DISORDERED EATING BEHAVIORS AND NUTRITIONAL ISSUES IN CHILDREN WITH FETAL ALCOHOL SPECTRUM DISORDERS (FASD)

Abstract

FASD is a leading cause of neurodevelopmental disability. Its nutritional impact is unknown. We found that FASD children have higher obesity risk & micronutrient deficiencies. To detail their eating behavior, caregivers completed a nutritional survey of case (63) and control (69) children enrolled in the Collaborative Initiative on FASD. FASD children had higher rates of mental health disorders (14%, P=0.005) & stimulant medication use (43%, P<0.001). Acquisition of age‐appropriate feeding skills (21%, P=0.001) & self‐feeding (max 7.4 yrs) was significantly delayed. Impaired satiety was common (P<0.001) & independent of stimulant use: 23% were never full/satisfied, 29% constantly snacked, 27% ate too quickly, & 24% concealed food. 23% of caregivers restricted food access to prevent overeating & children ate the equivalent of an additional meal/snack daily (4.9/d vs. 3.9/d; P<0.001). Despite this, 21% were underweight (P=0.004). Their meal disinterest (21%) and leaving before meal completion (35%) disrupted family mealtime. 19.4% of children ate separately, 45% were picky eaters, & 36% did not eat what the family ate. These behaviors precluded family dining out (67%). While children with FASD were physically active (mean 2.4 ± 1.2 hr/d), 58% had difficulty with organized games due to problems with focus (23%) and understanding rules (29%). We conclude that disordered eating is common in FASD and these children may benefit from diet counseling. Their poor satiety may reflect their poor impulse control. FASD should be considered in hyperphagic children. These behaviors stress the family dynamic and may lead to obesity in later life. Support: AA11085, AA19580