title: Childhood attention-deficit/hyperactivity disorder symptoms are risk factors for obesity and physical inactivity in adolescence.
abstract: OBJECTIVE
  To prospectively investigate the association and directionality between attention-deficit/hyperactivity disorder (ADHD) symptoms and obesity from childhood to adolescence in the general population. We examined whether obesogenic behaviors, namely, physical inactivity and binge eating, underlie the potential ADHD symptom-obesity association. We explored whether childhood conduct disorder (CD) symptoms are related to adolescent obesity/physical inactivity.
  
  
  METHODS
  At 7 to 8 years (n = 8,106), teachers reported ADHD and CD symptoms, and parents reported body mass index (BMI) and physically active play. At 16 years (n = 6,934), parents reported ADHD symptoms; adolescents reported physical activity (transformed to metabolic equivalent of task [MET] hours per week) and binge eating; BMI and waist-hip ratio (WHR) were measured via clinical examination. Obesity was defined using the International Obesity Task Force (IOTF) cut-offs for BMI and the 95th percentile cut-off for WHR.
  
  
  RESULTS
  Childhood ADHD symptoms significantly predicted adolescent obesity, rather than the opposite. Inattention-hyperactivity symptoms at 8 years were associated with indices of obesity at 16 years (obese BMI: odds ratio [OR] = 1.91, 95% confidence interval [CI] = 1.10-3.33; 95th percentile WHR: OR = 1.71, 95% CI = 1.05-2.78), adjusted for gender, baseline BMI, physical activity, family structure change, and maternal education. Child CD symptoms associated with indices of adolescent obesity. Reduced physically active play in childhood predicted adolescent inattention (OR = 1.61, 95% CI = 1.16-2.24). Childhood ADHD and CD symptoms were linked with physical inactivity in adolescence (inattention-hyperactivity; OR = 1.60, 95% CI = 1.20-2.13), but not binge eating. Physical inactivity mediated the associations.
  
  
  CONCLUSIONS
  Children with ADHD or CD symptoms are at increased risk for becoming obese and physically inactive adolescents. Physical activity may be beneficial for both behavior problems and obesity.
authors.affiliation: Imperial College London, UK.
authors.forename: Natasha
authors.initials: N
authors.lastname: Khalife
authors.affiliation: Imperial College London, UK; LIKES - Research Center for Sports and Health Sciences, Finland.
authors.forename: Marko
authors.initials: M
authors.lastname: Kantomaa
authors.affiliation: Imperial College London, UK.
authors.forename: Vivette
authors.initials: V
authors.lastname: Glover
authors.affiliation: LIKES - Research Center for Sports and Health Sciences, Finland.
authors.forename: Tuija
authors.initials: T
authors.lastname: Tammelin
authors.affiliation: Finnish Institute for Occupational Health, Finland.
authors.forename: Jaana
authors.initials: J
authors.lastname: Laitinen
authors.affiliation: Clinic of Child Psychiatry, University and University Hospital of Oulu, Finland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Ebeling
authors.affiliation: Institute of Health Sciences, University of Oulu, Finland.
authors.forename: Tuula
authors.initials: T
authors.lastname: Hurtig
authors.affiliation: Imperial College London, UK; Medical Research Council (MRC) Health Protection Agency (HMA) Centre for Environment and Health, Imperial College, UK; Institute of Health Sciences, University of Oulu, Finland; Biocenter Oulu, University of Oulu, Finland; Unit of Primary Care, Oulu University Hospital, Finland; and the National Institute for Health and Welfare, Finland.
authors.forename: Marjo-Riitta
authors.initials: MR
authors.lastname: Jarvelin
authors.affiliation: Imperial College London, UK; Mid Sweden University, Sweden. Electronic address: a.rodriguez@imperial.ac.uk.
authors.forename: Alina
authors.initials: A
authors.lastname: Rodriguez
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D002032:Bulimia / Q000453:epidemiology; D002648:Child; D015897:Comorbidity; D019955:Conduct Disorder / Q000453:epidemiology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology; D063766:Pediatric Obesity / Q000453:epidemiology*; D012307:Risk Factors
keywords: attention-deficit/hyperactivity disorder symptoms; conduct disorder symptoms; disruptive behavior; obesity; physical inactivity