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van der Lubbe A, Swaab H, Vermeiren R, van den Akker E, Ester W. Novel Insights into Obesity in Preschool Children with Autism Spectrum Disorder. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01679-1. [PMID: 38300430 DOI: 10.1007/s10578-024-01679-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/02/2024]
Abstract
Obesity is present in 8-32% of the children with Autism Spectrum Disorder (ASD). However, most studies are performed in school-aged children from the USA. The current study compares obesity rates of Dutch preschoolers with ASD with children from the Dutch general population and explores which child- and parental factors are related to obesity in children with ASD. This cross-sectional study is part of the ongoing Tandem Study (Dutch Trial register: NL7534). Seventy-eight children with ASD aged 3-7 years and their parents (77 mothers, 67 fathers) participated. Child factors are: Body Mass Index (by physical measurement), child eating behavior (Child Eating Behavior Questionnaire), child problem behavior (Child Behavior Checklist), and ASD severity (Autism Diagnostic Observation Scale 2). Parental factors are: BMI (by physical measurement), parental eating behavior (Dutch Eating Behavior Inventory), parenting stress (The Parenting Stress Questionnaire) and highest completed educational level (SES). Children with ASD were 8 times more often obese (16.8%) than children from the general population (2.0%). Child BMI correlated positively with child food approach behavior and maternal BMI, and correlated negatively with child 'Slowness in eating'. There was no correlation between child BMI and ASD severity, problem behavior, parental eating behavior, parental stress and SES. Thus, Dutch, preschool children with ASD have 8 times higher obesity rates than children from the general population. More attention to obesity risk in research and clinical care could contribute to the quality of life of individuals with ASD and their families. CLINICAL TRIAL REGISTRATION: Dutch Trial register, NL7534, https://trialsearch.who.int/Trial2.aspx?TrialID=NL7534 .
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Affiliation(s)
- Anna van der Lubbe
- Sarr Autism Rotterdam, Youz Child- and Adolescent Psychiatry, Parnassia Group, Dynamostraat 18, Rotterdam, 3083 AK, The Netherlands.
- Clinical Neurodevelopmental Sciences, Leiden University, Wassenaarseweg 52, Leiden, The Netherlands.
- Parnassia Group, Parnassia Academy, Den Haag, The Netherlands.
| | - Hanna Swaab
- Sarr Autism Rotterdam, Youz Child- and Adolescent Psychiatry, Parnassia Group, Dynamostraat 18, Rotterdam, 3083 AK, The Netherlands
- Clinical Neurodevelopmental Sciences, Leiden University, Wassenaarseweg 52, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Robert Vermeiren
- Child- and Adolescent Psychiatry, LUMC-Curium, Endegeesterstraatweg 27, Oegstgeest, The Netherlands
| | - Erica van den Akker
- Department of Pediatrics, Division Pediatric Endocrinology and Obesity Center CGG NL, Erasmus University Medical Centre-Sophia Children's Hospital, Dr. Molewaterplein 40, Rotterdam, The Netherlands
| | - Wietske Ester
- Sarr Autism Rotterdam, Youz Child- and Adolescent Psychiatry, Parnassia Group, Dynamostraat 18, Rotterdam, 3083 AK, The Netherlands
- Parnassia Group, Parnassia Academy, Den Haag, The Netherlands
- Child- and Adolescent Psychiatry, LUMC-Curium, Endegeesterstraatweg 27, Oegstgeest, The Netherlands
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Rojo-Marticella M, Arija V, Morales-Hidalgo P, Esteban-Figuerola P, Voltas-Moreso N, Canals-Sans J. Anthropometric status of preschoolers and elementary school children with ADHD: preliminary results from the EPINED study. Pediatr Res 2023; 94:1570-1578. [PMID: 37258718 DOI: 10.1038/s41390-023-02671-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND A current area of research interest is the association between ADHD and weight status. This paper aimed to describe the anthropometric status of school children with ADHD, considering age and clinical presentation (inattentive, hyperactive-impulsive, or combined), compared with control children. METHODS Participants came from the "Epidemiological Research Project on Neurodevelopmental Disorders" and consisted of 198 preschoolers (41 with ADHD) and 389 elementary school children (163 with ADHD). ADHD was diagnosed using DSM-5 criteria. Anthropometric measurements were taken at various anatomical points, and height, weight, and body composition were also measured. RESULTS In preschoolers, an association was found between hyperactive-impulsive ADHD and greater height and lower waist-to-height ratio. In elementary school children, regardless of the medication, combined ADHD was associated with smaller head, hip, arm, and thigh circumferences and lower weight, height, and BMI. A total of 19.7% of them were underweight. In contrast, children with inattentive and hyperactive/impulsive presentations presented the highest percentage of overweight/obesity (56%). CONCLUSION The anthropometric status of the school children with ADHD showed differences in terms of age and presentation. Preschoolers with hyperactive-impulsive ADHD are taller, and elementary school children with combined ADHD are shorter and smaller than their age-matched control peers. IMPACT The anthropometric status of the school children with ADHD showed differences in terms of age and presentation. Preschoolers with hyperactive-impulsive ADHD are taller than their control peers. Elementary school children with combined ADHD, regardless of the pharmacological treatment, are shorter and smaller than their control peers. Medication may anthropometrically affect the height of children with inattentive presentation. Anthropometric and dietary monitoring should be recommended to parents of children with ADHD, with and without medication.
