Abstract
Autism Spectrum Disorder (ASD) is a developmental disorder characterized by social and communication deficits and repetitive behaviors. Children with ASD are also at a higher risk for developing overweight or obesity than children with typical development (TD). Childhood obesity has been associated with adverse health outcomes, including insulin resistance, diabetes, heart disease, and certain cancers. Importantly some key factors that play a mediating role in these higher rates of obesity include lifestyle factors and biological influences, as well as secondary comorbidities and medications. This review summarizes current knowledge about behavioral and lifestyle factors that could contribute to unhealthy weight gain in children with ASD, as well as the current state of knowledge of emerging risk factors such as the possible influence of sleep problems, the gut microbiome, endocrine influences and maternal metabolic disorders. We also discuss some of the clinical implications of these risk factors and areas for future research.
Highlights
Autism Spectrum Disorder (ASD) is a developmental disorder characterized by social and communication impairments and repetitive behaviors [1,2]; the global prevalence is estimated at 1 in 160 children [3], current North American estimates are around 1 in 60 children [4,5]
Birthweight was greater in typical development (TD) children and compared to children with ASD (p = 0.03) Extremely rapid weight gain was associated with greater ASD risk
Because the etiologies of ASD and obesity are so complex, risk factors associated with one condition or the other are difficult to disentangle
Summary
Autism Spectrum Disorder (ASD) is a developmental disorder characterized by social and communication impairments and repetitive behaviors [1,2]; the global prevalence is estimated at 1 in 160 children [3], current North American estimates are around 1 in 60 children [4,5]. Children with ASD are often at an increased risk for becoming obese (i.e., body mass index [BMI]-for-age ≥95th percentile) or overweight (i.e., BMI-for-age ≥85th percentile) than children with typical development (TD) [6,7,8] These BMI levels are associated with adverse health outcomes, including insulin resistance, diabetes, heart disease, and certain cancers [9,10]. There is evidence showing that reduced gut microbiota diversity [16,17], hormonal imbalances [18,19,20], and maternal metabolic disorders [21,22] may influence the development of either ASD or childhood obesity alone It is yet not clear whether and to what extent these emerging factors are contributors for unhealthy weight gain and obesity among children with ASD. A critical synthesis of the literature is presented throughout the main text, describing the limitations of included articles
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