Renal and cardiovascular function in children with FASD: Potential links to food approach and avoidance behaviors

Fetal alcohol spectrum disorder (FASD) is associated with a range of developmental, behavioral, and physical impairments. While much research to date has focused on developmental and behavioral aspects of FASD, there is growing evidence that children with FASD may experience alterations in renal and cardiovascular function. By also comparing eating behaviors between children with FASD and typically developing children, this may provide some clues to the underlying causes of these physiological changes.

In this study, we recruited children and adolescents with (n = 34) and without (n = 22) a diagnosis of FASD. We measured several cardiovascular and renal outcomes and analyzed potential associations with eating behaviors related to food approach and avoidance, assessed from caregiver report using the Children's Eating Behavior Questionnaire (CEBQ).

Children with FASD had significantly elevated urinary sodium-to-potassium (Na⁺/K⁺) ratio, a trend for increasing urine sodium (Na⁺), and a reduction in the normal age-associated rise in urine creatinine compared to typically developing controls. The FASD group also exhibited significantly elevated resting heart rate. Additionally, those with a diagnosis of FASD had higher scores for subscales of food approach (food responsiveness, emotional overeating, desire to drink) and a trend toward a higher food avoidance score on the CEBQ. A subset of these behavioral scores was associated with cardiovascular but not renal outcomes.

Together, these findings suggest that renal and cardiovascular function may be altered in children and adolescents with FASD, which may be linked to abnormal food-related behaviors and/or other clinical or demographic factors. While the mechanisms underlying these early-life physiological changes are not fully understood, it is likely they contribute to poorer long-term health outcomes. Further research is needed to validate these preliminary findings in larger cohorts, explore the underlying mechanisms and investigate potential long-term implications of these findings.