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Affiliation(s)
- Meritxell Rojo-Marticella
- Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili (URV), Tarragona, Spain
- Department of Psychology, Research Centre for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili (URV), Tarragona, Spain
- Pere Virgili Institute for Health Research (IISPV), Universitat Rovira i Virgili (URV), Reus, Spain
| | - Victoria Arija
- Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili (URV), Tarragona, Spain
- Pere Virgili Institute for Health Research (IISPV), Universitat Rovira i Virgili (URV), Reus, Spain
| | - Paula Morales-Hidalgo
- Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili (URV), Tarragona, Spain
- Department of Psychology, Research Centre for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili (URV), Tarragona, Spain
- Pere Virgili Institute for Health Research (IISPV), Universitat Rovira i Virgili (URV), Reus, Spain
- Psychology and Education Studies, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - Patricia Esteban-Figuerola
- Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili (URV), Tarragona, Spain
- Department of Psychology, Research Centre for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili (URV), Tarragona, Spain
- Pere Virgili Institute for Health Research (IISPV), Universitat Rovira i Virgili (URV), Reus, Spain
| | - Núria Voltas-Moreso
- Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili (URV), Tarragona, Spain
- Department of Psychology, Research Centre for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili (URV), Tarragona, Spain
- Pere Virgili Institute for Health Research (IISPV), Universitat Rovira i Virgili (URV), Reus, Spain
- Serra Hunter Fellow, Universitat Rovira i Virgili (URV), Tarragona, Spain
| | - Josefa Canals-Sans
- Nutrition and Mental Health Research Group (NUTRISAM), Universitat Rovira i Virgili (URV), Tarragona, Spain.
- Department of Psychology, Research Centre for Behavioral Assessment (CRAMC), Universitat Rovira i Virgili (URV), Tarragona, Spain.
- Pere Virgili Institute for Health Research (IISPV), Universitat Rovira i Virgili (URV), Reus, Spain.
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Manojlovic M, Roklicer R, Trivic T, Milic R, Maksimović N, Tabakov R, Sekulic D, Bianco A, Drid P. Effects of school-based physical activity interventions on physical fitness and cardiometabolic health in children and adolescents with disabilities: a systematic review. Front Physiol 2023; 14:1180639. [PMID: 37362446 PMCID: PMC10289231 DOI: 10.3389/fphys.2023.1180639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/26/2023] [Indexed: 06/28/2023] Open
Abstract
Background: This study aimed to examine the influence of school-based physical exercise programs on physical fitness and cardiometabolic health in children and adolescents with disabilities. Methods: Web of Science, Scopus, and PubMed were thoroughly searched to identify relevant investigations. To be included in the systematic review, studies needed to fulfill the following inclusion criteria: 1) performed school-based physical exercise interventions; 2) parameters evaluated referred to health-related physical fitness (HRPF), skill-related physical fitness (SRPF), and cardiometabolic health; 3) a sample of participants consisted of children and adolescents with disabilities; 4) the mean age of respondents was less than 18 years; and 5) were written in the English language. Results: After searching the databases, a total of 474 studies have been identified, 18 of them met the eligibility criteria, and their outcomes were presented. Relating to the respondents' characteristics, the investigations involved 681 children and adolescents with disabilities, out of which 440 were male and 241 female. Regarding types of physical exercise interventions, the most commonly implemented were combined aerobic and resistance training, aerobic exercise, sports games, adapted high-intensity interval training, as well as sprint interval training. The obtained results unambiguously demonstrated that applied exercise interventions improved HRPF components such as cardiorespiratory fitness, muscular fitness, and flexibility. In terms of the SRPF, agility, balance, coordination, and power were considerably enhanced following the school-based exercise. On the other hand, the influence on indices of body composition and cardiometabolic health is quite controversial. The majority of the available studies did not find favorable effects. Additionally, no adverse events were reported in 7 of 8 research, and adherence to exercise was approximately 92%. Conclusion: School-based physical exercise programs were very efficient in improving HRPF and SRPF in children and adolescents with disabilities, while the evidence concerning the variables of body composition and cardiometabolic health is inconclusive and warrants further investigations.
