Bisphenol A (BPA) is a widely produced synthetic chemical used to manufacture polycarbonate plastics and epoxy resins. We aimed to investigate the association between exposure to BPA and behavioral and cognitive function in children with attention-deficit/hyperactivity disorder (ADHD) and healthy controls. The study included 444 children aged from 6 to 10 years. The ADHD and control groups included 195 and 249 children, respectively. BPA levels were assessed via urinalysis, while behavior was assessed using the Korean version of the ADHD Rating Scale (K-ARS) and the Behavior Assessment System for Children (BASC-2). Cognitive function was assessed using the Continuous Performance Test (i.e., ADHD Diagnostic System [ADS]). Participants were categorized into tertile groups based on urinary BPA concentration. Scores on the K-ARS and the hyperactivity, aggression, anxiety, and depression subscales of the BASC-2 were significantly different among tertile groups for urinary BPA levels. Scores on visual omission error, commission error, response time variability, and auditory commission error of the ADS were significantly different among three BPA groups. Subgroup analysis revealed that these differences of behavior and cognition among three BPA groups were observed in only boys and normal controls. Exposure to BPA was associated with unfavorable behavioral and cognitive outcomes. Our study extends the findings of previous studies regarding the association between BPA exposure and behavior/cognitive function by including children with ADHD. Further studies are required to determine the mechanisms underlying sex- and group-based differences in these associations.

Kyoung Min Kim, Jee Hyun Kim, Dohyun Kim, Myung Ho Lim, Hyunjoo Joo, Seung-Jin Yoo, Eunjung Kim, Mina Ha, Ki Chung Paik, Ho-Jang Kwon. Clin Psychopharmacol Neurosci 2020;18:553-61. https://doi.org/10.9758/cpn.2020.18.4.553

Background/Objectives: Diet quality is a leading modifiable determinant of non-communicable disease, yet its upstream, person-level determinants are seldom studied. We examined whether health literacy is associated with overall diet quality in a nationally representative Korean sample. Methods: This cross-sectional study analyzed 5353 adults aged ≥19 years from the 2024 Korea National Health and Nutrition Examination Survey. Health literacy, measured with a validated 10-item instrument, was analyzed as score-based categories, continuously, and as the official binary indicator; diet quality was the Korean Healthy Eating Index (KHEI, 0–100) from a single 24 h recall. Survey-weighted linear and logistic regression was used, with component, subgroup, sensitivity, and multiple imputation analyses. Results: The crude difference between the lowest (≤28 points) and highest (≥33 points) categories was positive (β = +1.41); adjustment for age alone inverted it (β = −2.76), and the fully adjusted difference was β = −1.70 (95% CI, −2.66 to −0.75; −0.13 SD), with higher odds of lowest tertile diet quality (OR = 1.37; 95% CI, 1.09 to 1.72; p = 0.007). Each 1-SD increment in health literacy corresponded to β = +0.77 (95% CI, 0.42 to 1.12). Component differences were negative for 12 of 14, but none survived false discovery rate correction. The association was more evident in men (women vs. men, interaction β = −1.03 per 1-SD increment; 95% CI, −1.67 to −0.40). Multiple imputation (m = 20; n = 5678) gave consistent estimates. Conclusions: Lower health literacy was associated with modestly poorer diet quality, an association masked and reversed by age until adjustment. The cross-sectional design precludes causal inference, the single-day assessment may not represent habitual intake, and component and subgroup findings are exploratory.

Background/Objectives: Adults living alone are vulnerable to nutritional inadequacy and depressive symptoms; however, their combined influence remains poorly understood. This study examined the independent and joint associations of nutritional imbalance and oral functional limitation with depressive symptoms among adults living alone and explored potential indirect pathways involving metabolic syndrome (exploratory). Methods: This cross-sectional study used nationally representative data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2022 and 2024, including 1572 adults aged ≥19 years living alone. Nutritional imbalance was assessed by the number of essential nutrients consumed below the Estimated Average Requirement (EAR; range 0–8). Oral functional limitation was defined as chewing or speaking difficulty. Depressive symptoms were evaluated using the Patient Health Questionnaire-9 (PHQ-9). Survey-weighted regression and bootstrapped indirect-effect analyses were performed. Results: Nutritional imbalance was associated with higher PHQ-9 scores (β = 0.216; 95% CI: 0.098–0.335). Oral functional limitation (β = 1.278; 95% CI: 0.739–1.816) and metabolic syndrome score (β = 0.156; 95% CI: 0.006–0.306) were independently associated with depressive severity. Participants with both high nutritional imbalance and oral functional limitation had substantially higher odds of clinical depression (PHQ-9 ≥ 10; OR = 4.268; 95% CI: 2.037–8.943) than the reference group. Exploratory analyses suggested that indirect effects via oral functional limitation and metabolic syndrome were directionally consistent but did not reach statistical significance. Conclusions: Nutritional imbalance and oral functional limitation were jointly associated with depressive symptoms among adults living alone. These findings highlight the importance of integrated strategies targeting dietary quality, oral health, and metabolic health in vulnerable single-person households.