dietary intake of multiethnic populations. Eur. J. Epidemiol. 2003, 18, 855–861. [Google Scholar] [CrossRef] [PubMed]
- World Health Organization. Obesity: Preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ. Tech. Rep. Ser. 2000, 894, 1–253. [Google Scholar]
- Willett, W.C. Food-frequency methods. In Nutritional Epidemiology, 2nd ed.; Oxford University Press: New York, NY, USA, 1998; pp. 74–100. [Google Scholar]
- Yang, Y.X.; Wang, G.Y.; Pan, X.C. China Food Composition 2002; Peking University Medical Press: Beijing, China, 2002. [Google Scholar]
- Yang, Y.X. China Food Composition 2004; Peking University Medical Press: Beijing, China, 2005. [Google Scholar]
- Biederman, J.; Faraone, S.V. The Massachusetts General Hospital studies of gender influences on attention-deficit/hyperactivity disorderin youth and relatives. Psychiatr. Clin. N. Am. 2004, 27, 225–232. [Google Scholar] [CrossRef] [PubMed]
- Arnett, A.B.; Pennington, B.F.; Willcutt, E.G.; DeFries, J.C.; Olson, R.K. Sex differences in ADHD symptom severity. J. Child Psychol. Psychiatry 2015, 56, 632–639. [Google Scholar] [CrossRef] [PubMed]
- Swanson, J.M.; Kinsbourne, M.; Nigg, J.; Lanphear, B.; Stefanatos, G.A.; Volkow, N.; Taylor, E.; Casey, B.J.; Castellanos, F.X.; Wadhwa, P.D. Etiologic subtypes of attention-deficit/hyperactivity disorder: Brain imaging, molecular genetic and environmental factors and the dopamine hypothesis. Neuropsychol. Rev. 2007, 17, 39–59. [Google Scholar] [CrossRef] [PubMed]
- Pettersson, E.; Sjölander, A.; Almqvist, C.; Anckarsäter, H.; D’Onofrio, B.M.; Lichtenstein, P.; Larsson, H. Birth weight as an independent predictor of ADHD symptoms: A within-twin pair analysis. J. Child Psychol. Psychiatry 2015, 56, 453–459. [Google Scholar] [CrossRef] [PubMed]
- Kleinbaum, D.G.; Kupper, L.L.; Muller, K.E. Variable reduction and factor analysis. In Applied Regression Analysis and Other Multivariable Methods; PWS Kent Publishing Company: Boston, MA, USA, 1988; pp. 595–640. [Google Scholar]
- Kim, J.-O.; Mueller, C.W. Factor Analysis: Statistical Methods and Practical Issues; Sage Publications Inc.: Thousand Oaks, CA, USA, 1978. [Google Scholar]
- Northstone, K.; Ness, A.R.; Emmett, P.M.; Rogers, I.S. Adjusting for energy intake in dietary pattern investigations using principal components analysis. Eur. J. Clin. Nutr. 2008, 62, 931–938. [Google Scholar] [CrossRef] [PubMed]
- Willett, W.C. Implications of total energy intake for epidemiologic analysis. In Nutritional Epidemiology, 2nd ed.; Oxford University Press: New York, NY, USA, 1998; pp. 273–301. [Google Scholar]
- Hu, F.B. Dietary pattern analysis: A new direction in nutritional epidemiology. Curr. Opin. Lipidol. 2002, 13, 3–9. [Google Scholar] [CrossRef] [PubMed]
