Abstract
Objective
To determine the prevalence of overweight/obese status in children with autism spectrum
disorders (ASD), identify associated characteristics, and develop a model to predict
weight status.
Methods
The prevalence of overweight and obesity was determined in 2769 children with ASD
enrolled in the Autism Speaks Autism Treatment Network, a collaboration of 17 academic
centers, and compared with a national sample matched for age, sex, and race. Associations
in the ASD sample between weight status and demographic and clinical variables, such
as age, race, head circumference, and adaptive functioning, were tested using ordinal
logistic regression. The accuracy of a final model that predicted weight status based
on early life variables was evaluated in a validation sample.
Results
The prevalence of overweight and obesity were 33.9% and 18.2%, respectively; ASD was
associated with a higher risk of obesity (but not overweight) relative to the national
sample (odds ratio [OR], 1.16; 95% confidence interval [CI], 1.05–1.28; P = .003). In the adjusted analysis, overweight/obese status was significantly associated
with Hispanic ethnicity (OR, 1.99; 95% CI, 1.37–2.89), parental high school education
(OR, 1.56; 95% CI, 1.09–2.21), high birth weight (OR, 1.56; 95% CI, 1.11–2.18), macrocephaly
(OR, 4.01; 95% CI, 2.96–5.43), and increased somatic symptoms (OR, 1.41; 95% CI, 1.01–1.95).
A prediction model designed to have high sensitivity predicted low risk of overweight/obesity
accurately, but had low positive predictive value.
Conclusions
The prevalence of obesity in children with ASD was greater than a national sample.
Independent associations with increased weight status included known risk factors
and macrocephaly and increased level of somatic symptoms. A model based on early life
variables accurately predicted low risk of overweight/obesity.
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
- Prevalence of overweight and obesity in a large clinical sample of children with autism.Acad Pediatr. 2014; 14: 408-414
- 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. 2014; 18: 1964-1975
- Prevalence of obesity among children with chronic conditions.Obesity (Silver Spring). 2010; 18: 210-213
- Obesity in young children with autism spectrum disorders: prevalence and associated factors.Child Obes. 2013; 9: 125-131
- 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
- Body mass index of children from the United Kingdom diagnosed with pervasive developmental disorders.Pediatr Int. 2004; 46: 531-533
- The physical status of children with autism in China.Res Dev Disabil. 2009; 30: 70-76
- Obesity and obesity-related secondary conditions in adolescents with intellectual/developmental disabilities.J Intellect Disabil Res. 2010; 54: 787-794
- Nutrient intake and obesity in children with autism.Focus Autism Other Dev Disabl. 1997; 12: 187-192
- Prevalence of overweight in children and adolescents with attention deficit hyperactivity disorder and autism spectrum disorders: a chart review.BMC Pediatr. 2005; 5: 48
- Body mass index in male and female children with infantile autism.Autism. 2002; 6: 197-205
- Food selectivity in children with autism spectrum disorders and typically developing children.J Pediatr. 2010; 157: 259-264
- Perceived barriers and facilitators of participation in after-school physical activity by children with autism spectrum disorders.J Dev Phys Disabil. 2011; 23: 195-211
- Weight gain associated with atypical antipsychotic use in children and adolescents.Paediatr Drugs. 2004; 6: 33-44
- Obesity estimates for children based on parent-reported versus direct measures.Health Rep. 2011; 22: 47-58
Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion. Cut-offs to define outliers in the 2000 CDC growth charts. Available at: http://www.cdc.gov/nccdphp/dnpa/growthcharts/resources/BIV-cutoffs.pdf. Accessed August 20, 2013.
- Development and validation of a measure of dysmorphology: useful for autism subgroup classification.Am J Med Genet A. 2008; 146A: 1101-1116
- Leadership in health care, research, and quality improvement for children and adolescents with autism spectrum disorders: Autism Treatment Network and Autism Intervention Research Network on Physical Health.Pediatrics. 2012; 130: S62-S68
- Vineland Adaptive Behavior Scales.American Guidance Service, Circle Pines, Minn1984
- Manual for the ASEBA School-Age Forms & Profiles.University of Vermont, Research Center for Children, Youth, & Families, Burlington, Vt2001
- The Children's Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children.Sleep. 2000; 23: 1043-1051
- Matching.in: Peter A. Encyclopedia of Biostatistics. John Wiley and Sons, New York, NY1998: 2441-2445
- Childhood obesity.Lancet. 2010; 375: 1737-1748
- The prevalence and determinants of obesity in adults with intellectual disabilities.Obes Rev. 2007; 8: 223-230
- Measuring heads. The Mismeasure of Man.WW Norton, New York1996: 73-112
- Head circumference and height in autism: a study by the Collaborative Program of Excellence in Autism.Am J Med Genet A. 2006; 140: 2257-2274
- Evidence of brain overgrowth in the first year of life in autism.JAMA. 2003; 290: 337-344
- Body length and head growth in the first year of life in autism.Pediatr Neurol. 2007; 37: 324-330
- Head circumference and body growth in autism spectrum disorders.Brain Dev. 2011; 33: 569-575
- Growth in stature and head circumference in high-functioning autism and Asperger disorder during the first 3 years of life.Dev Psychopathol. 2006; 18: 381-393
- Early generalized overgrowth in boys with autism.Arch Gen Psychiatry. 2011; 68: 1021-1031
- Elevated levels of growth-related hormones in autism and autism spectrum disorder.Clin Endocrinol (Oxf). 2007; 67: 230-237
- Clinical, morphological, and biochemical correlates of head circumference in autism.Biol Psychiatry. 2007; 62: 1038-1047
- Subset of individuals with autism spectrum disorders and extreme macrocephaly associated with germline PTEN tumour suppressor gene mutations.J Med Genet. 2005; 42: 318-321
- Association between the HOXA1 A218G polymorphism and increased head circumference in patients with autism.Biol Psychiatry. 2004; 55: 413-419
- Adjusting head circumference for covariates in autism: clinical correlates of a highly heritable continuous trait.Biol Psychiatry. 2013; 74: 576-584
- Correlates of head circumference growth in infants later diagnosed with autism spectrum disorders.J Child Neurol. 2007; 22: 700-713
Article Info
Publication History
Published online: April 30, 2015
Accepted:
March 16,
2015
Received:
August 11,
2014
Footnotes
The authors have no conflicts of interest to disclose.
Identification
Copyright
© 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
