TY - JOUR
T1 - Exploring the bidirectional associations of ADHD symptomatology, nutritional status, and body composition in childhood
T2 - evidence from a Brazilian Birth Cohort Study: Pediatrics
AU - Gonçalves, Bárbara Peter
AU - Martins-Silva, Thais
AU - Bierhals, Isabel
AU - Murray, Joseph
AU - Domingues, Marlos R.
AU - Hallal, Pedro C.
AU - Tovo-Rodrigues, Luciana
AU - Bertoldi, Andréa Dâmaso
N1 - This article is based on data from the study \u201CPelotas Birth Cohort, 2015\u201D conducted by the Postgraduate Program in Epidemiology at Universidade Federal de Pelotas, with the collaboration of the Brazilian Public Health Association (ABRASCO). The first phase of the 2015 Pelotas (Brazil) Birth Cohort was funded by the Wellcome Trust (095582). Funding for specific follow-up visits was also received from the Conselho Nacional de Desenvolvimento Cient\u00EDfico e Tecnol\u00F3gico (CNPq) and Funda\u00E7\u00E3o de Amparo a Pesquisa do Estado do Rio Grande do Sul (FAPERGS), Bernard van Leer Foundation (BRA-2018-178) and Department of Science and Technology (DECIT/Brazilian Ministry of Health) for the 4-year follow-up. The 6\u20137 years follow-up received funding from the Department of Science and Technology of the Ministry of Health (Department of Science and Technology (DECIT/Brazilian Ministry of Health), Instituto Todos Pela Sa\u00FAde, Celer Biotecnologia SA, FAPERGS PqG 21/2551-0002004 -0 and CNPq through public notices: 407813/2021-7, 406582/2021-1 and 406582/2021-1. This study was financed in part by the Coordena\u00E7\u00E3o de Aperfei\u00E7oamento de Pessoal de N\u00EDvel Superior - Brasil (CAPES) - Finance Code 001.
PY - 2025/5
Y1 - 2025/5
N2 - Background: Attention deficit hyperactivity disorder (ADHD) has been linked to excessive weight; however, the underlying mechanisms of this association are not well understood. To date, the bidirectional associations between ADHD and nutritional status in childhood have been explored in a limited number of studies, with particularly few of those incorporating body composition data. This study aims to evaluate the associations of ADHD symptoms, nutritional status, and body composition in childhood. Methods: We analyzed data from 3940 children from the 2015 Pelotas (Brazil) Birth Cohort at 4 and 6–7 years of age. Linear regression was performed to evaluate the association between ADHD symptoms and nutritional status (weight, height, and body mass index [BMI]) at ages 4 and 6–7, as well as body composition, specifically fat mass (FF) and fat-free mass (FFM) at ages 6–7. Moreover, a cross-lagged panel model (CLPM) analysis between ADHD symptoms and BMI was performed to explore the bidirectional associations. Results: ADHD symptoms were associated with increased height (β 0.01, 95%CI 0.001, 0.026) and FFM (β 0.02, 95%CI 0.008–0.035) at age 4, and increased BMI (β0.02, 95%IC 0.002, 0.038), weight (β 0. 02, 95%CI 0.005, 0.039), height (β 0.01, 95%CI 0.000, 0.024), and FFM (β 0.02, 95%CI 0.012, 0.040) at ages 6–7. Although the CLPM indicated a small effect suggesting a bidirectional relationship between ADHD symptoms and BMI, the observed associations were not statistically significant: ADHD scores at age 4 predicting BMI z-scores at ages 6–7 (β 0.003; 95% CI: –0.026, 0.020), and BMI z-scores at age 4 predicting ADHD scores at ages 6–7 (β 0.013; 95% CI: –0.018, 0.044). Conclusion: Children with higher ADHD symptoms showed increased growth in weight, height, and BMI. The observed increase in weight and BMI was attributed to greater FFM in these children.
AB - Background: Attention deficit hyperactivity disorder (ADHD) has been linked to excessive weight; however, the underlying mechanisms of this association are not well understood. To date, the bidirectional associations between ADHD and nutritional status in childhood have been explored in a limited number of studies, with particularly few of those incorporating body composition data. This study aims to evaluate the associations of ADHD symptoms, nutritional status, and body composition in childhood. Methods: We analyzed data from 3940 children from the 2015 Pelotas (Brazil) Birth Cohort at 4 and 6–7 years of age. Linear regression was performed to evaluate the association between ADHD symptoms and nutritional status (weight, height, and body mass index [BMI]) at ages 4 and 6–7, as well as body composition, specifically fat mass (FF) and fat-free mass (FFM) at ages 6–7. Moreover, a cross-lagged panel model (CLPM) analysis between ADHD symptoms and BMI was performed to explore the bidirectional associations. Results: ADHD symptoms were associated with increased height (β 0.01, 95%CI 0.001, 0.026) and FFM (β 0.02, 95%CI 0.008–0.035) at age 4, and increased BMI (β0.02, 95%IC 0.002, 0.038), weight (β 0. 02, 95%CI 0.005, 0.039), height (β 0.01, 95%CI 0.000, 0.024), and FFM (β 0.02, 95%CI 0.012, 0.040) at ages 6–7. Although the CLPM indicated a small effect suggesting a bidirectional relationship between ADHD symptoms and BMI, the observed associations were not statistically significant: ADHD scores at age 4 predicting BMI z-scores at ages 6–7 (β 0.003; 95% CI: –0.026, 0.020), and BMI z-scores at age 4 predicting ADHD scores at ages 6–7 (β 0.013; 95% CI: –0.018, 0.044). Conclusion: Children with higher ADHD symptoms showed increased growth in weight, height, and BMI. The observed increase in weight and BMI was attributed to greater FFM in these children.
UR - http://www.scopus.com/inward/record.url?scp=105001101129&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=105001101129&partnerID=8YFLogxK
U2 - 10.1038/s41366-025-01745-1
DO - 10.1038/s41366-025-01745-1
M3 - Article
C2 - 40148560
AN - SCOPUS:105001101129
SN - 0307-0565
VL - 49
SP - 965
EP - 972
JO - International Journal of Obesity
JF - International Journal of Obesity
IS - 5
M1 - dyae048
ER -