Abstract
This study was performed in order to investigate the relationship between attention deficit hyperactivity disorder (ADHD), dietary habit and caffeine intake in upper-grade elementary school children. The total number of the study subjects was 237 students (111 boys and 126 girls), where 30 students (12.7%) were diagnosed as ADHD. The dietary habit score of the ADHD group was significantly lower than that of the normal group. In particular, the ADHD group had lower dietary scores in consuming daily breakfast, diverse foods, fruit and milk than those in the normal group. Meanwhile, the daily intake frequency of instant noodle (ramyeon) was significantly higher in the ADHD group than that in the normal group. The mean caffeine intake of the students was 42.95 mg and the proportion of students consuming more than the ADI (acceptable daily intake) was 11.8%. The caffeine intake of ADHD group (63.63 mg) tended to be higher than that of the normal group (39.95 mg); however, it was not significantly different. The ADHD score of the students was negatively related with the dietary habit score (r = -0.279, p < 0.01) but positively related with caffeine intake (r = 0.164, p < 0.05). The dietary habit score had a negative relationship with caffeine intake (r = -0.180, p < 0.01) and a positive relationship with height (r = 0.195, p < 0.01). Caffeine intake had a negative relationship with the height of the students (r = -0.171, p < 0.05). In conclusion, ADHD in children was related to poor dietary habit and high caffeine intake.
References
1. Brown JE. Nutrition through the life cycle. 2004. 2nd edition. Belmont: Wadsworth;286–288.
2. Barkley RA. Attention-deficit hyperactivity disorder: a handbook for diagnosis and treatment. 1998. 2nd edition. New York: The Guilford Press.
3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. 2000. 4th edition, text revision. Washington D.C.: American Psychiatric Association;92–93.
4. Rowland AS, Lesesne CA, Abramowitz AJ. The epidemiology of attention-deficit/hyperactivity disorder (ADHD): a public health view. Ment Retard Dev Disabil Res Rev. 2002. 8(3):162–170.
5. Cho YK. Survey on screening and subtype of children with attention-deficit/hyperactivity disorder: based on teachers' observation and rating in the inclusive educare center. Korea J Child Care Educ. 2007. 50:275–295.
6. Root RW II, Resnick RJ. An update on the diagnosis and treatment of attention-deficit/hyperactivity disorder in children. Prof Psychol Res Pr. 2003. 34(1):34–41.
7. Lee HS. A study on attention-deficit/hyperactivity disorder. J Spec Educ Rehabil Sci. 2007. 46(1):169–190.
8. Sinn N. Nutritional and dietary influences on attention deficit hyperactivity disorder. Nutr Rev. 2008. 66(10):558–568.
9. Chung HK, Park SS. The effect of sugar intake on attention deficit hyperactivity disorder of school children. Korean J Nutr. 1995. 28(7):644–652.
10. Choi JY, Lee SS. Relation between dietary habit and nutrition knowledge, and attention deficit hyperactivity disorder (ADHD) in the middle school students in Seoul. Korean J Nutr. 2009. 42(8):682–690.
11. Joo N, Kim S, Park H, Lee S, Kim M, Jung K. The effect of snack intake of preschoolers on ADHD. Korean J Food Cult. 2006. 21(2):193–201.
12. Curtis LT, Patel K. Nutritional and environmental approaches to preventing and treating autism and attention deficit hyperactivity disorder (ADHD): a review. J Altern Complement Med. 2008. 14(1):79–85.
13. Braun JM, Kahn RS, Froehlich T, Auinger P, Lanphear BP. Exposures to environmental toxicants and attention deficit hyperactivity disorder in U.S. children. Environ Health Perspect. 2006. 114(12):1904–1909.
14. Orbeta RL, Overpeck MD, Ramcharran D, Kogan MD, Ledsky R. High caffeine intake in adolescents: associations with difficulty sleeping and feeling tired in the morning. J Adolesc Health. 2006. 38(4):451–453.
15. Barry RJ, Rushby JA, Wallace MJ, Clarke AR, Johnstone SJ, Zlojutro I. Caffeine effects on resting-state arousal. Clin Neurophysiol. 2005. 116(11):2693–2700.
16. Temple JL. Caffeine use in children: what we know, what we have left to learn, and why we should worry. Neurosci Biobehav Rev. 2009. 33(6):793–806.
