The association between dietary acid load and risk of attention-deficit hyperactivity disorder: a case-control study

Fatemeh Ghasemi, Khadijeh Abbasi, Reza Ghiasvand, Cain C T Clark, Mohammad Hossein Rouhani

    Research output: Contribution to journalArticlepeer-review


    Although previous studies have suggested that dietary acid load may be associated with mental health, the relationship between food-induced acid production and odds of attention-deficit hyperactivity disorder remains (ADHD) unclear. The aim of the present study was to evaluate the relationship between dietary renal acid load and odds of ADHD among children. A case-control study was designed to assess the data of 500 children aged 4 to 12 years (200 children with diagnosed ADHD and 300 control group). Patients were clinically diagnosed according to the Diagnostic and Statistical Manual-5th Edition criteria. Subjects in the control group did not have any history of chronic diseases and they were screened for the absence of ADHD. Dietary intake was assessed by a semi-quantitative food frequency questionnaire. The odds of incident ADHD for each unit increase of potential acid load (PRAL) in the raw model showed ~9.8% (OR = 1.098, 95% CI: 1.072, 1.125, p <.001) higher odds of ADHD. In model 1, where age, gender, Body mass index (BMI), and socio-economic status were adjusted, the odds of ADHD was ~10.7% (OR = 1.107, 95% CI: 1.076, 1.140, p <.001). Also, in model 2 (model 1 in addition to energy) the odds was ~10.8% (OR = 1.108, 95% CI: 1.065, 1.152, p <.001). Findings of the present study suggest a possible relationship between oxidative stresses and odds of development of ADHD. Furthermore, the size of the odds ratio is small. It appears that dietary considerations are warranted in order to ameliorate the impact and/or incidence of ADHD.

    Original languageEnglish
    Article number2099536
    Pages (from-to)474-485
    Number of pages12
    JournalChild neuropsychology : a journal on normal and abnormal development in childhood and adolescence
    Issue number3
    Early online date11 Jul 2022
    Publication statusPublished - 3 Apr 2023


    • case-control
    • Attention-deficit hyperactivity disorder
    • dietary renal acid load
    • potential renal acid load
    • children


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