Diet and sleep in children and adolescents with Attention-Deficit Hyperactivity Disorder

Attention-deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in early childhood and adolescence and its consequences can persist through adulthood. It is characterized by continuous inattention and/or hyperactivity- impulsivity. Cognitive impairments are also associated with this disorder. The etiology of ADHD continues to be debated, although several contributing factors have been acknowledged, including diet and sleep. Several studies have analyzed the association between dietary patterns and ADHD. The common result is that unhealthy dietary patterns (i.e. high in saturated fat, refined sugars and low in fruits and vegetables) are associated with ADHD. Although the mechanisms linking low quality diet and ADHD are still unknown, an unbalanced diet, can lead to deficiencies in essential nutrients or higher intakes of certain food components. For instance, low levels of serum iron, ferritin, and long-chain omega-3 seem to have a relationship with ADHD. Specifically, iron deficiency has been reported to be a possible risk factor in the pathophysiology of ADHD. However, to date, the results regarding the potential relationship between iron deficiency and ADHD have shown some inconsistency. On the other hand, sleep disturbances are particularly widespread in ADHD and they contribute to ADHD symptomatology. Moreover, there is evidence that suggest an additional and independent relationship between diet and sleep. The data on this topic are really scarce but associations between more sleep disturbance and higher intakes of carbohydrates, fat, and, most particularly, sugar have been reported. Serum iron levels and long-chain polyunsaturated fatty acid also seem to play a role in the sleep quality of children and adolescents with ADHD. Therefore, the aim of the present thesis project is to assess the possible relationship between our characteristic and healthy dietary pattern, the Mediterranean diet, and the incidence of ADHD. Moreover, the influence of the dietary intake and nutrient deficiencies in children and adolescents with ADHD on their behavioral symptoms and their cognitive abilities as well as their sleep quality will be also analyze