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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    • "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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    • "); this combination of problems should be seen by parents and health care providers as a 'red flag.' Consistent with prior studies (Curtin et al. 2005; Egan et al. 2013), we found few treatment associations with ASD. The one significant treatment association we found, melatonin use, was likely related to increased sleep problems among children with elevated BMI. "
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    ABSTRACT: Autism Spectrum Disorders (ASDs) and childhood obesity (OBY) are rising public health concerns. This study aimed to evaluate the prevalence of overweight (OWT) and OBY in a sample of 388 Oregon children with ASD, and to assess correlates of OWT and OBY in this sample. We used descriptive statistics, bivariate, and focused multivariate analyses to determine whether demographic characteristics, cognitive and adaptive functioning, behavioral problems, ASD symptoms, and medication use were associated with OWT and OBY in ASD. Overall, 33.8% of children met criteria for OWT and 16.5% met criteria for OBY. OBY was associated with sleep difficulties, melatonin use, and affective problems. Interventions that consider unique needs of children with ASD may hold promise for improving weight status among children with ASD.
    Journal of Autism and Developmental Disorders 03/2014; in press. DOI:10.1007/s10803-014-2050-9 · 3.34 Impact Factor
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