Poster #75 - Autism Spectrum Disorders Increase the Risk of Childhood Obesity: a Systematic Review and Meta-analysis

• In Event: 2-002 - Special Poster Session 05 with Continental Breakfast Reception
  In Poster Session: PS 05 - Interdisciplinary Section

Integrative Statement

Background: In the United States, 33.4% of children between 2-19 years are considered to be overweight or have obesity (i.e. body mass index; BMI ≥ 85th percentile for age and sex) and 17.2% of children are considered to have obesity (i.e. BMI ≥ 95th percentile) (Ogden et al., 2016). Autism spectrum disorders (ASD), is a neurodevelopmental disorder characterized by repetitive behaviors, impaired communication and social interactions (McPartland et al., 2016). Multiple studies have demonstrated that ASD, may increase the risk of development of obesity (Bicer et al., 2013; Castro et al., 2017), while other studies have found no association between ASD and obesity (Mari-Bauset et al., 2015, Barnhill et al., 2016). We aimed to address this ambiguity through a systematic review and meta-analysis.
Methods: All procedures were conducted in accord with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. PubMed, Scopus, ProQuest and Web of Science databases were searched in November 2017 using pre-specified keyword combinations (see Figure 1). Outcomes of the initial search were narrowed down by removing duplicate records. The full-text manuscripts of the records that passed an initial title and abstract screen were examined for eligibility. Additional records identified from the bibliography of relevant manuscripts were also evaluated. Total number of children with ASD in each eligible study sample and the number of children (age < 18 years) with coexisting ASD and a BMI of ≥ 85th and 95th percentiles for age and sex were extracted from eligible records. Similarly, the total number of typically developing children and the number of typically developing children with BMI of ≥ 85th and 95th percentiles for age and sex were extracted when available. DerSimonian–Laird random‐effects meta‐analyses were performed using the ‘metafor’ package in R (version 3.4.2) to estimate the overall prevalence and relative risk of developing BMI ≥ 85th and 95th percentiles for age and sex with ASD.
Results: Outcomes of the initial database search and subsequent screening are summarized in a PRISMA flow chart (see Figure 1). Thirty-five studies representing 37 study arms were determined eligible. The prevalence of combined overweight and obesity in children with ASD was 37.43% [34.01; 40.99] (34 study arms; 11,318 children) and the prevalence of obesity in children with ASD was 22.35% [18.28; 27.03] (32 study arms; 61,475 children). These estimates were significantly greater than the corresponding prevalence of combined overweight and obesity (i.e. 33.4%) and obesity (i.e. 17.2%) among children in the US. Pooled relative risk of having a BMI ≥ 85th (11 studies) and ≥ 95th (12 studies) percentiles in children with ASD were 1.189 [0.971; 1.456] (p = 0.0942) and 1.425 [1.095; 1.856] (p = 0.008) respectively (see Figure 2).
Conclusion: Our results strongly suggest that ASD seem to be associated with a higher prevalence and a relative risk of development of obesity. Specifically, ASD was observed to increase the risk of childhood obesity by 42.5%. Future studies should investigate potential contributors to this association in order to prevent obesity and related comorbidities in children with ASD.

Authors

• Chanaka N. Kahathuduwa, Texas Tech University
  Presenting Author

• Blake D. West, Texas Tech University - Human Development & Family Studies
  Non-Presenting Author

• Naima Moustaid-Moussa, Department of Nutritional Sciences, Texas Tech University
  Non-Presenting Author

• Ann Mastergeorge, Texas Tech University
  Non-Presenting Author