Academic journal article Childhood Obesity

The Effect of Age on the Prevalence of Obesity among US Youth with Autism Spectrum Disorder

Academic journal article Childhood Obesity

The Effect of Age on the Prevalence of Obesity among US Youth with Autism Spectrum Disorder

Article excerpt

[Author Affiliation]

Aviva Must. 1 Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA.

Misha Eliasziw. 1 Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA.

Sarah M. Phillips. 1 Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA.

Carol Curtin. 2 Department of Family Medicine and Community Health, E. K. Shriver Center, UMass Medical School, Charlestown, MA.

Tanja V.E. Kral. 3 Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA.

Mary Segal. 4 The Research Center for Health Care Decision-Making, Inc. , Wyndmoor, PA.

Nancy E. Sherwood. 5 HealthPartners Institute, Bloomington, MN.

Linmarie Sikich. 6 Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University School of Medicine, Durham, NC.

Heidi I. Stanish. 7 Department of Exercise and Health Sciences, University of Massachusetts Boston, Boston, MA.

Linda G. Bandini. 2 Department of Family Medicine and Community Health, E. K. Shriver Center, UMass Medical School, Charlestown, MA. 8 Department of Health Sciences, Boston University, Boston, MA.

Address correspondence to: Aviva Must, PhD, Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, E-mail: aviva.must@tufts.edu

Background

Childhood obesity has been called a pandemic because its prevalence has increased across all child demographic subgroups.1 Since 1980, obesity rates in the United States have tripled among children, ages 6-11, and quadrupled among adolescents2 ; 2012 estimates indicate that more than one-third of children and adolescents are overweight or obese. Although the problem is ubiquitous, groups at high risk for obesity have been identified based on race/ethnicity, income, and disability status.3,4 African American and Hispanic and low-income children have higher obesity prevalence than their counterparts without these characteristics.5,6 Children with developmental disabilities (DD), including those with autism spectrum disorder (ASD), also appear to be at elevated risk for obesity.7-10

ASD is a developmental disorder that is characterized by persistent social impairments, verbal and nonverbal communication difficulties, and restrictive and repetitive patterns of behaviors, activities, and/or interests11 that frequently become evident by 3 years of age and are typically diagnosed by 5 years of age.12 In the most recent CDC survey, 1 in 68 (1.47%) 8-year-old US children have been diagnosed with ASD.13

The etiology of obesity is complex and multifactorial, but at the most basic level, obesity arises from positive energy imbalance, where calories consumed exceed those expended to support basal metabolism, activity, and growth. Children with ASD often exhibit selective eating, frequently resulting in low intakes of fruits and vegetables with ASD and high intakes of calorically dense foods.14-17 As youth age, they are more likely to have access to more energy-dense snacks and less engagement in physical activity compared with the peers without ASD,18 and their physical activity levels decline with age.19,20

Parents of children with ASD report using television for its calming effect,21 which may contribute to high levels of sedentary behavior. Our own work has demonstrated that screen time is greater in children with ASD than their typically developing peers.22 Finally, the proportion of youth with ASD who are treated with atypical antipsychotics and other psychotropic medications associated with weight gain increases with age. …

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