Dietary Alignment with the Mediterranean Diet is Associated with a Lower Risk of Attention Deficit Hyperactivity Disorder in University Students: A Cross-Sectional Study.

Background and objective: Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders of childhood, causing cognitive and social dysfunctions. Symptoms may persist into adolescence and adulthood or may occur later in life without childhood onset. Nutrition, which is an environmental risk factor, is also important in the treatment of ADHD. The Mediterranean diet (MD) is a dietary model in accordance with the nutritional recommendations indicated in ADHD. The aim of this study was to investigate the relationship between ADHD and dietary alignment with the MD.

Methods: This cross-sectional study was conducted with 440 students aged 18 to 24 years studying at Tekirdağ Namık Kemal University, Türkiye. The data collection tools used in the study were a sociodemographic characteristics form, an MD Quality Index (KIDMED), and the Adult ADHD Self-Report Scale (ASRS).

Results: The mean scores for the Attention Deficit subscale, Hyperactivity/Impulsivity subscale, and total ASRS total score of the participants with low dietary alignment with the MD were significantly higher than those of the participants with moderate and high dietary alignment with the MD (p < 0.001). The KIDMED scores showed a strong negative correlation with the total ASRS scores (r = -0.681; p < 0.001) and the Attention Deficit subscale scores (r = -0.643; p < 0.001) and a moderate negative correlation with the Hyperactivity/Impulsivity subscale scores (r = -0.533; p < 0.001). According to the results of the multivariate linear regression analysis, a one-unit increase in the KIDMED score is associated with a decrease of 2.333 units in the ASRS score (β = -2.333, p < 0.001).

Conclusion: Greater dietary alignment with the MD was associated with a lower risk of ADHD symptoms, including attention deficit and hyperactivity/impulsivity, and the positive relationship between the ASRS subscales suggests that these symptoms often co-occur. Though the findings suggest that the MD may help reduce ADHD risk, the cross-sectional design precludes causal inference.