P3.166: Hunger's Hidden Impact: How Childhood Malnutrition Shapes ADHD Risk in Underserved Communities

Background: The rising prevalence of Attention Deficit Hyperactivity Disorder (ADHD) parallels increasing nutritional deficiencies in underserved communities. AHDH affects 5-7% of children globally, with higher diagnosis rates in underprivileged communities. Economic constraints lead to nutrient deficiencies in early development, possibly linked to long-term cognitive and behavioral effects.

Methods: This systematic review examined the relationship between nutritional deficiencies and ADHD prevalence in children from underserved communities, with emphasis on folate deficiency. We screened 2,110 studies from PubMed Central (January 2014-November 2024), identifying 68 randomized controlled trials meeting inclusion criteria.

Results: Our findings revealed a significant association between early childhood malnutrition and persistent attention deficits into adulthood. In a longitudinal study of 145 adults (n=80 with childhood malnutrition history, n=65 without), 69% of those with childhood malnutrition demonstrated clinical ADHD symptoms between ages 37-43 (p < 0.001). Previously malnourished children exhibited reduced stress response and environmental adaptation capabilities, symptoms commonly associated with ADHD (Galler et al., 2012).

Children with inattentive ADHD were significantly less likely to follow nutritional eating patterns compared to both sibling and community controls (p < 0.001). Specific deficiencies in folate, magnesium, and serine showed strong correlations with ADHD symptom severity. Socioeconomic status emerged as a significant mediating factor influencing both childhood nutrition status and ADHD risk.

Conclusion: While our review demonstrates a compelling link between early childhood malnutrition and ADHD risk in underserved communities, limitations include relatively small sample sizes in longitudinal studies (n < 200) and insufficient quantitative measurements for assessing socioeconomic impacts. Future research should focus on larger-scale longitudinal studies examining the long-term impacts of socioeconomic factors and nutrition on ADHD outcomes, while developing effective nutritional interventions. Our findings underscore the importance of early nutritional intervention in underserved communities, suggesting that targeted nutrition programs could serve as a cost-effective strategy for ADHD prevention in populations facing socioeconomic challenges. This work highlights the need for both preventive nutrition programs and evidence-based intervention strategies for clinical implementation to address this public health concern.