The Link Between Ultra-Processed Foods and ADHD

Ultra-processed foods (UPFs), as defined by the NOVA classification system, are foods and beverages produced with extensive industrial processing; they are typically made with low-cost ingredients, designed for long shelf-life, and formulated to be highly palatable.¹ Because these products are engineered rather than prepared from basic ingredients, they often include additives such as emulsifiers and color and flavor enhancers, along with food substances never or rarely used in home kitchens (eg, hydrolysed proteins, gluten, casein, whey protein) and processed sweeteners (eg, high-fructose corn syrup, invert sugar, fruit juice concentrate).¹ An Israeli cross-sectional study is among the first to explore the possible link between UPFs and attention-deficit/hyperactivity disorder (ADHD) in children.² 

Study Design

The study analyzed 1135 children aged 6 to 11 years (median age 8.4 years; 51.7% male) who had participated in the 1st Rav-Mabat Kids Survey. ADHD status of the study participants was self-reported by parents/guardians, and dietary intake was assessed using the 24-h recall method. Of the 1135 participants, 111 were classified into the ADHD group.² 

Study Results

Median UPF intake was significantly higher in the ADHD group compared to the non-ADHD group, as measured by grams/day (419.0 grams/day vs 334.0 grams/day, respectively; P = .006) or percentage of total daily food weight (20.8% vs 16.4%, respectively; P = .003). Multivariable models were used to examine the association between ADHD and above-median UPF consumption. The models were sequentially adjusted for potential confounders, including sociodemographic characteristics (age, sex, and socioeconomic status), followed by total daily energy intake, and further adjusted for dietary fiber and alpha-linolenic acid intake. Across all models, children with ADHD in this study had significantly higher odds of consuming above-median levels of UPFs.²

Of the 111 participants in the ADHD group, 37 reported regular treatment with stimulants. No significant differences in UPF consumption were observed according to stimulant treatment status, regardless of whether intake was measured by weight, percent weight, energy, or percent energy, nor was any association found between stimulant treatment and UPF consumption in multivariable logistic and linear regression models.² 

Study Strengths and Limitations

The study benefited from a large sample size, a high response rate, and detailed dietary data collection. Analyses were rigorously adjusted for potential confounding variables; however, residual confounding by unmeasured factors cannot be excluded. The findings may also be subject to selection and information bias, given that participation was voluntary and both ADHD status and dietary intake were parent-reported. The focus on Israeli children may also limit the generalizability of these findings to other age groups or cultural contexts.² 

Implications for ADHD Care

The results of this study expand the ADHD-diet literature by investigating UPF consumption as a distinct dietary dimension. ADHD was associated with higher UPF intake, and this association persisted after adjustment for sociodemographic and nutritional variables.² While causality and directionality remain unresolved, it is possible to consider a bidirectional model in which ADHD-related behavioral phenotypes may promote reliance on highly palatable, convenient foods, while UPF formulations may also contribute to ADHD-related symptoms.² For health care providers, these findings reinforce the value of incorporating dietary pattern assessment into routine ADHD care. Future longitudinal and mechanistic studies are needed to clarify whether reducing UPF exposure can meaningfully alter clinical trajectories in ADHD.

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References:

1. Monteiro CA, Cannon G, Levy RB, et al. Ultra-processed foods: what they are and how to identify them. Public Health Nutr. 2019;22(5):936-941. doi:10.1017/S1368980018003762
2. Namimi-Halevi C, Dor C, Kaufman-Shriqui V, Dichtiar R, Bromberg M, Sinai T. Attention-deficit/hyperactivity disorder is associated with increased consumption of ultra-processed foods among children. Pediatr Res. Published online March 3, 2026. doi:10.1038/s41390-026-04844-5