- Bowman, S.A.; Vinyard, B.T. Fast food consumption of U.S. adults: Impact on energy and nutrient intakes and overweight status. J. Am. Coll. Nutr. 2004, 23, 163–168. [Google Scholar] [CrossRef] [PubMed]
- El-Seweidy, M.M.; Hashem, R.M.; Abo-El-matty, D.M.; Mohamed, R.H. Frequent inadequate supply of micronutrients in fast food induces oxidative stress and inflammation in testicular tissues of weanling rats. J. Pharm. Pharmacol. 2008, 60, 1237–1242. [Google Scholar] [CrossRef] [PubMed]
- Johnson, M.; Ostlund, S.; Fransson, G.; Kadesjö, B.; Gillberg, C. Omega-3/omega-6 fatty acids for attention deficit hyperactivity disorder: A randomized placebo-controlled trial in children and adolescents. J. Atten. Disord. 2009, 12, 394–401. [Google Scholar] [CrossRef] [PubMed]
- Bourre, J.M. Effects of nutrients (in food) on the structure and function of the nervous system: Update on dietary requirements for brain. Part 1: Micronutrients. J. Nutr. Health Aging 2006, 10, 377–385. [Google Scholar] [PubMed]
- Akhondzadeh, S.; Mohammadi, M.R.; Khademi, M. Zinc sulfate as an adjunct to methylphenidate for the treatment of attention deficit hyperactivity disorder in children: A double blind and randomized trial. BMC Psychiatry 2004, 4, 9. [Google Scholar] [CrossRef] [PubMed]
- Toren, P.; Eldar, S.; Sela, B.A.; Wolmer, L.; Weitz, R.; Inbar, D.; Koren, S.; Reiss, A.; Weizman, R.; Laor, N. Zinc deficiency in attention-deficit hyperactivity disorder. Biol. Psychiatry 1996, 40, 1308–1310. [Google Scholar] [CrossRef]
- Black, M.M. Zinc deficiency and child development. Am. J. Clin. Nutr. 1998, 68, 464S–469S. [Google Scholar] [PubMed]
- Quist, J.R.; Kennedy, J.L. Genetics of childhood disorders: XXIII. ADHD, Part 7: The serotonin system. J. Am. Acad. Child Adolesc. Psychiatry 2001, 40, 253–256. [Google Scholar] [CrossRef] [PubMed]
- Kirby, K.; Floriani, V.; Bernstein, H. Diagnosis and management of attention-deficit hyperactivity disorder in children. Curr. Opin. Pediatr. 2001, 13, 190–199. [Google Scholar] [CrossRef] [PubMed]
- Arnold, L.E.; DiSilvestro, R.A. Zinc in attention-deficit/hyperactivity disorder. J. Child Adolesc. Psychopharmacol. 2005, 15, 619–627. [Google Scholar] [CrossRef] [PubMed]
Characteristic | ADHD (n = 296) | Controls (n = 296) | p 2 |
---|---|---|---|
Matched Factors | |||
Age (years) | 8.42 ± 1.72 | 8.46 ± 1.84 | - |
Gender | - | ||
Male | 248 (83.8) | 248 (83.8) | |
Female | 48 (16.2) | 48 (16.2) | |
Child Factors | |||
BMI (kg/m2) | 16.00 ± 3.00 | 16.41 ± 2.93 | 0.263 |
Energy intake (kcal/day) | 1778.4 ± 508.1 | 1895.7 ± 631.9 | 0.681 |
Breast feeding | 172 (58.1) | 182 (61.5) | 0.225 |
Emotional abuse | 180 (60.8) | 101 (34.1) | <0.001 |
