High Prevalence of Overweight and Obesity in Toddlers With Autism Spectrum Disorder

Background and Objectives: Globally, childhood obesity is a major public health crisis. One subgroup at particularly high risk is children with autism spectrum disorders (ASD). This study examined the weight status of Israeli toddlers aged 2–4 years, who were recently diagnosed with ASD, in comparison to controls with typical development (TD).

Methods: Toddlers with ASD, enrolled in the 2015 and 2016 school years at early intervention day care centers, participated in the study. Demographic and clinical data were collected. Growth parameters were measured and presented as z-scores, based on World Health Organization (WHO) standards. The Israeli MABAT Child National Health and Nutrition Survey (2015-2016) provided the control data for TD toddlers. Exclusion criteria included genetic syndromes, chronic diseases and endocrine abnormalities. Descriptive statistics were utilized to display prevalence of overweight/obesity, and logistic regressions were used to examine the relationship between ASD and obesity, adjusting for age, sex, birth weight and maternal education.

Results: Data was collected for toddlers (n=142), 69% males, aged 2.5±0.4 years with ASD and compared to controls (n=129) 53.5% males, aged 3.4±0.4 years with TD. BMI z-scores were significantly higher in ASD versus TD toddlers: 0.65±1.21versus,-0.18±1.41, p<0.0001, while no significant differences were found in height z-scores. Higher rates of overweight/obesity (BMI z-score>1SD) were found in ASD toddlers compared to TD toddlers: 36.6% versus 9.9%, (p<0.0001). After adjustment for potential confounders the association between ASD and overweight/obesity remained significant: OR=3.50, 95% CI: 1.24, 9.85, (p = 0.02).

Conclusions: Children with ASD have elevated risk of obesity which presents at a young age. Possible explanations include restricted dietary habits, problematic mealtime behaviors, higher levels of sedentary activities and sleep disorders. Special efforts should be taken to prevent early onset obesity in ASD children starting as early as possible.