Weight Status in Children with Autism Spectrum Disorder

L. McCarron1, M. Fitzgerald1,2, S. Gallagher1,2, C.S. O’Gorman2, 3, 4 

  1. Department of Paediatrics, The Children’s Ark, University Hospital Limerick, Limerick, Ireland
  2. Graduate Entry Medical School, University of Limerick, Limerick, Ireland
  3. Research Centre, University of Limerick, Limerick, Ireland
  4. National Children’s Research Centre, Dublin, Ireland

Dear Editor,

Obesity in infants and children is rapidly becoming a worldwide epidemic; evidence suggests 1 in 4 Irish children are obese1.  Children with autism or with autism spectrum disorder (ASD) may have unusual eating habits, most frequently described as being overly selective or “picky-eaters”. Cohort studies suggest children with autism prefer energy-dense foods including high sugar and high fat foods which are known to contribute to obesity.4

The aim of our report was to describe the weight, food and dietary habits of children with a diagnosis of autism, using data from the Growing up in Ireland Study, a nationally representative cohort study.

Data derived from the National Longitudinal Study of Children Growing up in Ireland detailing a cohort of 9 year olds (8568) was used to identify children with Autism Spectrum Disorder, including Asperger Syndrome. Parents reported the diagnosis and supporting evidence from the school was recorded. Parents also reported on any chronic health conditions for the child (subsequently coded using ICD-10) and their own perception of their child’s weight. Both height and weight were objectively measured and recorded by a trained interviewer in the home. The children were classified as overweight or obese in accordance with the age and sex specific parameters devised by the International Obesity Task Force1. Weighted frequencies and percentages are presented.

54 parents (0.6% of full cohort) reported a diagnosis of Autism Spectrum disorder which was provided by a professional. Of these, 43 had supporting evidence from the child’s teacher stating that the child received additional resources in school. Over a third of parents (38%) reported that their child’s daily activities were severely hampered by their condition.  34 (80%) of the 43 children were male and 8 (19%) of those had a comorbid physical condition, most commonly diseases of the genitourinary system.  Of the children with measured height and weight, 8 (19%) were overweight and 5 (14%) were obese. Only half of those overweight or obese children were perceived by their parents as ‘slightly overweight’, with the remainder perceived as ‘about the right weight’.

The data from our report demonstrates a significant incidence of obesity and comorbid health conditions in children with Asperger’s and ASD. The incidence of obesity in the full GUI cohort was 7% compared with 14% in children with ASD. The incidence of comorbid health conditions in the full cohort of the GUI study was 11% compared with 19% in children with ASD. This is a significant increase.

Food preferences might be an important risk factor. Our study describes that 43.9% of children with autism had consumed high energy dense foods on at least one occasion in the 24 hours prior. Although “picky eating” and food selectivity can be present in typically developing children, it appears to be more prevalent in those with ASD. Physical activity levels are influential in weight regulation. In our study, 79% of children travelled to school via car or bus with the remaining 14% cycling or walking. Interestingly 61.9% of children had at least 9 days of light exercise in the preceding weeks of the questionnaire.

Although our report describes increased incidence of obesity and comorbid chronic health conditions in children with ASD compared with the general population, it does not identify the specific risk factors contributing to this difference. More targeted studies are required to further examine these risk factors.

Conflicts of Interest Statement
There was no conflict of interest in preparing this report.

Acknowledgements 
Heken Purtill, Ailish Hannigan, Statistics Department, University of Limerick

Corresponding Author
Clodagh O’Gorman
GEMS3-019, Graduate Entry Medical School, University of Limerick, Castletroy, Limerick, Ireland.
Email: Clodagh.OGorman@ul.ie
Telephone: +353 863428384

References

  1. The Childhood Obesity Surveillance Initiative (COSI) in the Republic of Ireland: Findings from 2008, 2010 and 2012
  2. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. Journal of the American Medical Association 2014;311(8):806-814.
  3. National Center for Health Statistics. Health, United States, 2011: With Special Features on Socioeconomic Status and Health. Hyattsville, MD; U.S. Department of Health and Human Services; 2012.
  4. Obesity in Children with Autism Spectrum Disorders Carol Curtin, MSW, Mirjana Jojic, MD, and Linda G. Bandini, PhD, RD Harv Rev Psychiatry.2014 22(2)

P904