Birth weight (kg) | 3.27 ± 0.56 | 3.24 ± 0.52 | 0.436 |
Full-term pregnancy | 254 (85.8) | 273 (92.2) | 0.017 |
Labor or delivery complications | 29 (9.8) | 21 (7.1) | 0.150 |
Twin | 16 (5.4) | 14 (4.7) | 0.426 |
Family history of ADHD | 40 (13.5) | 21 (7.1) | 0.007 |
Family Environmental Factors | |||
Household composition | 0.011 | ||
Two parents | 210 (70.9) | 241(81.4) | |
Single parent | 20 (6.8) | 17 (5.7) | |
Recombined | 66 (22.3) | 38 (12.9) | |
Household income (yuan/month/person) | 0.922 | ||
≤1000 | 95 (32.1) | 93 (30.7) | |
1000–2000 | 99 (33.4) | 99 (33.4) | |
≥2000 | 102 (34.5) | 106 (35.8) | |
Maternal age at childbirth | 25.39 ± 3.46 | 25.55 ± 3.60 | 0.609 |
Maternal education (years) | 0.032 | ||
≤9 | 37 (12.5) | 55 (18.6) | |
9–12 | 126 (42.6) | 101 (34.1) | |
≥12 | 133 (44.9) | 140 (47.3) | |
Paternal education (years) | 0.229 | ||
≤9 | 22 (7.4) | 28 (9.5) | |
9–12 | 116 (39.2) | 102 (34.5) | |
≥12 | 158 (53.4) | 166 (56.0) | |
Maternal abortion history | 107 (36.1) | 76 (25.7) | 0.004 |
Family conflicts | 11 (3.7) | 10 (3.4) | 0.500 |
Maternal drinking during pregnancy | 3 (1.0) | 3 (1.0) | 0.657 |
Maternal smoking during pregnancy | 2 (0.7) | 1 (0.3) | 0.500 |
Paternal smoking before childbirth | 151 (51.0) | 141 (47.6) | 0.230 |
Paternal smoking after childbirth | 372 (40.2) | 101 (34.1) | 0.074 |
Food Groups or Foods 2 | Dietary Patterns | |||
---|---|---|---|---|
Factor 1 (Vegetable-Fruit) | Factor 2 (Fish-White Meat) | Factor 3 (Grain-Bean) | Factor 4 (Fast Food-Sweet) | |
Leafy vegetables | 0.71 | 0.01 | 0.11 | 0.02 |
Fruiting vegetables | 0.68 | 0.03 | 0.24 | 0.01 |
Tuber vegetables | 0.67 | 0.07 | 0.10 | −0.01 |
Fruits | 0.47 | 0.21 | −0.12 | −0.02 |
Root vegetables | 0.35 | 0.00 | 0.25 | −0.05 |
Shellfish | −0.13 | 0.65 | 0.10 | −0.05 |
Deep water fish | −0.12 | 0.58 | 0.11 | −0.10 |
White meat | 0.04 | 0.54 | −0.05 | 0.02 |
Freshwater fish | 0.08 | 0.51 | 0.02 | −0.15 |
Organ meat | 0.00 | 0.50 | −0.06 | 0.05 |
Fungi and algae | 0.21 | 0.42 | 0.10 | −0.02 |
Condiments | 0.12 | 0.24 | −0.07 | 0.13 |
Animal fats | −0.01 | −0.24 | −0.11 | 0.02 |
Nuts | 0.14 | 0.14 | 0.05 | −0.02 |
Process grains | −0.14 | −0.22 | 0.69 | 0.21 |
Soya beans | 0.10 | 0.03 | 0.62 | 0.01 |
Grains | −0.14 | −0.12 | 0.57 | −0.15 |
Drinks | −0.07 | 0.06 | −0.53 | 0.22 |
Other beans | 0.22 | 0.10 | 0.41 | 0.04 |
Vegetable oils | −0.10 | 0.07 | −0.24 | 0.11 |
Tuber crops | 0.14 | 0.09 | 0.24 | −0.04 |
Fast food | 0.14 | −0.08 | −0.15 | 0.73 |
Ice cream | 0.07 | −0.09 | −0.16 | 0.60 |
Sweets | 0.17 | 0.07 | −0.16 | 0.49 |
Snacks | 0.16 | −0.21 | −0.16 | 0.47 |
Dairy products | 0.17 | −0.16 | −0.01 | 0.32 |
Red meat | −0.14 | 0.12 | 0.08 | −0.01 |
Eggs | 0.71 | 0.01 | 0.11 | 0.02 |
