Dietary carbohydrates and ADHD symptoms: a systematic review

The connection between dietary carbohydrates and attention-deficit/hyperactivity disorder (ADHD), a common neurodevelopmental disorder, has garnered interest due to its potential implications for behavioral management. Specifically, research has investigated how added sugars, refined starches, and high-glycemic index/load (GI/GL) foods may influence ADHD symptoms and regulation.

A systematic review was conducted in accordance with PRISMA 2020 guidelines, using databases such as PubMed, Scopus, and Web of Science to identify relevant studies published between January 2015 and December 2025. The criteria for inclusion encompassed observational and interventional research focusing on children, adolescents, or adults with a formal ADHD diagnosis or validated symptom assessments. The analysis also involved evaluating the risk of bias using NOS/NOS-adapted criteria, RoB 2, and ROBINS-I methods.

From an initial pool of 1174 records, 48 studies were selected for final analysis, comprising 38 observational and 10 interventional studies. A notable pattern emerged regarding sugar-related dietary exposures; specifically, 15 out of 16 investigations indicated a positive correlation between the consumption of added sugars, sugar-sweetened beverages, candies, and other sweet foods with ADHD diagnoses, symptom severity, hyperactivity, or overall adverse outcomes related to ADHD. However, the evidence relating to total carbohydrate intake appeared inconclusive. In terms of GI/GL, findings were limited, but the available data generally pointed towards negative associations.

Among the interventional studies, six out of ten reported improvements in symptoms following dietary modifications, while four studies yielded mixed or non-significant results. Furthermore, the majority of observational data displayed a moderate to high risk of bias, whereas interventional studies varied in their risk assessment across different areas.

In conclusion, there seems to be a relationship between poorer carbohydrate quality and increased ADHD-related symptoms, while the effect of total carbohydrate consumption remains ambiguous. The findings, however, are tempered by factors such as heterogeneity, residual confounding, and varying levels of bias, alongside a scarcity of targeted carbohydrate intervention studies. [Behavior, ADHD, carbohydrate, hyperactivity]

Year: 2026

Reference: Panayotova, G. G., & Hachmeriyan, A. (2026). Dietary Carbohydrates and ADHD Symptoms: A Systematic Review. Nutrients, 18(10), 1625. https://doi.org/10.3390/nu18101625

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