Increased resting energy expenditure in children with attention-deficit-hyperactivity disorder.
BACKGROUND
Attention Deficit Hyperactivity Disorder (ADHD) is one of the most frequently reported neuropsychiatric disorders in childhood. However, there is limited data on the biological basis for this disorder. Disturbances in neurotransmitters have been suggested to play a pathophysiologic role. Phenotypically an increased prevalence of obesity has been reported.


OBJECTIVE
To investigate resting energy expenditure (REE) and diet-induced thermogenesis in stimulant medication-naïve children with ADHD.


METHODS
Case control study of 12 pre-pubertal boys with ADHD of the hyperactive-impulsive type and 12 control boys without ADHD. Anthropometric testing and indirect calorimetry were performed before and after a standardized meal. REE and thermogenesis were measured in each subject at 2 time points. In an independent group of 60 boys with ADHD, BMI standard deviation scores (BMI-SDS) were compared to age-adapted reference values.


RESULTS
REE was on average 6.5 kcal/kg fat free mass/day higher in the ADHD compared to the control group (p<0.01). In contrast, the thermogenic effect of food was not different between the two groups (average increase by 16%, p=n.s.). The repeat measurements, an average of 5±1 months apart, were highly reproducible in all subjects. Age and restlessness did not explain the differences in REE. Boys with ADHD had similar BMI-SDS values (mean BMI-SDS -0.10±0.98) as reference groups.


CONCLUSIONS
REE, in contrast to diet-induced thermogenesis, is higher in medication-naïve boys with ADHD. The normal BMI levels suggest increased energy intake in these children.
Mueller
T F
TF
Department of Medicine, University of Alberta, 260 Heritage Medical Research Centre, Edmonton, Alberta T6G2S2, Canada. tmueller@ualberta.ca
Brielmaier
S
S
Domsch
H
H
Luyckx
V A
VA
Ehlers
T
T
Krowatschek
D
D
D000886:Anthropometry; D001289:Attention Deficit Disorder with Hyperactivity / Q000378:metabolism* / Q000503:physiopathology / Q000523:psychology; D001823:Body Composition; D015992:Body Mass Index; D002153:Calorimetry, Indirect; D016022:Case-Control Studies; D002648:Child; D004435:Eating; D002149:Energy Intake; D004734:Energy Metabolism; D006801:Humans; D008297:Male; D012016:Reference Values; D012146:Rest