The Association of Lifestyle Factors and Attention Problems in Adolescents

Authors

Keywords:

lifestyle factors, dietary patterns, attention problems, ADHD, adolescence

Abstract

Objective  This study aims to  explore the associations between lifestyle factors such as physical activity, sleep patterns, media usage, and diet, and attention problems in adolescents.

Methods  This cross-sectional study involved 4,370 adolescents aged 13-18 years in Chiang Mai, Thailand. Lifestyle factors were assessed using the Youth Risk Behavior Surveillance System questionnaire, while attention problems were evaluated with the Youth Self-Report (YSR) Attention Problems subscale. Associations were analyzed using univariable and multivariable regression analysis.

Results Media use exceeding two hours per day was significantly asso-ciated with clinical attention problems (aOR = 3.21, 95% CI: 1.81-5.71). Additionally, increased media use (b = 0.24, 95% CI: 0.19-0.28, p < 0.01), and high soft drinks consumption (b = 0.19, 95% CI: 0.12-0.26, p < 0.01) were positively associated with higher attention problem scores. Conversely, active physical activity (b = -0.09, 95% CI: -0.13 to -0.05, p < 0.01), adequate sleep (b = -0.26, 95% CI: -0.33 to -0.19, p < 0.01), regular breakfast intake (b = -0.09, 95% CI: -0.12 to -0.05, p < 0.01), vegetable consumption (b = -0.07, 95% CI: -0.13 to -0.02, p = 0.01), and milk consumption (b = -0.06, 95% CI: -0.11 to -0.01, p = 0.03) were negatively associated with attention problems scores.

Conclusions The study highlights the significant impact of lifestyle factors on attention problems among adolescents. These findings support the integration of lifestyle modifications into the assessment and manage-ment of attention issues in this age group, particularly emphasizing the need to reduce excessive media use. 

References

Polanczyk G, Salum G, Sugaya L, Caye A, Rohde L. Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry. 2015;56:345-65.

Sayal K, Prasad V, Daley D, Ford T, Coghill D. ADHD in children and young people: prevalence, care pathways, and service provision. Lancet Psychiatry. 2018; 5:175-86.

Thomas R, Sanders S, Doust J, Beller E, Glasziou P. Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics. 2015;135:e994-1001. PubMed PMID: 25733754

Association Psychiatric Association. Diagnostic and statistical manual of mental disorders, Fifth Edition. Arlington, VA: American Psychiatric Association; 2013.

Harpin V, Mazzone L, Raynaud JP, Kahle J, Hodgkins P. Long-term outcomes of ADHD: a systematic review of self-esteem and social function. J Atten Disord. 2016;20:295-305.

Challman T, Lipsky J. Methylphenidate: its pharmacology and uses. Mayo Clin Proc. 2000;75:711-21.

Storebo OJ, Pedersen N, Ramstad E, Kielsholm ML, Nielsen SS, Krogh HB, et al. Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents - assessment of adverse events in non-randomised studies. Cochrane Database Syst Rev. 2018;5:CD012069. PubMed PMID: 29744873

Ching C, Eslick GD, Poulton AS. Evaluation of methylphenidate safety and maximum-dose titration rationale in attention-deficit/hyperactivity disorder: a meta-analysis. JAMA Pediatr. 2019;173:630-9.

Sonuga-Barke EJ, Brandeis D, Cortese S, Daley D, Ferrin M, Holtmann M, et al. Nonpharmacological interventions for ADHD: systematic review and meta- analyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry. 2013; 170:275-89.

Pelsser LM, Frankena K, Toorman J, Rodrigues Pereira R. Diet and ADHD, reviewing the evidence: a systematic review of meta-analyses of double-blind placebo- controlled trials evaluating the efficacy of diet interventions on the behavior of children with ADHD. PLoS One. 2017;12:e0169277. PubMed PMID: 28121994

Heilskov Rytter MJ, Andersen LB, Houmann T, Bilenberg N, Hvolby A, Molgaard C, et al. Diet in the treatment of ADHD in children - a systematic review of the literature. Nord J Psychiatry. 2015;69:1-18.

Henriksson P, Cuenca-Garcia M, Labayen I, Esteban- Cornejo I, Henriksson H, Kersting M, et al. Diet quality and attention capacity in European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Br J Nutr. 2017;117:1587-95.

Del-Ponte B, Quinte GC, Cruz S, Grellert M, Santos IS. Dietary patterns and attention deficit/hyperactivity disorder (ADHD): a systematic review and meta-analysis. J Affect Disord. 2019;252:160-73.

Boonchooduang N, Louthrenoo O, Chattipakorn N, Chattipakorn SC. Possible links between gut-microbiota and attention-deficit/hyperactivity disorders in children and adolescents. Eur J Nutr. 2020;59:3391-403.

Kim K, Lim M, Kwon H, Yoo S, Kim E, Kim J, et al. Associations between attention-deficit/hyperactivity disorder symptoms and dietary habits in elementary school children. Appetite. 2018;127:274-9.

Peacock PJ, Lewis G, Northstone K, Wiles N. Childhood diet and behavioural problems: results from the ALSPAC cohort. Eur J Clin Nutr. 2011;65:720-6.

Park S, Cho S, Hong Y, Oh S, Kim J, Shin M, et al. Association between dietary behaviors and attention-deficit/hyperactivity disorder and learning disabilities in school-aged children. Psychiatry Res. 2012;198:468-76.

