Correlates and Contributing Factors to Obesity in Autism Spectrum Disorder Populations Kelsey Borner MA

1,2

, Cy Nadler, PhD

3

, Katrina Poppert

1,2

, Cathleen Odar Stough MA

1,2

, Meredith Dreyer Gillette PhD

1,3

, Rebecca Swinburne Romine PhD

4

1

Center for Children’s Healthy Lifestyles & Nutrition, Kansas City, Missouri

3

Children’s Mercy Hospitals and Clinics, Kansas City, Missouri

2

University of Kansas, Clinical Child Psychology Program, Lawrence, Kansas

4

The Schiefelbusch Institute for Life Span Studies, University of Kansas

Background

• Youth with autism spectrum disorder (ASD) are at increased risk for obesity compared to their typically developing peers (Eaves & Ho, 2008).

• Youth with ASD are also at risk for poor health behaviors, including lower levels of physical activity (Memari et al., 2013), increased screen time use (Must et al., 2014), and more sleep problems (Goldman et al., 2012). However, an exploration of how health risk factors are related to overweight and obesity among youth with ASD does not yet exist in a large sample. • This study examines the relationships between child weight status and health behaviors for children with and without ASD.

Methods

• •

Procedures

: Participants were drawn from the 2011/2012 National Survey of Children’s Health, a nationally representative (50 states, the District of Columbia, and U.S. Virgin Islands) telephone-based survey designed to provide national- and state-level estimates of child health indicators.

The survey randomly sampled parents of children ages 0-17.

•

Measures:

Parent reports of child anthropometrics (height/weight), frequency of physical activity, sleep, and screen time use, and whether or not a doctor had ever told the parent that the child had an ASD.

Participants:

• 45,217 children (ages 10-17 years) with BMI information.

• 925 (1 in 49) reportedly had a current diagnosis of ASD. • Children with ASD : • • • 84.0% male.

White: 62.4%; Hispanic: 21.3%; Black:10.2%; Multiracial/Other: 6.1%.

Mean age = 13.1 years (SD =.175).

• • •

Data Analysis

Non-response and unequal selection probabilities were accounted for by using sampling weights to help establish population-based estimates.

Analyses were conducted using AM Statistical Software (Beta Version 0.06.04. (c) The American Institutes for Research and Jon Cohen, 2011). Aside from descriptive analyses, logistic regression was used for all analyses. The Wald test was used to determine significance.

Acknowledgments

Data used from the 2011/12 National Survey of Children’s Health. Maternal and Child Health Bureau in collaboration with the National Center for Health Statistics. 2011/12 NSCH Indicator Data Set prepared by the Data Resource Center for Child and Adolescent Health, Child and Adolescent Health Measurement Initiative.

www.childhealthdata.org

Results ASD vs. Non-ASD Health Behaviors: Vigorous Physical Activity 0 Days/Week

1-3 Days/Week

4-6 Days/Week

7 Days/Week

Adequate Sleep

0 Days/Week 1-3 Days/Week

4-6 Days/Week

7 Days/Week

Screen Time

TV/Video/Video Games:

<1 Hr/Day 1-4 Hrs/Day ≥ 4 Hrs/Day

Computer/Cell Phone/Electronics:

Never

<1 Hr/Day 1-4 Hrs/Day ≥ 4 Hrs/Day

Electronics in Bedroom:

Yes No

All Children (10 – 17 Years)

ASD

18.8%

30.0%

31.3%

19.9%

Non-ASD

10.2%

26.8%

39.8%

23.2% 3.5% 10.0%

27.2%

59.3% 41.4% 42.2% 16.4%

19.8%

42.7% 25.5% 12.0% 57.7% 42.3% 3.1% 7.4%

34.9%

54.7% 40.5% 44.6% 14.9%

8.7%

46.8% 28.9% 15.6% 61.7% 38.2%

T-test; (p-value) 2.527;

(

.01

) 0.985; (.33)

-2.960;

(

<.01)

-0.932; (.35) 0.236; (.81) 1.298; (.20)

-1.858;

(

.07

) 1.110; (.27) 0.194; (.85) -0.512; (.61) 0.833; (.41)

2.749;

(

<.01

) -1.759; (.82) -1.045; (.30) -1.658; (.10) -1.061; (.29) 1.064; (.29)

Health Behaviors of Children with ASD by Weight Status: Children with ASD (10 - 17 Years) Normal Weight Overweight Obese Wald-test; (p-value) Vigorous Physical Activity

0 Days/Week 1-3 Days/Week 4-6 Days/Week 7 Days/Week

Adequate Sleep 0 Days/Week 1-3 Days/Week

4-6 Days/Week 7 Days/Week

Screen Time

TV/Video/Video Games:

<1 Hr/Day 1-4 Hrs/Day ≥ 4 Hrs/Day

Computer/Cell Phone/Electronics:

Never > 1 Hr/Day 1-4 Hrs/Day ≥ 4 Hrs/Day

Electronics in Bedroom:

Yes No 20.3% 26.5% 28.7% 24.5%

3.8% 6.6%

27.3% 62.3% 39.7% 45.5% 14.7% 24.9% 43.5% 23.9% 7.7% 55.5% 44.4% 12.0% 38.0% 34.7% 15.3%

3.4% 8.7%

27.5% 60.5% 53.7% 30.9% 15.4% 6.6% 43.8% 26.9% 22.7% 57.7% 42.3% 21.1% 33.2% 29.8% 15.8%

1.2% 20.0%

27.0% 51.9% 35.1% 44.5% 20.4% 21.0% 36.9% 29.0% 13.1% 61.0% 39.0% <.001; (.97) 1.221; (.27) 0.196; (.66) 0.377; (.54)

4.818;

(

.03

)

9.494;

(

<.01

) <.001; (.99) 2.210; (.14) 0.214; (.64) 0.027; (.87) 0.676; (.41) 0.353; (.55) 1.504; (.22) 1.779; (.18) 1.134; (.29) 0.103; (.75) 0.097; (.76)

Results Continued Prevalence of Weight Status Non-ASD ASD

Obese 15% Overweight 16% Normal weight 69% Obese 24% Overweight 17% Normal Weight 59%

Conclusions

• Children with ASD are significantly more likely to be obese than their non-ASD peers; however, a clear understanding of the contributing factors remains unknown. • Screen time and sleep patterns as assessed in this survey were not different between children with and without ASD, and did not differentiate between weight statuses among children with ASD.

• Children with ASD are more likely to be sedentary (i.e., zero days of physical activity per week) than their non-ASD peers, which suggests that physical activity among children with ASD should be prioritized as a potential intervention strategy.

population.

References

Eaves, L. C., & Ho, H. H. (2008). Young adult outcome of autism spectrum disorders.

Journal of Autism and Developmental Disorders

,

38

(4), 739-747.

Memari, A. H., Ghaheri, B., Ziaee, V., Kordi, R., Hafizi, S., & Moshayedi, P. (2013). Physical activity in children and adolescents with autism assessed by triaxial accelerometry.

Pediatric Obesity

,

8

(2), 150-158.

Must, A., Phillips, S. M., Curtin, C., Anderson, S. E., Maslin, M., Lividini, K., & Bandini, L. G. (2014). Comparison of sedentary behaviors between children with autism spectrum disorders and typically developing children.

Autism

,

18

, 376-384.

Goldman, S. E., Richdale, A. L., Clemons, T., & Malow, B. A. (2012). Parental sleep concerns in autism spectrum disorders: Variations from childhood to adolescence.

Journal of Autism and Developmental Disorders

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42

(4), 531-538.