FACTORS ASSOCIATED WITH BODY WEIGHT STATUS AMONG CHILDREN WITH AUTISM SPECTRUM DISORDER AGED 2-11 IN KUCHING DIVISION, SARAWAK

Authors

  • Teoh Wan Jool Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Malaysia. 94300, Kota Samarahan, Sarawak, Malaysia.
  • Law Leh Shii Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Malaysia. 94300, Kota Samarahan, Sarawak, Malaysia.
  • Cheah Whye Lian Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Malaysia. 94300, Kota Samarahan, Sarawak, Malaysia.

Keywords:

Autism spectrum disorder, child, body weight status, feeding practices, eating behaviour, dietary intakes.

Abstract

The high prevalence of overweight and obese among children with autism spectrum disorder (ASD) gains attention due to its substantial adverse health impacts. This study aimed to determine the associations between sociodemographic characteristics, parental feeding practices, child eating behaviour, and dietary intake with the body weight status of ASD children in Kuching Division, Sarawak. A cross-sectional study was conducted among 124 ASD children (83.9% boys and 16.1% girls) aged 2-11 years, together with their caregivers. The weight and height of ASD children were taken, and body mass index-for-age z-score (BAZ) was computed using AnthroPlus software. Child feeding practices, eating behaviour, and dietary intake were assessed through interviews, with the aid of a questionnaire. Multiple binary logistic regression was used in data analysis. The prevalence of underweight, risk-of-overweight, overweight, and obese ASD children was 3.2% (3.8% boys; 0% girls), 4.8% (2.9% boys; 15.0% girls), 16.9% (17.3% boys; 15.0% girls), and 20.2% (23.1% boys; 5.0 % girls), respectively. The multiple binary logistic regression revealed that the caregivers with high perceived child weight (AOR 31.313, 95% CI=6.127-47.218), high concern towards child weight (AOR 1.774, 95% CI=1.112-2.829), and high sodium intakes (AOR 3.747, 95% CI= 1.515-9.269) were significantly associated with increased risk of overweight or obesity, explaining 37.2% of the variation in body weight status. It is important to prioritise the perspective of caregivers’ feeding practices especially the caregivers with high perceived child weight and concerned child’s weight as well as sodium level of the ASD children while planning for obesity intervention programmes.

References

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.

World Health Organization (WHO). Autism Spectrum Disorder [Internet]. WHO; 2019. Available from: https://www.who.int/news-room/fact-sheets/detail/autism- spectrum-disorders

Qiu S, Lu Y, Li Y, et al. Prevalence of autism spectrum disorder in Asia: A systematic review and meta-analysis. Psychiatry Res. 2020;284:112679.

Ministry of Health Malaysia, Family Health Division. Meeting Proceeding on the Pilo Study of Using Autism to Screen for Autism; 2006; Kuala Lumpur, Malaysia.

Leader G, Tuohy E, Chen JL, et al. Feeding Problems, Gastrointestinal Symptoms, Challenging Behavior and Sensory Issues in Children and Adolescents with Autism Spectrum Disorder. J Autism Dev Disord. 2020;50(4):1401–10.

Huxham L, Marais M, van Niekerk E. Idiosyncratic food preferences of children with autism spectrum disorder in England. South African J Clin Nutr. 2021;34(3):90-6.

Trambacz-Oleszak S. Why are individuals with autism spectrum disorder at risk group for unhealthy weight? Anthropol Rev. 2019;82(3):313–26.

Mcphillips M, Finlay J, Bejerot S, et al. Motor Deficits in Children With Autism Spectrum Disorder: A Cross-Syndrome Study. Autism Res. 2014;7(6):664–76.

Polfuss M, Simpson P, Neff Greenley R, et al. Parental Feeding Behaviors and Weight-Related Concerns in Children With Special Needs. West J Nurs Res. 2017;39(8):1070–93.

Sahoo K, Sahoo B, Choudhury AK et al. Childhood obesity: Causes and consequences. J Fam Med Prim Care. 2015;4(2):187.

Rankin J, Matthews L, Cobley S, et al. Psychological consequences of childhood obesity: psychiatric comorbidity and prevention. Adolesc Health Med Ther. 2016; 7:125–46.

Lindberg L, Danielsson P, Persson M, et al. Association of childhood obesity with risk of early all-cause and cause-specific mortality: A swedish prospective cohort study. PLoS Med. 2020;17(3):1–14.

Ministry of Health Malaysia, Malaysian Psychiatric Association, Malaysian Child and Adolescent Psychiatry Association et al. Clinical Practice Guidelines: Management of Autism Spectrum Disorder in Children and Adolescents. Putrajaya, Malaysia: Malaysian Health Technology Assessment Section (MaHTAS); 2014.

The National Autism Society of Malaysia. Our services [Internet]. NASOM; 2022. Available from: http://www.nasom.org.my/autism/.

Curtin C, Jojic M, Bandini LG. Obesity in Children with Autism Spectrum Disorder. Harv Rev Psychiatry. 2014; 22(2):93–103.

