Dietary Profiles, Nutritional Biochemistry Status, and Attention-Deficit/Hyperactivity Disorder: Path Analysis for a Case-Control Study.

This study aims to investigate dietary and nutritional biochemistry profiles of attention-deficit/hyperactivity disorder (ADHD) and to explore their potential relationship by path analysis. We enrolled 216 children with ADHD and 216 age-, height- and gender-matched controls from 31 elementary schools in Taiwan. Dietary intake of the participants was assessed using a food frequency questionnaire (FFQ). Fasting blood samples were collected to determine the serum levels of multiple nutritional markers. Moreover, we employed a structural equation model (SEM) to link diet, nutritional markers and ADHD. Compared to healthy control, ADHD children had significantly lower serum levels of vitamin B12, folate, vitamin B6, ferritin concentration, and monounsaturated fatty acids (MUFA), but higher levels of serum saturated fatty acids (SFA), n-6/n-3 fatty acid ratio, and inorganic phosphorous concentration. Children with ADHD had more intake of nutrient-poor foods such as high sugar and high fat foods, and had less intake of vegetable, fruit, protein-rich foods than their counterpart. SEM analysis showed that the poor nutritional biochemistry profiles linked the association between unhealthy dietary patterns and ADHD. In conclusion, an unhealthy dietary pattern may be a predecessor of the poor nutritional biochemistry status, and managing diet and nutrition conditions should be considered to improve ADHD symptoms in children.

Attention deficit-hyperactivity disorder is associated with allergic symptoms and low levels of hemoglobin and serotonin.

This study investigated whether common comorbidities or biochemical factors, such as allergic disease, anemia, inflammation, and neurotransmitters, are singly or additively associated with an increased risk of attention deficit-hyperactivity disorder (ADHD). We recruited 216 children diagnosed with ADHD and 216 age-, sex-, height-, weight-, and class-matched controls from 31 elementary schools in Taipei, Taiwan. The International Study of Asthma and Allergies in Childhood questionnaire was used to measure allergic symptoms. Fasting venous blood was collected and analyzed for complete blood count, white blood cell differential count, immunoglobulin (Ig) E level, and serotonin (5-HT) level. The results showed that symptoms of both rhinitis (OR = 2.08, 95% CI = 1.42-3.05) and eczema (OR = 1.72, 95% CI = 1.02-2.88) were significantly associated with increased risk of ADHD. Children with ADHD showed considerably lower levels of hemoglobin (p = 0.001) and 5-HT (p < 0.001) and higher IgE level (p < 0.001) and eosinophil count (p = 0.001) than did control children. ADHD risk increased with the number of aforementioned biochemical risk factors present (one factor: OR = 1.87, 95% CI = 0.87-4.18; two factors: OR = 2.90, 95% CI = 1.29-6.48; three factors: OR = 4.47, 95% CI = 1.97-10.13; four factors: OR = 6.53, 95% CI = 2.43-17.57). Findings suggest that either ADHD's etiology is multidimensional or the aforementioned conditions have shared etiology with ADHD.

Association between unhealthful eating patterns and unfavorable overall school performance in children.

The objective of this article is to evaluate the relationship between children's unhealthful eating patterns and overall school performance. The Nutrition and Health survey in Taiwan Elementary School Children, 2001-2002, was carried out by using a multistaged complex sampling design. A total of 2,222 elementary school children who had complete data on demographics, anthropometrics, diet and lifestyle, and overall school performance were included in the analyses. Differences in characteristics between children with favorable and unfavorable overall performance were compared using t test and chi(2) test. Using factor analysis, food frequency of 22 food groups was grouped into five factors, which were used to construct dietary patterns. The association between dietary patterns and unfavorable overall performance was assessed by multiple logistic regression after adjustment for known risk factors. Prevalence of unfavorable overall performance in Taiwanese elementary school children was 7.1%. Unfavorable overall school performance was positively associated with unhealthful eating patterns, which included high intake of low-quality foods (eg, sweets and fried foods) and low intake of dairy products and highly nutrient-dense foods (eg, vegetables, fruit, meat, fish, and eggs). Children with a greater number of unhealthful eating patterns were more at risk for unfavorable overall performance in school. The study shows that children with unfavorable overall school performance were more likely to eat sweets and fried foods, and were less likely to eat foods rich in protein, vitamins, and minerals. A potential relationship between eating patterns and unfavorable overall school performance is supported by a positive relationship between frequency of food intake and food preferences in our study.

Plasma retinol and a-tocopherol status of the Taiwanese elderly population.

Biochemical assessment of vitamin A and vitamin E status of Taiwanese elderly persons was conducted by quantitative analysis of the concentration of retinol and alpha-tocopherol in plasma samples collected in the Elderly Nutrition and Health Survey in Taiwan (1999-2000). Plasma samples were analyzed by a reverse phase HPLC that can detect retinol and alpha-tocopherol simultaneously. The mean (SE) plasma retinol and alpha-tocopherol values in the 2373 valid samples were 2.73 (0.03) and 27.12 (0.47) microM, respectively, after weighting to the whole population using the SUDDAN program. Among the elderly persons studied, 99.52% of the population demonstrated normal plasma vitamin A status (plasma retinol equal to or greater than 0.7 microM or 0.2 microg/mL). The prevalence of deficient (less than 11.63 microM or 5 microg/mL) and marginal (greater than or equal to 11.63, but less than 16.28 microM or 7 g/mL) plasma alpha-tocopherol concentrations in the elderly population in Taiwan were 2.91% and 10.61%, respectively. However, the prevalence of low or inadequate vitamin E status decreased to 4.20% when the plasma alpha-tocopherol/cholesterol ratio was used as the indicator (less than 2.8 microg/mg). Results of the multiple linear regression analysis revealed that serum lipids had a strong influence on plasma alpha-tocopherol concentration. The results also showed that elderly men, those living in two Central Taiwan regions, and subjects with plasma cholesterol levels higher than 200 or lower than 174 mg/dL all had higher risk of low or inadequate alpha-tocopherol status than their counterparts. In conclusion, the plasma vitamin A and vitamin E status in the Taiwanese elderly are comparable to those reported for adults of developed Western societies.