Summary:
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition with rising prevalence worldwide and a substantial contribution to disability, particularly in childhood. Although both genetic and environmental factors are thought to play a role, dietary influences remain poorly understood. This study was a global observational analysis that examined whether differences in food and nutrient supply are associated with ADHD. It focused on the broader food and nutritional environment, defined by the availability and composition of nutrients within a country. National nutrient supply data were used to understand population-level dietary exposure, as these measures are known to reflect average dietary patterns. ADHD prevalence and incidence data, along with macronutrient supply were collected from more than 150 countries between 1990 and 2018. The findings indicated that food environment and socioeconomic context interact in their association with ADHD burden. Higher fat supply, particularly from plant sources, was associated with lower ADHD prevalence and incidence. These associations were consistent across age groups and sexes and were independent of total energy supply. Carbohydrate and protein supply showed weaker or less consistent relationships. Overall, this study suggests that higher availability of plant-based fats at a population level may have a protective association with ADHD. These findings align with previous reports of symptom improvement with high-fat dietary patterns, such as the ketogenic diet. Further research using individual-level data is needed to clarify biological pathways and inform future dietary strategies for ADHD prevention and management.
Abstract:
Background: Diet and nutrients are emerging key players in neurological disorders. Attention-Deficit/Hyperactivity Disorder (ADHD) is a major neurodevelopmental disorder on a global scale, affecting children and increasingly being recognized and diagnosed in adult populations. While its aetiology is unclear, it appears to involve a combination of genetic and environmental factors, particularly food environments including diets and nutrients. However, most studies so far have focused on the impacts of individual nutrients or dietary patterns on clinically established ADHD. In contrast, the interactive effects of diets and nutrients and their complex interplay with other factors like socioeconomic status on ADHD prevalence and incidence have so far been overlooked. Here, we aim to systematically interrogate the association between nutrient supply, reflecting the food exposure and dietary environment, socioeconomic status and ADHD disease prevalence and incidence at a global level over time. Methods: ADHD disease burden data (incidence and prevalence), macronutrient supply and gross domestic product (GDP) were collated from more than 150 countries from 1990 to 2018 and analyzed with nutritional geometric framework generalized additive mixed models (GAMMs). Results: Modeling results suggested the interactive effects of food environment and socioeconomic status on ADHD. Fat supply, especially plant-based fat supply, is associated with decreased ADHD prevalence and incidence. These associations were conserved across sexes and ages. They were not confounded by the total energy supply. Conclusion: Globally, fat, particularly plant-based fat supply in food environment correlated with the reduction of ADHD prevalence and incidence, implying its potential protective effects. This is supported by previous reports about the amelioration of ADHD with ketogenic diets. Further in-depth studies are needed to elucidate the underlying mechanistic. This might potentially provide some evidence for future targeted dietary interventions for ADHD prevention.
Article Publication Date: 11/11/2025
DOI: 10.3389/fnut.2025.1658228
