Prevalence of Overweight in Children and Adolescents with Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorders: A Chart Review

Eunice Kennedy Shriver Center, University of Massachusetts Medical School, Waltham, MA, USA.
BMC Pediatrics (Impact Factor: 1.93). 02/2005; 5(1):48. DOI: 10.1186/1471-2431-5-48
Source: PubMed


The condition of obesity has become a significant public health problem in the United States. In children and adolescents, the prevalence of overweight has tripled in the last 20 years, with approximately 16.0% of children ages 6-19, and 10.3% of 2-5 year olds being considered overweight. Considerable research is underway to understand obesity in the general pediatric population, however little research is available on the prevalence of obesity in children with developmental disorders. The purpose of our study was to determine the prevalence of overweight among a clinical population of children diagnosed with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD).
Retrospective chart review of 140 charts of children ages 3-18 years seen between 1992 and 2003 at a tertiary care clinic that specializes in the evaluation and treatment of children with developmental, behavioral, and cognitive disorders. Diagnostic, medical, and demographic information was extracted from the charts. Primary diagnoses of either ADHD or ASD were recorded, as was information on race/ethnicity, age, gender, height, and weight. Information was also collected on medications that the child was taking. Body mass index (BMI) was calculated from measures of height and weight recorded in the child's chart. The Center for Disease Control's BMI growth reference was used to determine an age- and gender-specific BMI z-score for the children.
The prevalence of at-risk-for-overweight (BMI > 85th%ile) and overweight (BMI > 95th%ile) was 29% and 17.3% respectively in children with ADHD. Although the prevalence appeared highest in the 2-5 year old group (42.9%ile), differences among age groups were not statistically significant. Prevalence did not differ between boys and girls or across age groups (all p > 0.05). For children with ASD, the overall prevalence of at-risk-for-overweight was 35.7% and prevalence of overweight was 19%.
When compared to an age-matched reference population (NHANES 1999-2002), our estimates indicate that children with ADHD and with ASD have a prevalence of overweight that is similar to children in the general population.