Proportion of explained variance (%) | 8.57 | 8.49 | 8.23 | 7.21 |
Tertiles of Dietary Energy-Adjusted Intake | p for Trend | |||
---|---|---|---|---|
T1 (Referent) | T2 | T3 (Highest) | ||
Factor 1 (vegetable-fruit dietary pattern) | ||||
n (ADHD/control) | 108/90 | 94/103 | 94/103 | |
Model 1 | 1.00 | 0.76 (0.51, 1.13) | 0.76 (0.51, 1.13) | 0.293 |
Model 2 | 1.00 | 0.72 (0.43, 1.19) | 0.69 (0.42, 1.13) | 0.274 |
Factor 2 (fish-white meat dietary pattern) | ||||
n (ADHD/control) | 118/80 | 90/107 | 88/109 | |
Model 1 | 1.00 | 0.57 (0.38, 0.85) | 0.55 (0.37, 0.82) | 0.003 |
Model 2 | 1.00 | 0.64 (0.38, 1.06) | 0.44 (0.27, 0.73) | 0.006 |
Factor 3 (grain-bean dietary pattern) | ||||
n (ADHD/control) | 114/84 | 92/105 | 90/107 | |
Model 1 | 1.00 | 0.65 (0.43, 0.96) | 0.62 (0.42, 0.92) | 0.018 |
Model 2 | 1.00 | 0.61 (0.37, 1.01) | 0.60 (0.36, 1.05) | 0.087 |
Factor 4 (fast food-sweet dietary pattern) | ||||
n (ADHD/control) | 91/106 | 95/102 | 110/88 | |
Model 1 | 1.00 | 1.09 (0.73, 1.61) | 1.46 (0.98, 2.16) | 0.148 |
Model 2 | 1.00 | 0.94 (0.57, 1.57) | 1.25 (0.76, 2.06) | 0.490 |
Nutrient 2 | Nutrient Patterns | |||
---|---|---|---|---|
Factor 1 (Amino Acid-Carbohydrate) | Factor 2 (Vitamin-Dietary Fiber) | Factor 3 (Mineral-Protein) | Factor 4 (Fatty Acid-Cholesterol) | |
Isoleucine | 0.76 | 0.15 | 0.16 | 0.07 |
Valine | 0.76 | 0.14 | 0.20 | 0.05 |
Phenylalanine | 0.75 | 0.18 | 0.12 | 0.03 |
Leucine | 0.74 | 0.16 | 0.18 | 0.06 |
Histidine | 0.64 | 0.20 | 0.19 | 0.08 |
Threonine | 0.63 | 0.13 | 0.22 | 0.09 |
Lysine | 0.52 | 0.16 | 0.19 | 0.10 |
Tryptophan | 0.51 | 0.21 | 0.10 | −0.20 |
Carbohydrate | 0.50 | −0.10 | −0.22 | −0.20 |
Methionine | 0.34 | 0.13 | 0.24 | −0.47 |
Folic acid | 0.06 | 0.64 | 0.06 | 0.15 |
Vitamin B6 | 0.23 | 0.62 | −0.08 | 0.09 |
Dietary fiber | 0.21 | 0.58 | 0.12 | −0.01 |
Magnesium | 0.16 | 0.51 | 0.23 | −0.15 |
Iron | 0.23 | 0.43 | 0.24 | −0.18 |
Potassium | 0.19 | 0.42 | 0.24 | −0.13 |
Vitamin A | −0.05 | 0.40 | 0.18 | 0.07 |
Vitamin E | 0.15 | 0.40 | 0.02 | 0.17 |
Thiamine | 0.19 | 0.34 | 0.20 | −0.07 |
Copper | 0.22 | 0.34 | 0.21 | −0.31 |
Niacin | 0.02 | 0.33 | 0.17 | −0.18 |
Choline | 0.21 | 0.32 | 0.04 | 0.16 |
Vitamin C | −0.04 | 0.32 | 0.06 | −0.14 |
Iodine | 0.16 | 0.20 | −0.06 | 0.17 |
Sodium | −0.08 | 0.09 | 0.09 | 0.08 |
Zinc | 0.19 | 0.23 | 0.59 | −0.17 |
Protein | 0.21 | 0.18 | 0.54 | −0.16 |
Phosphorus | 0.21 | 0.16 | 0.50 | 0.01 |
Selenium | 0.03 | 0.11 | 0.49 | −0.16 |
Riboflavin | 0.06 | 0.03 | 0.47 | 0.13 |
Calcium | 0.24 | 0.07 | 0.42 | 0.03 |
Total fat | −0.11 | −0.15 | 0.16 | 0.57 |
Polyunsaturated fatty acids | 0.16 | 0.08 | 0.18 | 0.53 |
Saturated fatty acids | 0.03 | −0.10 | −0.25 | 0.43 |
Monounsaturated fatty acids | 0.18 | 0.16 | 0.01 | 0.39 |
