Eating Behaviors, Dietary Patterns and Diet Quality in Newly Diagnosed, Treatment-Naïve Children with ADHD: An Age- and Sex-Matched Case–Control Study

Background/Objectives: Evidence on eating behaviors and dietary characteristics in children with ADHD is limited by clinical heterogeneity and narrow assessment approaches. This exploratory matched case–control study compared eating behaviors, diet quality, highly processed food consumption, and empirically derived dietary patterns between newly diagnosed, treatment-naïve children with ADHD and age- and sex-matched healthy controls. Methods: The study included 64 children with ADHD without major comorbidities and 64 healthy controls individually matched by sex and age (±6 months). Eating behaviors were assessed using the Children’s Eating Behaviour Questionnaire and Behavioral Pediatrics Feeding Assessment Scale. Dietary intake was assessed using a food frequency questionnaire; diet quality, highly processed food consumption, and dietary patterns were evaluated using the MIND Diet Index, the Screening Questionnaire of Highly Processed Food Consumption (sQ-HPF), and principal component analysis, respectively. Each exposure was examined separately using conditional logistic regression, with maternal education included in the primary adjusted models and Holm correction applied across exposure analyses. Results: Children with ADHD had higher desire to drink and sQ-HPF scores and lower MIND Diet Index and healthy dietary pattern scores than matched controls. In the primary adjusted models, higher desire to drink scores (OR = 1.88, 95% CI: 1.37–2.58) and sQ-HPF scores (OR = 2.44, 95% CI: 1.61–3.71) were associated with higher odds of ADHD, whereas higher MIND Diet Index scores were associated with lower odds (OR = 0.77, 95% CI: 0.66–0.89); these associations remained significant after Holm correction. The healthy dietary pattern association did not remain significant after correction. Conclusions: In this exploratory matched study, children with ADHD had higher desire to drink and sQ-HPF scores and lower MIND Diet Index scores; however, the observational design precludes temporal or causal inference, and larger independent prospective studies are needed.