Abstract
Background. Over the last few decades, an increasing number of studies have suggested a connection between neurodevelopmental problems (NDPs) and body mass index (BMI). Attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) both seem to carry an increased risk for developing extreme BMI. However, the results are inconsistent, and there have been only a few studies of the general population of children.Aims. We had three aims with the present study: (1) to define the prevalence of extreme (low or high) BMI in the group of children with ADHD and/or ASDs compared to the group of children without these NDPs; (2) to analyze whether extreme BMI is associated with the subdomains within the diagnostic categories of ADHD or ASD; and (3) to investigate the contribution of genetic and environmental factors to BMI in boys and girls at ages 9 and 12.Method. Parents of 9- or 12-year-old twins (n = 12,496) were interviewed using the Autism—Tics, ADHD and other Comorbidities (A-TAC) inventory as part of the Child and Adolescent Twin Study in Sweden (CATSS). Univariate and multivariate generalized estimated equation models were used to analyze associations between extremes in BMI and NDPs.Results. ADHD screen-positive cases followed BMI distributions similar to those of children without ADHD or ASD. Significant association was found between ADHD and BMI only among 12-year-old girls, where the inattention subdomain of ADHD was significantly associated with the high extreme BMI. ASD scores were associated with both the low and the high extremes of BMI. Compared to children without ADHD or ASD, the prevalence of ASD screen-positive cases was three times greater in the high extreme BMI group and double as much in the low extreme BMI group. Stereotyped and repetitive behaviors were significantly associated with high extreme BMIs.Conclusion. Children with ASD, with or without coexisting ADHD, are more prone to have low or high extreme BMIs than children without ADHD or ASD.
Highlights
A recent report estimated that 43 million children worldwide are either overweight or obese, and another 92 million are at risk of becoming overweight (de Onis, Blossner & Borghi, 2010)
Prevalence of Attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) diagnoses according to body mass index (BMI) categories There was a normal distribution of BMI in the comparison group, with 69% of the children having a normal BMI and close to equal distribution of the lower and higher ends of the scale (Fig. 2)
Association between extremes in BMI and neurodevelopmental problems (NDPs) Both ADHD and ASD modules were weakly but significantly associated with high and high extreme BMI in the univariable models
Summary
A recent report estimated that 43 million children worldwide are either overweight or obese, and another 92 million are at risk of becoming overweight (de Onis, Blossner & Borghi, 2010). We had three aims with the present study: (1) to define the prevalence of extreme (low or high) BMI in the group of children with ADHD and/or ASDs compared to the group of children without these NDPs; (2) to analyze whether extreme BMI is associated with the subdomains within the diagnostic categories of ADHD or ASD; and (3) to investigate the contribution of genetic and environmental factors to BMI in boys and girls at ages 9 and 12. Significant association was found between ADHD and BMI only among 12-year-old girls, where the inattention subdomain of ADHD was significantly associated with the high extreme BMI. Compared to children without ADHD or ASD, the prevalence of ASD screen-positive cases was three times greater in the high extreme BMI group and double as much in the low extreme BMI group. Children with ASD, with or without coexisting ADHD, are more prone to have low or high extreme BMIs than children without ADHD or ASD
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