Cholesterol | 0.16 | −0.16 | 0.13 | 0.34 |
Manganese | 0.18 | 0.19 | 0.18 | −0.32 |
Proportion of explained variance (%) | 24.99 | 16.93 | 12.90 | 10.38 |
Tertiles of Nutrient Energy-Adjusted Intake | p for Trend | |||
---|---|---|---|---|
T1 (Referent) | T2 | T3 (Highest) | ||
Factor 1 (amino acid-carbohydrate nutrient pattern) | ||||
n (ADHD/control) | 103/93 | 104/94 | 89/109 | |
Model 1 | 1.00 | 0.99 (0.67, 1.48) | 0.74 (0.50, 1.10) | 0.220 |
Model 2 | 1.00 | 1.20 (0.74, 1.97) | 0.89 (0.54, 1.46) | 0.449 |
Factor 2 (vitamin-dietary fiber nutrient pattern) | ||||
n (ADHD/control) | 105/92 | 94/104 | 97/100 | |
Model 1 | 1.00 | 0.79 (0.53, 1.18) | 0.85 (0.57, 1.26) | 0.495 |
Model 2 | 1.00 | 0.87 (0.53, 1.41) | 0.95 (0.58, 1.55) | 0.842 |
Factor 3 (mineral-protein nutrient pattern) | ||||
n (ADHD/control) | 113/85 | 107/90 | 76/121 | |
Model 1 | 1.00 | 0.89 (0.60, 1.33) | 0.47 (0.32, 0.71) | <0.001 |
Model 2 | 1.00 | 0.79 (0.49, 1.28) | 0.53 (0.32, 0.88) | 0.014 |
Factor 4 (fatty acid-cholesterol nutrient pattern) | ||||
n (ADHD/control) | 93/104 | 101/96 | 102/96 | |
Model 1 | 1.00 | 1.18(0.79, 1.75) | 1.19 (0.80, 1.76) | 0.631 |
Model 3 | 1.00 | 1.50(0.92, 2.46) | 1.50 (0.91, 2.47) | 0.181 |
Blood Elements | Model 1 | Model 2 | ||||||
---|---|---|---|---|---|---|---|---|
OR 1 (95% CI) | p | OR per SD (95% CI) | p | OR (95% CI) | p | OR per SD (95% CI) | p | |
Zinc (μmol/L) | 0.96 (0.96–0.99) | 0.005 | 0.74 (0.60–0.90) | 0.002 | 0.98 (0.96–0.99) | 0.008 | 0.73 (0.60–0.89) | 0.003 |
Iron (mmol/L) | 1.16 (0.90–1.49) | 0.243 | 1.22 (0.99–1.49) | 0.073 | 1.11 (0.83–1.47) | 0.492 | 1.19 (0.98–1.46) | 0.086 |
Calcium (mmol/L) | 0.77 (0.49–1.21) | 0.258 | 0.96 (0.80–1.14) | 0.608 | 0.82 (0.18–3.68) | 0.795 | 0.94 (0.78–1.12) | 0.464 |
Copper (μmol/L) | 1.02 (0.96–1.08) | 0.531 | 1.09 (0.89–1.33) | 0.399 | 1.03 (0.96–1.10) | 0.407 | 1.09 (0.89–1.33) | 0.424 |
Magnesium (mmol/L) | 0.78 (0.47–1.28) | 0.320 | 0.98 (0.83–1.15) | 0.763 | 0.74 (0.42–1.29) | 0.286 | 0.98 (0.83–1.15) | 0.804 |
© 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Zhou, F.; Wu, F.; Zou, S.; Chen, Y.; Feng, C.; Fan, G. Dietary, Nutrient Patterns and Blood Essential Elements in Chinese Children with ADHD. Nutrients 2016, 8, 352. https://doi.org/10.3390/nu8060352
Zhou F, Wu F, Zou S, Chen Y, Feng C, Fan G. Dietary, Nutrient Patterns and Blood Essential Elements in Chinese Children with ADHD. Nutrients. 2016; 8(6):352. https://doi.org/10.3390/nu8060352
Chicago/Turabian StyleZhou, Fankun, Fengyun Wu, Shipu Zou, Ying Chen, Chang Feng, and Guangqin Fan. 2016. "Dietary, Nutrient Patterns and Blood Essential Elements in Chinese Children with ADHD" Nutrients 8, no. 6: 352. https://doi.org/10.3390/nu8060352