Novel Insights into Obesity in Preschool Children with Autism Spectrum Disorder.

This Dutch study found that preschool children with autism are 8 times more likely to be obese compared to other children their age. About 17% of children with autism in the study were obese, compared to only 2% of children without autism. The researchers found that children's eating behaviors and their mother's weight were linked to higher weight, but autism severity wasn't a factor. This shows parents and doctors need to pay more attention to weight issues in young children with autism.

This cross-sectional study examined obesity rates in 78 Dutch preschoolers with autism spectrum disorder (ASD) aged 3-7 years, comparing them to the general population. Results showed children with ASD had an 8-fold higher obesity rate (16.8%) compared to typically developing children (2.0%). Child BMI was positively correlated with food approach behaviors and maternal BMI, while negatively correlated with slowness in eating. Notably, obesity was not associated with ASD severity, problem behaviors, parental eating behaviors, parenting stress, or socioeconomic status.

The findings highlight the urgent need for obesity prevention and intervention strategies specifically targeting young children with ASD in clinical practice.

Early obesity screening should be prioritized for preschool children with ASD. Family-based interventions addressing eating behaviors and maternal weight management may be beneficial. Clinical protocols should include weight monitoring regardless of ASD severity. Further research needed to develop ASD-specific obesity prevention strategies.

Single cross-sectional study from one country limits generalizability. Small sample size (n=78) may affect statistical power. Study design cannot establish causation. No information provided about dietary intake or physical activity levels, which are key obesity risk factors.

Obesity is present in 8-32% of the children with Autism Spectrum Disorder (ASD). However, most studies are performed in school-aged children from the USA. The current study compares obesity rates of Dutch preschoolers with ASD with children from the Dutch general population and explores which child- and parental factors are related to obesity in children with ASD. This cross-sectional study is part of the ongoing Tandem Study (Dutch Trial register: NL7534).

Seventy-eight children with ASD aged 3-7 years and their parents (77 mothers, 67 fathers) participated. Child factors are: Body Mass Index (by physical measurement), child eating behavior (Child Eating Behavior Questionnaire), child problem behavior (Child Behavior Checklist), and ASD severity (Autism Diagnostic Observation Scale 2). Parental factors are: BMI (by physical measurement), parental eating behavior (Dutch Eating Behavior Inventory), parenting stress (The Parenting Stress Questionnaire) and highest completed educational level (SES). Children with ASD were 8 times more often obese (16.8%) than children from the general population (2.0%).

Child BMI correlated positively with child food approach behavior and maternal BMI, and correlated negatively with child 'Slowness in eating'. There was no correlation between child BMI and ASD severity, problem behavior, parental eating behavior, parental stress and SES. Thus, Dutch, preschool children with ASD have 8 times higher obesity rates than children from the general population. More attention to obesity risk in research and clinical care could contribute to the quality of life of individuals with ASD and their families.

CLINICAL TRIAL REGISTRATION: Dutch Trial register, NL7534, https://trialsearch.who.int/Trial2.aspx?TrialID=NL7534 .