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The prevalence and risk factors for overweight/obesity among Turkish children with neurodevelopmental disorders
Sezen Köse1, Helin Yılmaz Kafalı1, Zeynep Gökçe Erkan İdris1
1Ege University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Turkey.
Insights
Overweight and obesity are common in children with neurodevelopmental disorders. Food rewards increase this risk in autism spectrum disorder (ASD), suggesting non-edible reinforcements are preferable.
Area of Science:
- Neurodevelopmental Disorders
- Pediatric Health
- Obesity Research
Background:
- Overweight and obesity (OW/OB) are significant health concerns in children.
- Neurodevelopmental disorders, including autism spectrum disorder (ASD), intellectual disability (ID), and attention deficit-hyperactivity disorder (ADHD), may influence OW/OB prevalence and correlates.
Purpose of the Study:
- To compare the prevalence and contributing factors of OW/OB among children with ASD, ID, and ADHD.
- To identify specific variables associated with OW/OB in each diagnostic group.
Main Methods:
- A cross-sectional study of 267 children (aged 2-18 years) diagnosed with ASD, ID, or ADHD.
- Data collected included body mass index (BMI) percentiles, birth weight, food reward usage, physical activity, screen time, and psychotropic medication use.
Main Results:
- OW/OB prevalence was substantial across all groups: 36.4% in ASD, 40% in ID, and 27.5% in ADHD.
- While ADHD participants had higher stimulant use and lower antipsychotic/antidepressant use, BMI percentiles did not significantly differ between groups.
- In ASD, food reward usage (OR=4.65) and number of psychotropics (OR=2.17) were linked to OW/OB risk. In ADHD, medication and higher birth weight (per kg) increased OW/OB risk (OR=4.09 and OR=2.82, respectively).
Conclusions:
- OW/OB is prevalent in children with neurodevelopmental disorders irrespective of diagnosis.
- Food rewards pose a significant risk for OW/OB in children with ASD.
- Alternative, non-edible positive reinforcement strategies are recommended to mitigate OW/OB in this population.
Objective:
To compare the prevalence and correlates of overweight (OW) and obesity (OB) between autism spectrum disorder (ASD), intellectual disability (ID), and attention deficit-hyperactivity disorder (ADHD) and to investigate which variables significantly contribute to OW/OB in each group.
Methods:
Of 267 cases (96 with ASD, 80 with ID, and 91 with ADHD) aged 2-18 years, body mass index (BMI) percentiles, birth weight, food reward usage, weekly screen and physical activity time, and psychotropics used were recorded.
Results:
OB (OB + OW) prevalence was 22.9 % (36.4 %) in ASD; 22.5 % (40 %) in ID; and 17.6 % (27.5 %) in ADHD. Although the ADHD group had the highest rate of stimulant usage (χ2 = 69.605, p < 0.001), physical activity attendance (χ2 = 49.751, p < 0.001), and the lowest anti-psychotic (χ2 = 69.142, p < 0.001), and anti-depressant usage (χ2 = 7.219, p < 0.001) than ID/DD or ASD, BMI percentile of the participants did not differ between the groups (H(2) = 1.652, p = 0.43). In hierarchical logistic regression analysis, in ASD, food reward (OR = 4.65, 95 %Cl = 1.25-17.19) and the number of psychotropics used (OR = 2.168, 95 %Cl = 1.07-4.36) were significantly related to the risk of OW/OB. In ADHD, each drugs administered and a 1-kilogram elevation in birth weight was associated with a 4.09 and 2.82 increased risk for OW/OB.
Conclusion:
OW/OB is prevalent in children with neurodevelopmental disorders regardless of their diagnosis. Our findings showed that food rewards put a higher risk for OW/OB in ASD than administering a psychotropic. It could be better to use other positive reinforcements other than edible ones to prevent OW/OB in these children.
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