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Affiliation(s)
- Marko Manojlovic
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Roberto Roklicer
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
- Faculty of Education, Free University of Bozen-Bolzano, Brixen-Bressanone, Italy
| | - Tatjana Trivic
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Rade Milic
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Nemanja Maksimović
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Roman Tabakov
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Damir Sekulic
- Faculty of Kinesiology, University of Split, Split, Croatia
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
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Hernández Fernández IG, Omaña Covarrubias A, Conde Vega J, Rodríguez Ávila J, Díaz Martínez G, Moya Escalera A, López Pontigo L. [Nutritional status and food intake frequency in children with autism spectrum disorder]. NUTR HOSP 2023; 40:347-353. [PMID: 36719005 DOI: 10.20960/nh.04258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Introduction Introduction: children with autism spectrum disorder (ASD) commonly present food hyperselectivity, which could lead to malnutrition. Furthermore, they are usually observed with eutrophic development, and a tendency to overweight or obesity, which might occur because of food preferences. Objectives: to evaluate nutritional status based on anthropometric measurements, and to determine the food intake frequency of Mexican children with ASD. Methods: a cross-sectional study that included 31 children of both sexes, from 5 to 10 years of age, with ASD, recruited for convenience at the Hospital del Niño DIF Hidalgo, Mexico. The variables considered were: weight, height, body mass index, muscle mass, fat mass, and frequency of food consumption. Results: the eutrophic nutritional status had a prevalence of 70.9 %, overweight of 12.9 % and obesity of 12.9 %. According to sex, women had significantly lower BMI and fat mass, but higher muscle mass than men. When comparing by diagnosis, there were no statistical differences. The most commonly consumed foods were tomato, carrot, banana, apple, corn tortilla, wheat flour bread, rice, beans, chicken, egg, whole milk, vegetable oil, gelatin and sweetened beverages. They mostly consumed plain water every day. Conclusions: children with ASD have a eutrophic nutritional status in addition to a significant tendency to overweight and obesity, probably related to a high consumption of sweetened beverages and jelly, as well as a low intake of vegetables. This indicates the need for nutritional surveillance to prevent the development of chronic degenerative diseases.
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Affiliation(s)
| | - Arianna Omaña Covarrubias
- Área Académica de Nutrición. Instituto de Ciencias de la Salud. Universidad Autónoma del Estado de Hidalgo
| | | | | | | | - Adrián Moya Escalera
- Área Académica de Medicina. Instituto de Ciencias de la Salud. Universidad Autónoma del Estado de Hidalgo
| | - Lydia López Pontigo
- Área Académica de Gerontología. Instituto de Ciencias de la Salud. Universidad Autónoma del Estado de Hidalgo
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Arija V, Esteban-Figuerola P, Morales-Hidalgo P, Jardí C, Canals-Sans J. Nutrient intake and adequacy in children with autism spectrum disorder: EPINED epidemiological study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:371-388. [PMID: 35722960 DOI: 10.1177/13623613221098237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT Children with autism spectrum disorder (ASD) have a fivefold elevated risk of developing eating problems, which predisposes them to nutritional deficiencies. This study assesses nutritional intake and adequacy in children with ASD, subdiagnostic autistic symptoms and typically developing (TD) children. Preschool children with ASD and subdiagnostic symptoms had slightly lower intake of monounsaturated fatty acids (MUFA), vitamin D and vitamin B12. Primary school children with ASD and subdiagnostic symptoms had slightly higher intake of protein, cholesterol, thiamine and niacin, and a higher percentage of obesity than children with TD. All children had a high intake in sugars, fats and saturated fatty acids; a very highly inadequate intake of vitamins (vitamins D and E), fibre, b-carotene, calcium and magnesium; and a moderately inadequate intake of vitamin C, folate and iron. However, although all children need nutrition advice, children with ASD and subdiagnostic autistic symptoms had a poorer quality diet than those with TD.
