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Prevalence of Malnutrition Among School-Aged Children With and Without Intellectual and Developmental Disabilities in

Lujain A Almousa¹, Naseem M Alshwaiyat², Jozaa Z ALTamimi³

¹Department of Health Sciences, College of Health and Rehabilitation Sciences Princess Nourah bint Abdulrahman University Riyadh Saudi Arabia.

Food Science & Nutrition

|April 27, 2026

Insights

Nearly half of Saudi school-aged children have malnutrition, with overnutrition more common than undernutrition. Prevalence was similar between children with intellectual and developmental disabilities (IDD) and those without, but varied significantly across IDD subtypes.

Area of Science:

Pediatric Nutrition
Developmental Pediatrics
Public Health

Background:

Millions of children globally have intellectual and developmental disabilities (IDD), increasing malnutrition risk.
Limited data exists on malnutrition prevalence in Saudi Arabian school-aged children with IDD.
This study addresses the data gap by examining malnutrition in Saudi children with and without IDD.

Purpose of the Study:

To determine the prevalence of malnutrition among school-aged children with and without IDD in Saudi Arabia.
To compare malnutrition rates between children with and without IDD.
To analyze malnutrition distribution across different IDD subtypes.

Main Methods:

Cross-sectional study conducted at a University Hospital in Riyadh, Saudi Arabia.
Recruited school-aged children (5-17 years) with diagnosed ASD, DS, ADHD, CP, and age-matched controls without IDD.
Measured weight and height to calculate BMI-for-age z-scores (BAZ), height-for-age z-scores (HAZ), and weight-for-age z-scores (WAZ) using WHO standards.

Main Results:

Overall malnutrition prevalence was similar in children with (47%) and without (48%) IDD.
Overnutrition (overweight/obesity) was more prevalent than undernutrition in both groups.
Significant heterogeneity in malnutrition prevalence was observed across IDD subtypes: Down syndrome (90%), ADHD (50%), Cerebral Palsy (48%), and Autism Spectrum Disorder (24%).

Conclusions:

Nearly half of the studied Saudi school-aged children exhibited malnutrition, with overnutrition being more common.
While overall malnutrition rates were comparable between children with and without IDD, significant variations exist among IDD subtypes.
Routine growth monitoring and targeted nutritional interventions are crucial in clinical and school settings for children with and without IDD.

Read full analysis

Abstract:

Globally, millions of children live with intellectual and developmental disabilities (IDD), which can raise the risk of malnutrition in children. Data from Saudi Arabia on school-aged children with IDD remain limited. Therefore, this study aimed to determine the prevalence of malnutrition among school-aged children with and without IDD in Saudi Arabia. This cross-sectional study was conducted during August-December of 2024 at the Child Development Center at University Hospital, Riyadh, Saudi Arabia. School-aged children (5-17 years) with clinician-diagnosed autism spectrum disorder (ASD), Down syndrome (DS), attention deficit/hyperactivity disorder (ADHD), or cerebral palsy (CP) and age-matched children without IDD were recruited. Weight and height were measured, and body mass index (BMI) was calculated. WHO Growth Reference 2007 (5-19 years) was used to generate BMI-for-age z-scores (BAZ) and height-for-age z-scores (HAZ) using WHO AnthroPlus; weight-for-age z-scores (WAZ) were computed only for children aged ≤ 10 years. Malnutrition was defined as undernutrition (thinness and/or stunting and/or underweight) and/or overnutrition (overweight and/or obesity). A total of 168 children participated (IDD, n = 68; non-IDD, n = 100). Overall malnutrition prevalence was similar in children with and without IDD (47% vs. 48%; risk ratio [RR] 0.98, 95% CI 0.71-1.36; p = 0.905). Overnutrition was more common than undernutrition in both groups (IDD: 29% overnutrition vs. 25% undernutrition; non-IDD: 32% vs. 28%). Although overall prevalence was comparable, marked heterogeneity was observed across IDD subtypes (malnutrition: DS 90%, ADHD 50%, CP 48%, ASD 24%; χ ² (3) = 12.02, p = 0.007; FDR-adjusted q = 0.022). Concurrent stunting and overweight/obesity (individual-level double burden) was observed in 12% of non-IDD children and 7% of children with IDD. In conclusion, nearly half of this hospital-based sample of Saudi school-aged children had evidence of malnutrition, with overnutrition exceeding undernutrition. While overall malnutrition prevalence did not differ between children with and without IDD, the distribution across IDD subtypes was clinically meaningful. Routine growth monitoring and targeted nutrition support are needed in both clinical and school settings.

Keywords:

Saudi Arabia intellectual and developmental disabilities malnutrition school‐aged children

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