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Neurodevelopmental problems and extremes in BMI
Nóra Kerekes1, Armin Tajnia2, Paul Lichtenstein3
1CELAM (Centre for Ethics, Law and Mental Health), Institute of Neuroscience and Physiology, University of Gothenburg , Gothenburg , Sweden ; Swedish Prison and Probation Services, R&E , Sweden.
Insights
Children with autism spectrum disorder (ASD), with or without attention deficit/hyperactivity disorder (ADHD), show higher risks for extreme body mass index (BMI). This study examined BMI in relation to neurodevelopmental problems in children.
Area of Science:
- Child and Adolescent Psychiatry
- Developmental Psychology
- Pediatric Endocrinology
Background:
- Growing evidence links neurodevelopmental problems (NDPs) to body mass index (BMI) variations.
- Attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) are associated with increased risks of extreme BMI, though findings are inconsistent.
- Limited research exists on extreme BMI prevalence within general pediatric populations concerning NDPs.
Purpose of the Study:
- To determine the prevalence of extreme BMI (low or high) in children with and without ADHD and/or ASD.
- To analyze associations between extreme BMI and specific ADHD or ASD diagnostic subdomains.
- To explore genetic and environmental influences on BMI in children aged 9 and 12.
Main Methods:
- Utilized data from the Child and Adolescent Twin Study in Sweden (CATSS), interviewing parents of 12,496 twins aged 9 and 12.
- Employed the Autism-Tics, ADHD and other Comorbidities (A-TAC) inventory for data collection.
- Applied univariate and multivariate generalized estimating equation models to analyze BMI extremes and NDPs.
Main Results:
- ADHD screen-positive children showed BMI distributions similar to controls, except for 12-year-old girls where ADHD inattention correlated with high BMI.
- ASD scores were linked to both low and high extreme BMIs.
- ASD screen-positive cases were threefold more common in the high BMI group and twofold in the low BMI group compared to controls. Stereotyped behaviors were linked to high BMI.
Conclusions:
- Children diagnosed with ASD, irrespective of co-occurring ADHD, exhibit a greater propensity for developing extreme BMIs (both low and high) compared to their peers without these conditions.
- The findings highlight a significant link between ASD and altered BMI trajectories.
- Further research is warranted to understand the underlying mechanisms and inform interventions.
Abstract:
Background. Over the last few decades, an increasing number of studies have suggested a connection between neurodevelopmental problems (NDPs) and body mass index (BMI). Attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) both seem to carry an increased risk for developing extreme BMI. However, the results are inconsistent, and there have been only a few studies of the general population of children. Aims. We had three aims with the present study: (1) to define the prevalence of extreme (low or high) BMI in the group of children with ADHD and/or ASDs compared to the group of children without these NDPs; (2) to analyze whether extreme BMI is associated with the subdomains within the diagnostic categories of ADHD or ASD; and (3) to investigate the contribution of genetic and environmental factors to BMI in boys and girls at ages 9 and 12. Method. Parents of 9- or 12-year-old twins (n = 12,496) were interviewed using the Autism-Tics, ADHD and other Comorbidities (A-TAC) inventory as part of the Child and Adolescent Twin Study in Sweden (CATSS). Univariate and multivariate generalized estimated equation models were used to analyze associations between extremes in BMI and NDPs. Results. ADHD screen-positive cases followed BMI distributions similar to those of children without ADHD or ASD. Significant association was found between ADHD and BMI only among 12-year-old girls, where the inattention subdomain of ADHD was significantly associated with the high extreme BMI. ASD scores were associated with both the low and the high extremes of BMI. Compared to children without ADHD or ASD, the prevalence of ASD screen-positive cases was three times greater in the high extreme BMI group and double as much in the low extreme BMI group. Stereotyped and repetitive behaviors were significantly associated with high extreme BMIs. Conclusion. Children with ASD, with or without coexisting ADHD, are more prone to have low or high extreme BMIs than children without ADHD or ASD.
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