Rice-based baby food linked to lower ADHD risk in Taiwan study

An analysis of data from the Taiwan Birth Cohort Study found that complementary feeding with rice-based solid food was a protective factor against the development of ADHD, reducing the hazard of the disorder by 27%. Male sex, low family income, low birth weight, and advanced maternal age were among risk factors for ADHD. The research was published in the Journal of Child Psychology and Psychiatry.

Attention-deficit/hyperactivity disorder, or ADHD, is a neurodevelopmental condition that affects focus, impulse control, and activity levels. Commonly diagnosed in childhood, it can persist into adulthood. ADHD often becomes apparent when a child starts primary school, as behaviors symptomatic of ADHD conflict with school rules. People with ADHD tend to struggle with inattention, such as difficulty staying focused or following through on tasks. They also tend to experience hyperactivity, including excessive movement or talking, or impulsivity, such as interrupting conversations or making hasty decisions.

Mainstream treatments for ADHD include behavioral therapy, medication, and lifestyle adjustments. ADHD can negatively impact academic, work, and social life, but many individuals are able to manage it effectively. The proportion of children diagnosed with ADHD has increased in recent decades. For example, the proportion of children with ADHD was between 3.3% and 7.5% in the mid-1990s and increased to around 10% in the mid-2010s.

Study author Chiu-Ying Chen and her colleagues aimed to explore the relationship between infant feeding practices and the later onset of ADHD, specifically examining breastfeeding and complementary feeding. Currently, the causes of ADHD are not fully understood. Scientists believe it likely develops through an interaction of genetic and environmental factors. Nutrition and specific nutrients might also play a role.

These authors analyzed data from the Taiwan Birth Cohort Study, “a nationally representative cohort study designed to establish national norms for children’s development.” Participants in this study were 24,200 newborns and their mothers, born in Taiwan in 2005. Since then, study participants have completed six waves of data collection. The data used in this study were collected when the children were 6 months old, 18 months old, and when they were 3 and 5 years old. By the last analyzed data collection point, the number of participants had decreased to 19,721.

The data analyzed in this study included ADHD diagnosis (“Was your child ever diagnosed with ADHD by a physician or professional of child development?”), information about maternal breastfeeding, complementary feeding (solid food feeding), and data about other potential risk factors for ADHD, such as birth order, birth weight, prematurity, disease, maternal conditions during pregnancy, maternal smoking and alcohol use habits, and others.

Results showed that ADHD was diagnosed in 38 children at age 3 and in 169 children at age 5. Eighty-two percent of mothers breastfed their infants after delivery. The mean duration of breastfeeding was 59 days (slightly less than 2 months), but there was significant variability among mothers in this practice. The majority of mothers breastfed their infants for up to 2 months; 26% breastfed for 3 months, and around 10% breastfed for 6 months.

Sixty-four percent of mothers providing complementary feeding to their infants primarily gave them a variety of rice-based solid foods, but not traditional rice porridge. The remaining 44% of mothers gave their infants traditional rice porridge. Approximately half of the mothers also provided fruits and vegetable juice and mash to their infants. One in three mothers gave their children wheat solid foods.

Children who received rice-based solid foods as complementary feeding had a 27% lower hazard of developing ADHD. Additional factors associated with an increased hazard of ADHD were male sex, lower family income, low birth weight, maternal weight, advanced maternal age, child gastrointestinal disease, child seizures, maternal heart disease, and paternal diabetes mellitus.

“Complementary feeding within 6 months is important to protect infants from developing ADHD. The beneficial effect of breastfeeding within 6 months was not observed while controlling for other risk factors. However, owing to the limitation of a smaller number of ADHD cases, further studies should rely on larger observational periods,” study authors concluded.

The study contributes to the scientific understanding of the links between nutrition in infancy and ADHD. However, the number of children with ADHD in the study was very low. Also, the average breastfeeding period of these infants was 2 months, which is much shorter than the typical duration of breastfeeding globally (6–12 months). This is also much shorter than UNICEF’s recommendation to exclusively breastfeed children for the first 6 months of life.

The paper, “Association between infant feeding and ADHD development in childhood: a birth cohort study in Taiwan,” was authored by Chiu-Ying Chen, Pin-Yang Shih, Chih-Ting Su, Chi-Fung Cheng, Meng-Chih Lee, and Hsien-Yuan Lane.