Abstract
Background
Overweight and obesity are major pediatric public health problems in the United States;
however, limited data exist on the prevalence and correlates of overnutrition in children
with autism.
Methods
Through a large integrated health care system's patient database, we identified 6672
children ages 2 to 20 years with an assigned ICD-9 code of autism (299.0), Asperger
syndrome (299.8), and control subjects from 2008 to 2011 who had at least 1 weight
and height recorded in the same visit. We calculated age-adjusted, sex-adjusted body
mass index and classified children as overweight (body mass index 85th to 95th percentile)
or obese (≥95th percentile). We used multinomial logistic regression to compare the
odds of overweight and obesity between groups. We then used logistic regression to
evaluate factors associated with overweight and obesity in children with autism, including
demographic and clinical characteristics.
Results
Compared to control subjects, children with autism and Asperger syndrome had significantly
higher odds of overweight (odds ratio, 95% confidence interval: autism 2.24, 1.74–2.88;
Asperger syndrome 1.49, 1.12–1.97) and obesity (autism 4.83, 3.85–6.06; Asperger syndrome
5.69, 4.50–7.21). Among children with autism, we found a higher odds of obesity in
older children (aged 12–15 years 1.87, 1.33–2.63; aged 16–20 years 1.94, 1.39–2.71)
compared to children aged 6 to 11 years. We also found higher odds of overweight and
obesity in those with public insurance (overweight 1.54, 1.25–1.89; obese 1.16, 1.02–1.40)
and with co-occurring sleep disorder (obese 1.23, 1.00–1.53).
Conclusions
Children with autism and Asperger syndrome had significantly higher odds of overweight
and obesity than control subjects. Older age, public insurance, and co-occurring sleep
disorder were associated with overweight or obesity in this population.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Academic PediatricsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Childhood obesity: public-health crisis, common sense cure.Lancet. 2002; 360: 473-482
- Prevalence of childhood and adult obesity in the United States, 2011–2012.JAMA. 2014; 311: 806-814
- Childhood obesity.Lancet. 2010; 375: 1737-1748
- Childhood obesity and adult morbidities.Am J Clin Nutr. 2010; 91: 1499S-1505S
- The role of pediatricians in the coordinated national effort to address childhood obesity.Pediatrics. 2010; 126: 574-575
- Diagnostic and Statistical Manual of Mental Disorders.4th ed., text revision ed. American Psychiatric Association, Washington, DC2000
- Changes in Prevalence of Parent-Reported Autism Spectrum Disorder in School-Aged US Children: 2007 to 2011–2012.National Center for Health Statistics, Hyattsville, Md2013 (National Health Statistics Report 65)
- A comparison of eating behaviors between children with and without autism.J Autism Dev Disord. 2004; 34: 433-438
- What is the current status of research concerning use of a gluten-free, casein-free diet for children diagnosed with autism?.J Am Diet Assoc. 2009; 109: 572
- Objectively measured physical activity between children with autism spectrum disorders and children without disabilities during inclusive recess settings in Taiwan.J Autism Dev Disord. 2008 Aug; 38: 1292-1301
- Physical activity, dietary habits and overall health in overweight and obese children and youth with intellectual disability or autism.Res Dev Disabil. 2013; 34: 1170-1178
- Obesity and obesity-related secondary conditions in adolescent with intellectual/developmental disabilities.J Intellect Disabil Res. 2010; 54: 787-794
- A longitudinal investigation of psychotropic and non-psychotropic medication use among adolescents and adults with autism spectrum disorders.J Autism Dev Disord. 2009; 39: 1339-1349
- A systematic review of the use of atypical antipsychotics in autism.J Psychopharmacol. 2002; 16: 93-101
- Weight gain and metabolic risks associated with antipsychotic medications in children and adolescents.J Child Adolesc Psychopharmacol. 2011; 21: 517-535
- Weight gain associated with use of psychotropic medications.J Clin Psychiatry. 1999; 60: 16-19
- The prevalence of obesity in children with autism: a secondary data analysis using nationally representative data from the National Survey of Children's Health.BMC Pediatr. 2010; 10: 11
- Prevalence of overweight in children and adolescents with attention deficit hyperactivity disorder and autism spectrum disorders: a chart review.BMC Pediatr. 2005; 5: 48
- Obesity in young children with autism spectrum disorders: prevalence and associated factors.Child Obes. 2013; 9: 125-131
- Obesity in children with autism spectrum disorder.Harv Rev Psychiatry. 2014; 22: 93-103
Zuckerman KE, Hill AP, Guion K, et al. Overweight and obesity: prevalence and correlates in a large clinical sample of children with autism spectrum disorder. J Autism Dev Disord. In press.
Phillips KL, Schieve LA, Visser S, et al. Prevalence and impact of unhealthy weight in a national sample of US adolescents with autism and other learning and behavioral disabilities. Matern Child Health J. In press.
- Calculating the benefits of a research patient data repository.AMIA Annu Symp Proc. 2006; : 1044
- Pediatrician identification of Latino children at risk for autism spectrum disorder.Pediatrics. 2013; 132: 445-453
- 2000 CDC growth charts for the United States: methods and development. National Center for Health Statistics.Vital Health Stat. 2002; 11
- Health Insurance Coverage in Massachusetts: Estimates from the 2008 Massachusetts Health Insurance Survey.Massachusetts Division of Health Care Finance and Policy, Commonwealth of Massachusetts, and Urban Institute, Boston, Mass2008 (Available at: http://www.urban.org/UploadedPDF/411815_Massachusetts_Insurance.pdf. Accessed May 13, 2014.)
- Pharmacological treatments prescribed to people with autism spectrum disorder (ASD) in primary health care.Psychopharmacology (Berl). 2014; 231: 1011-1021
- Medical comorbidities in autism: challenges to diagnosis and treatment.Neurotherapeutics. 2010; 7: 320-327
- Prevalence of overweight and obesity in the United States, 1999–2004.JAMA. 2006; 295 (http://www.urban.org/UploadedPDF/411815_Massachusetts_Insurance.pdf. Accessed May 13, 2014.): 1549-1555
- Racial/ethnic disparities in the identification of children with autism spectrum disorders.Am J Public Health. 2009; 99: 493-498
- Early diagnoses of autism spectrum disorders in Massachusetts birth cohorts, 2001–2005.Pediatrics. 2011; 127: 1043-1051
Article info
Publication history
Accepted:
April 26,
2014
Received:
August 24,
2013
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