17. Nawrot P, Jordan S, Eastwood J, Rotstein J, Hugenholtz A, Feeley M. Effects of caffeine on human health. Food Addit Contam. 2003. 20(1):1–30.
18. Castellanos FX, Rapoport JL. Effects of caffeine on development and behavior in infancy and childhood: a review of the published literature. Food Chem Toxicol. 2002. 40(9):1235–1242.
19. Pollak CP, Bright D. Caffeine consumption and weekly sleep patterns in US seventh-, eighth-, and ninth-graders. Pediatrics. 2003. 111(1):42–46.
20. Berkey CS, Rockett HR, Field AE, Gillman MW, Colditz GA. Sugar-added beverages and adolescent weight change. Obes Res. 2004. 12(5):778–788.
21. Blum JW, Jacobsen DJ, Donnelly JE. Beverage consumption patterns in elementary school aged children across a two-year period. J Am Coll Nutr. 2005. 24(2):93–98.
22. Marshall TA, Broffitt B, Eichenberger-Gilmore J, Warren JJ, Cunningham MA, Levy SM. The roles of meal, snack, and daily total food and beverage exposures on caries experience in young children. J Public Health Dent. 2005. 65(3):166–173.
23. Korea Food and Drug Administration. Maximum daily intake levels for caffeine. 2007. Cheongwon:
24. Kim SH. Study of establishment of recommended daily allowance for caffeine. The annual report of KFDA. 2007. Seoul: The Korea Food and Nutrition Foundation.
25. Kim HY, Chun DW. Relationships among personality preferences, dietary habit and nutrient intake of university students. Korean J Food Cult. 2003. 18(5):418–427.
26. Haller J. Lieberman HR, Kanarek RB, Prasad C, editors. Vitamins and brain function. Nutritional Neuroscience. 2005. Boca Raton: Taylor & Francis;207–233.
27. Gornick MC, Addington A, Shaw P, Bobb AJ, Sharp W, Greenstein D, Arepalli S, Castellanos FX, Rapoport JL. Association of the dopamine receptor D4 (DRD4) gene 7-repeat allele with children with attention-deficit/hyperactivity disorder (ADHD): an update. Am J Med Genet B Neuropsychiatr Genet. 2007. 144B(3):379–382.
28. Scheffer RE. Psychopharmacology: clinical implications of brain neurochemistry. Pediatr Clin North Am. 2006. 53(4):767–775.
29. School Health Promotion Center. Yearbook of school health. 2011. Seoul:
30. Kim KA, Shim YH. Cognitive performance and hyperactivity in terms of eating behavior and physical growth among preschoolers:-2. The relationships of several factors (nutritional and social factors, cognition and hyperactivity) on preschoolers-. Korean J Diet Cult. 1995. 10(4):269–279.
32. Virkkunen M. Reactive hypoglycemic tendency among habitually violent offenders. Nutr Rev. 1986. 44:Suppl. 94–103.
33. Bernstein GA, Carroll ME, Thuras PD, Cosgrove KP, Roth ME. Caffeine dependence in teenagers. Drug Alcohol Depend. 2002. 66(1):1–6.
34. Health Canada. Caffeine. It's your health. 2006. 02. cited 2012 Aug 1. Available from: http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/food-aliment/caffeine-eng.php.
35. Warzak WJ, Evans S, Floress MT, Gross AC, Stoolman S. Caffeine consumption in young children. J Pediatr. 2011. 158(3):508–509.
36. Chang YE, Chung HK. Survey of caffeine intake from children's favorite foods. Korean J Nutr. 2010. 43(5):475–488.
37. Lee E, Kim HJ, Im JY, Kim JA, Park H, Ryu JY, Ko KR, Kim HS. Survey of caffeine levels in the favorite diets of children. J Food Hyg Saf. 2007. 22(3):173–178.
38. Kim SD, Yun ES, Chang MS, Park YA, Jung SO, Kim DG, Kin YC, Chae YZ, Kim MY. Survey of daily caffeine intakes from children's beverage consumption and the effectiveness of nutrition education. J Korean Soc Food Sci Nutr. 2009. 38(6):709–720.
39. Walker LR, Abraham AA, Tercyak KP. Adolescent caffeine use, ADHD, and cigarette smoking. Child Health Care. 2010. 39:73–90.
40. Cruz NV, Bahna SL. Do food or additives cause behavior disorders? Pediatr Ann. 2006. 35(10):744–745. 748–754.