Abstract
BACKGROUND: Industrialized eating habits have disrupted the balance between n-6 to n-3 polyunsaturated fatty acids, a change reflected in human tissue composition. Increased n-6 to n-3 ratios may contribute to the emergence of several neurodevelopmental conditions. This study aims to determine how the balance between dietary n-6 and n-3 fatty acids relates to attention-deficit/hyperactivity disorder (ADHD) in kids and teenagers in the U.S. METHODS: Data were derived from 5,882 participants aged 4-15 years who participated in the National Health and Nutrition Examination Survey between 1999 and 2004. To examine the connection between dietary n-6 to n-3 fatty acid ratios and ADHD, multivariable logistic regression models were utilized. Additionally, restricted cubic spline models were used to analyze dose-response relationships while conducting stratified, interaction, and sensitivity analyses to support the robustness of the findings. RESULTS: Among 5,882 participants, 386 (6.6%) were diagnosed with ADHD. Relative to the lowest tertile (T1: < 8.56), participants in the second tertile (T2: 8.56-11.21) exhibited a 44% higher adjusted likelihood of having ADHD (95% confidence interval: 1.09-1.90; P = 0.011), while those in the top tertile (T3: > 11.21) had a 49% increased adjusted likelihood of having ADHD (95% confidence interval: 1.11-1.99; P = 0.007). Restricted cubic-spline modeling revealed an approximately linear relationship between dietary n-6 to n-3 fatty acid ratios and ADHD risk, without significant non-linearity (P = 0.547). These findings remained consistent in subgroup and sensitivity analyses. CONCLUSIONS: Higher ratios of n-6 to n-3 fatty acids in diets correlated with a greater likelihood of ADHD in American kids and teens. These findings suggest that dietary modification to restore a healthier fatty acid balance reduces ADHD risk. Further research, particularly long-term cohort studies and randomized controlled trials, remains warranted to establish causality and to determine whether reducing the n-6 to n-3 ratio provides protective effects.