Association between executive function and food addiction among children and adolescents with attention deficit hyperactivity disorder

Objectives: To examine the prevalence of food addiction (FA) among children and adolescents with attention deficit hyperactivity disorder (ADHD), and to explore the association between executive function and FA. Study design: This is a cross-sectional study. A total of 1021 children and adolescents aged 6-18 years and their parents participated in this study and completed the Vanderbilt ADHD Diagnostic Parent Rating Scale, Yale Food Addiction Scale and Executive Function Behavior Rating Scale. Results: Among the 1021 children, 139 had both a parent-reported diagnosis of ADHD and met the cutoffs of the VADPRS score; 99 were considered to have food addiction (FA) according to their YFAS scores. After adjusting for age, sex, family income level, parental education level, paternal accompaniment time (hours per week the father spent with the child), maternal accompaniment time (hours per week the mother spent with the child), weekly exercise time, weekday screen time, and sleep time, children with ADHD had significantly higher FA scores compared to children without ADHD (B coefficient = 1.66; 95% CI = 0.19-3.12; p = 0.027). Additionally, FA scores increased with each quartile of executive function level, showing stronger associations at higher levels. Specifically, the B coefficients were 1.01 (95% CI =- 0.29-2.30, p = 0.13) for the second quartile, 3.78 (95% CI = 2.49-5.08, p < 0.001) for the third quartile, and 7.18 (95% CI = 5.89-8.47, p < 0.001) for the fourth quartile. Conclusions: In this cross-sectional study, we found a higher prevalence of FA, as well as a significant association between executive function and FA in children and adolescents with ADHD. These findings provide a new perspective for the early prevention of FA in children with ADHD.