Yan S, Cao H, Gu C, Ni L, Tao H, Shao T, et al. Dietary patterns are associated with attention-deficit/hyperactivity disorder (ADHD) symptoms among preschoolers in mainland China. Eur J Clin Nutr. 2018;72: 1517-23.

Abbasi K, Beigrezai S, Ghiasvand R, Pourmasoumi M, Mahaki B. Dietary patterns and attention deficit hyperactivity disorder among iranian children: a case-control study. J Am Coll Nutr. 2019;38:76-83.

Hvolby A. Associations of sleep disturbance with ADHD: implications for treatment. Atten Defic Hyperact Disord. 2015;7:1-18.

Schneider H, Lam J, Mahone E. Sleep disturbance and neuropsychological function in young children with ADHD. Child Neuropsychology. 2016;22:493-506.

Rommel A, Lichtenstein P, Rydell M, Kuja-Halkola R, Asherson P, Kuntsi J, Larsson H. Is physical activity causally associated with symptoms of attention-deficit/hyperactivity disorder? J Am Acad Child Adolesc Psychiatry. 2015;54:565-70.

Nikkelen S, Valkenburg P, Huizinga M, Bushman B. Media use and ADHD-related behaviors in children and adolescents: a meta-analysis. Dev Psychol. 2014; 50:2228-41.

Beyens I, Valkenburg P, Piotrowski J. Screen media use and ADHD-related behaviors: four decades of research. Proc Natl Acad Sci U S A. 2018;115:9875-81.

Organization WH [Internet]. BMI-for-age (5-19 years). 2018 [cited 2023 Sep 10]. Available from: https://www.who.int/tools/growth-reference-data-for-5to19-years/indicators/bmi-for-age

Achenbach T, Dumenci L. Advances in empirically based assessment: revised cross-informant syndromes and new DSM-oriented scales for the CBCL, YSR, and TRF: comment on Lengua, Sadowksi, Friedrich, and Fischer (2001). J Consult Clin Psychol. 2001; 69:699-702.

Achenbach T, Ruffle T. The child behavior checklist and related forms for assessing behavioral/emotional problems and competencies. Pediatr Rev. 2000;21: 265-71.

Achenbach T. Manual for ASEBA school-age forms & profiles. University of Vermont, Research Center for Children, Youth & Families. 2001.

Biederman J, DiSalvo M, Vaudreuil C, Wozniak J, Uchida M, Woodworth K, et al. The child behavior checklist can aid in characterizing suspected comorbid psychopathology in clinically referred youth with ADHD. J Psychiatr Res. 2021;138:477-84.

Centers for Disease Control and Prevention [Internet]. 2015 National Youth Risk Behavior Survey. 2015 [cited 2023 Sep 10]. Available from: https://www.cdc.gov/healthyyouth/data/yrbs/files/2015/pdf/2015_xxh_questionnaire.pdf.

Thorell LB, Burén J, Ström Wiman J, Sandberg D, Nutley SB. Longitudinal associations between digital media use and ADHD symptoms in children and adolescents: a systematic literature review. Eur Child Adolesc Psychiatry. 2022.

Engelhard MM, Kollins SH. The many channels of screen media technology in ADHD: a paradigm for quantifying distinct risks and potential benefits. Curr Psychiatry Rep. 2019;21:90. PubMed PMID: 31410653

Adolphus K, Lawton C, Champ C, Dye L. The effects of breakfast and breakfast composition on cognition in children and adolescents: a systematic review. Adv Nutr. 2016;7:590s-612s. PubMed PMID: 27184287

Maffeis C, Fornari E, Surano M, Comencini E, Corradi M, Tommasi M, et al. Breakfast skipping in prepubertal obese children: hormonal, metabolic and cognitive consequences. Eur J Clin Nutr. 2012;66:314-21.

LeLeiko N, Dorfzaun S, Picoraro J. The role of diet, nutrition, and exercise in preventing disease. Pediatr Rev. 2022;43:298-308.

Asiamah N, Petersen C, Kouveliotis K, Eduafo R, Borkey R. The association between physical activity and self-reported health in older adults: lessons implied by lifestyle factors. Adv Gerontol. 2020;33:289-98.

Rios-Hernandez A, Alda JA, Farran-Codina A, Ferreira-Garcia E, Izquierdo-Pulido M. The mediterranean diet and ADHD in children and adolescents. Pediatrics. 2017;139. PubMed PMID: 28138007

Woo H, Kim D, Hong Y, Kim Y, Seo J, Choe B, et al. Dietary patterns in children with attention deficit/hyperactivity disorder (ADHD). Nutrients. 2014;6:1539-53.

Lien L, Lien N, Heyerdahl S, Thoresen M, Bjertness E. Consumption of soft drinks and hyperactivity, mental distress, and conduct problems among adolescents in Oslo, Norway. Am J Public Health. 2006;96:1815-20.

Benton D. Sucrose and behavioral problems. Crit Rev Food Sci Nutr. 2008;48:385-401.

Schoenfelder EN, Kollins SH. Topical review: ADHD and health-risk behaviors: toward prevention and health promotion. J Pediatr Psychol. 2016;41:735-40.

Downloads

Published

2024-06-21

How to Cite

1.
Boonchooduang N, Likhitweerawong N, Louthrenoo O. The Association of Lifestyle Factors and Attention Problems in Adolescents. BSCM [Internet]. 2024 Jun. 21 [cited 2024 Nov. 21];63(3):128-35. Available from: https://he01.tci-thaijo.org/index.php/CMMJ-MedCMJ/article/view/267652

Issue

Section

Original Article