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    • "A higher percentage of overweight and obesity in school children with ADHD and in adolescents may result from low self-esteem, which is frequent in this group (Treuting and Hinshaw 2001; Hancánd Brzezin´ska 2009), and which may start to develop at that time (Barber et al. 2005), a well as from social exclusion (Diamantopoulou et al. 2005). Because of social isolation, children with ADHD may have fewer opportunities to participate in team sports associated with physical activity, and, therefore, spend more time watching television or playing on a computer than with their peers (Curtin et al. 2005). Peer rejection is often caused by the following behaviors characteristic of children with ADHD: Interrupting conversations, shouting out comments or answers to questions, failure of social cue recognition, and coping with frustration in an aggressive and impulsive way (Dumas and Pelletier 1999, Barber et al. 2005). "
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    ABSTRACT: Objective: Previous studies have associated attention-deficit/hyperactive disorder (ADHD) with growth deviations and obesity. However, available data regarding the growth of children with ADHD in their early childhood are insufficient. Therefore, we aimed to examine whether there are differences in body size between preschool boys with and without ADHD. Methods: The study used cross-sectional and retrospective longitudinal data concerning 112 boys with ADHD and a community-based sample of 308 boys without ADHD. The groups were homogeneous in terms of socioeconomic status, place of residence, term of birth, and birth weight. The average age of diagnosis was 8.3 years, and none of boys had been treated with stimulants before they were 7 years of age. Comparisons were made at the ages of 2, 4, and 6 years, for World Health Organization (WHO)-norm-standardized height, weight, body mass index (BMI), prevalence of underweight, overweight, and obesity. Separate analysis were made for the cross-sectional measurements of current body size. Results: Boys with ADHD at the age of 2 had significantly lower z scores for weight (t=-1.98, p=0.04) and BMI (t=-2.09, p=0.04), and at the age of 4 for weight (t=-2.05, p=0.04) than the boys from the control group. A significantly lower percentage of overweight/obesity was observed in boys with ADHD at the age of 2 in comparison with the control group. At the age of 6, boys with ADHD were underweight more often. Cross-sectional analysis of current body size showed that boys with ADHD had lower z scores for height (t=-3.08, p=0.002) and higher z scores (t=3.13, p=0.002) for BMI. Overweight was more frequent in this group. Conclusions: Preschool boys with ADHD (age of 2-6 years) have a tendency toward lower body weight than their peers. But in subsequent phases of development, they are shorter and more frequently overweight than boys without ADHD, when place of residence, socioeconomic status, term of birth, birth weight, comorbid conditions, and treatment are controlled.
    Journal of child and adolescent psychopharmacology 09/2015; 25(9). DOI:10.1089/cap.2014.0157 · 2.93 Impact Factor
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    • "Evidenced-based health promotion programmes for youth with I/DD are notably absent. Youth with I/DD have not been included broadly in school-based nutrition interventions despite the likelihood that many will become obese and face diet-related chronic diseases in adulthood (Bandini, et al. 2005; Chen 2009; Curtin et al. 2010; Curtin et al. 2005). An important strategy to address disparities in health outcomes and to increase the availability of effective interventions is to adapt existing evidenced-based programmes (Rimmer 2011). "
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    ABSTRACT: Background Evidenced-based health promotion programmes for youth with intellectual and developmental disabilities (I/DD) are notably absent. Barriers include a lack of understanding of how to adapt existing evidence-based programmes to their needs, maximize inclusion and support mutual goals of health and autonomy.Methods We undertook a community-engaged process to adapt a school-based nutrition intervention in a residential school for youth with I/DD. Focus groups and interviews with school staff elicited recommendations for adaptation strategies; these were then reviewed by an expert panel.ResultsAdaptations were developed to address needs in three categories: food-related challenges among students, adjusting to change and transition and social environment factors. Choice and heterogeneity were overarching themes across the adaptation categories.Conclusions Future research should consider community-engaged approaches for adaptation so that youth with I/DD can participate and benefit from evidence-based health promotion programmes to their maximum potential.
    Journal of Applied Research in Intellectual Disabilities 06/2014; 27(6). DOI:10.1111/jar.12104 · 1.38 Impact Factor
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    • "A 2005 meta-analysis of stratified clinical data attempted to statistically evaluate the prevalence of overweight subjects within populations of children diagnosed with ADHD [12]. Subsequently, a similar analysis indicated that a study population of children and adolescents diagnosed with ADD/ADHD and not currently being treated with psychostimulant medication had an approximately 50% greater risk of being overweight in comparison to healthy control subjects [9]. "
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    ABSTRACT: Background Attention deficit hyperactivity disorder (ADHD) is a neurological/behavioral disorder characterized by inattention or hyperactivity and impulsivity, or combined symptomatology. Children with ADHD are predisposed to irregular and/or impulsive eating patterns often leading to compromised physical condition. The goal of the present study was to statistically evaluate parental scoring of patterned eating behaviors and associated lifestyles within a cohort of 100 boys diagnosed with ADHD in comparison to age-matched male controls. Material/Methods The study population consisted of 100 boys aged 6–10 years diagnosed with mixed type ADHD by DSM-IV criteria and 100 aged-matched healthy male control subjects. Patterns of eating behaviors and associated lifestyles were scored by structured parental interviews using a nominal rating scale. Results Interview scores indicated statistically significant differences in patterned eating behaviors in subjects with ADHD in comparison to healthy controls. Notably, subjects diagnosed with ADHD exhibited markedly diminished adherence to a traditional breakfast, lunch, and dinner schedule, which was linked to a significantly higher frequency (>5/day) of irregular eating times. In the ADHD cohort, disruptive patterns of eating behaviors were associated with diminished nutritional value of ingested food (expressed as lowered content of fruits and vegetables) and increased consumption of sweetened beverages. Conclusions Disruptive patterns of eating behaviors, metabolically unfavorable nutritional status, and diminished physical activities of male children diagnosed with ADHD are linked to compromised growth and development and appearance of metabolic diseases in adulthood.
    Medical science monitor: international medical journal of experimental and clinical research 04/2014; 20:608-613. DOI:10.12659/MSM.890495 · 1.43 Impact Factor
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