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Affiliation(s)
- Victoria Arija
- Rovira i Virgili University (URV), Spain.,Institut d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Spain
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Sammels O, Karjalainen L, Dahlgren J, Wentz E. Autism Spectrum Disorder and Obesity in Children: A Systematic Review and Meta-Analysis. Obes Facts 2022; 15:305-320. [PMID: 35263756 PMCID: PMC9210004 DOI: 10.1159/000523943] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/27/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Children and adolescents with autism spectrum disorder (ASD) appear to be at greater risk of excess weight gain. The aim of this systematic review and meta-analysis was to examine whether children with ASD have a greater prevalence of obesity and whether the prevalence of ASD is higher in children with obesity. METHODS We conducted a systematic search on PubMed, Scopus, and PsychINFO until May 21, 2021. We used the meta package in the R in order to calculate the pooled prevalence and relative risk of obesity in children with ASD. RESULTS We found 20 eligible studies investigating the prevalence of obesity in children with ASD, with the prevalence ranging from 7.9 to 31.8% and from 1.4 to 23.6% among controls. All but three studies originated from the USA. The proportion of children with obesity in ASD populations was 17% (95% confidence interval [CI]: 13-22). The relative risk of obesity in children with ASD compared with control children was 1.58 (95% CI: 1.34-1.86). There were no controlled studies reporting on the prevalence of ASD in children with obesity. CONCLUSION Children and adolescents with ASD have a higher prevalence of obesity than healthy controls. There is a need for further prevalence studies of obesity in children with ASD, especially outside the USA, since the few European studies carried out have failed to show a significant difference between obesity prevalence in children with and without ASD. There is no knowledge at all regarding the prevalence of ASD among children with obesity.
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Affiliation(s)
- Olivia Sammels
- Regional Rehabilitation Centre, Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Louise Karjalainen
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Jovanna Dahlgren
- Department of Pediatrics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Elisabet Wentz
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- *Elisabet Wentz,
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Molina-López J, Leiva-García B, Planells E, Planells P. Food selectivity, nutritional inadequacies, and mealtime behavioral problems in children with autism spectrum disorder compared to neurotypical children. Int J Eat Disord 2021; 54:2155-2166. [PMID: 34704615 DOI: 10.1002/eat.23631] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate body composition, nutritional status through food selectivity and degree of inadequate intake, and mealtime behavior in children with autism spectrum disorder (ASD) compared to neurotypical children. METHOD A cross-sectional case-control study was carried out in 144 children (N = 55 with ASD; N = 91 with neurotypical children) between 6 and 18 years of age. Body composition, nutritional intake, food consumption frequency (FFQ), and mealtime behavior were evaluated. RESULTS Results showed a greater presence of children with a low weight (18.4% ASD vs. 3.20% comparison group) and obesity (16.3% ASD vs. 8.6% comparison group) in the ASD group for body mass index (BMI) categories (p = .003; number needed to take [NNT] = 8.07). The presence of obesity in ASD children compared to the comparison group was even higher when considering the fat component (47.5% ASD vs. 19.4% comparison group, p = .002; NNT = 10.3). ASD children had greater intake inadequacy (50% ASD vs. 22% comparison group, p = .014; NNT = 3.58), high food selectivity by FFQ (60.6% ASD vs. 37.9% comparison group, p < .037; NNT = 4.41), and more eating problems (food rejection, limited variety, disruptive behavior), compared to neurotypical children (p = .001). CONCLUSION Children with ASD showed an unbalanced body composition toward both underweight and obesity, a greater degree of inadequate intake, high food selectivity as indicated by their consumption frequency, and more disturbed eating behavior than children with neurotypical development. We suggest monitoring nutritional inadequacies and implementing nutritional strategies to expand the variety of foods children with ASD consume.
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Affiliation(s)
- Jorge Molina-López
- Faculty of Education, Psychology and Sport Sciences, University of Huelva, Huelva, Spain.,Institute of Nutrition and Food Technology. Biomedical Research Center, Health Sciences Technological Park, University of Granada, Granada, Spain
| | | | - Elena Planells
- Institute of Nutrition and Food Technology. Biomedical Research Center, Health Sciences Technological Park, University of Granada, Granada, Spain.,Department of Physiology, Faculty of Pharmacy, University of Granada, Granada, Spain
| | - Paloma Planells
- Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
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