Al-Farsi YM, Al-Sharbati MM, Waly MI et al. Malnutrition among preschool-aged autistic children in Oman. Res Autism Spectr Disord. 2011;5(4):1549–52.

Rodgers RF, Paxton SJ, Massey R, et al. Maternal feeding practices predict weight gain and obesogenic eating behaviors in young children: a prospective study.

Int J Behav Nutr Phys Act. 2013 Dec;10(1):1-10.

Savage JS, Fisher JO, Birch LL. Parental influence on eating behavior: Conception to adolescence. J Law, Med Ethics. 2007;35(1):22–34.

Steinsbekk S, Belsky J, Wichstrøm L. Parental Feeding and Child Eating: An Investigation of Reciprocal Effects. Child Dev. 2016;87(5):1538–49.

Esteban-Figuerola P, Canals J, Fernández-Cao JC, et al. Differences in food consumption and nutritional intake between children with autism spectrum disorders and typically developing children: A meta-analysis. Autism. 2019 Jul;23(5):1079-95.

National Coordinating Committee on Food and Nutrition (NCCFN), Ministry of Health Malaysia. National Plan of Action for Nutrition of Malaysia III (2016-2025). Putrajaya,Kuala Lumpur, Malaysia: National Coordinating Committee on Food and Nutrition (NCCFN); 2016.

Schaeffer RL, Mendenhall W, Ott L. Elementary Survey Sampling. 4th Ed., Belmont, California: Duxbury Press;1990.

Nor NK, Ghozali AH, Ismail J. Prevalence of overweight and obesity among children and adolescents with autism spectrum disorder and associated risk factors. Front Pediatr. 2019;7(38):1–10.

Birch LL, Fisher JO, Grimm-Thomas K, et al. Confirmatory factor analysis of the Child Feeding Questionnaire: A measure of parental attitudes, beliefs and practices about child feeding and obesity proneness. Appetite. 2001;36(3):201–10.

Wan Abdul Manan WM, Norazawati AK, Lee YY. Overweight and obesity among Malay primary school children in Kota Bharu, Kelantan: parental beliefs, attitudes and child feeding practices. Malays J Nutr. 2012;18(1):27-36.

Wardle J, Guthrie CA, Sanderson S, Rapoport L. Development of the children's eating behaviour questionnaire.J Child Psychol Psychiatry. 2001;42(7):963-70.

Loh DA, Moy FM, Zaharan NL, Mohamed Z. Eating behaviour among multi-ethnic adolescents in a middle-income country as measured by the self-reported Children’s Eating Behaviour Questionnaire. PloS one. 2013;8(12):e82885.

Tee ES, Ismail MN, Nasir MA, et a;. Nutrient Composition of Malaysian Foods. Malaysian Food Composition Database Programme. Kuala Lumpur, Malaysia: Institute for Medical Research; 1997.

Institute for Medical Research. Malaysian Food Composition Database

(MYFCD) [Internet]. IMR; 1997. Available from: https://myfcd.moh.gov.my/

Singapore Health Promotion Board. Food Composition Guide Singapore [Internet]. HPB; 2011. Available from: https:// www.hpb.gov.sg

National Coordinating Committee on Food and Nutrition (NCCFN). Malaysian Dietary Guidelines. Putrajaya, Malaysia: Technical Working Group on Nutritional Guidelines, Ministry of Health, Malaysia; 2017.

WHO Multicentre Growth Reference Study Group, de Onis M. WHO Child Growth Standards based on length/height, weight and age. Acta paediatrica. 2006;95:76-85.

Onis MD, Onyango AW, Borghi E, et al. Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World health Organization. 2007;85(9):660-7.

Law LS, Sulaiman N, Gan WY, et al. Predictors of overweight and obesity and its consequences among Senoi Orang Asli (indigenous people) women in Perak, Malaysia. Int J Environ Res Public Health. 2020;17(7):2354.

Mickey RM, Greenland S. The impact of confounder selection criteria on effect estimation. Am J Epidemiol. 1989;129(1):125-37.

Human Resource Policy Division. Malaysia Standard Classification of Occupations Putrajaya, Malaysia: Ministry of Human Resources Malaysia; 2013.

Barnhill K, Gutierrez A, Ghossainy M, et al. Growth status of children with autism spectrum disorder: A case–control study. J Hum Nutr Diet. 2017;30(1):59-65.

Lawson LM, Foster L. Sensory patterns, obesity, and physical activity participation of children with autism spectrum disorder. Am J Occup Ther 2016 ;70(5):7005180070p1-8.

Levy SE, Pinto-Martin JA, Bradley CB, et al. Relationship of weight outcomes, co-occurring conditions, and severity of autism spectrum disorder in the study to explore early development. J Pediatr. 2019; 205:202-9.

Evans EW, Must A, Anderson SE, et al. Dietary patterns and body mass index in children with autism and typically developing children. Res Autism Spectr Disord 2012;6(1):399-405.

Must A, Phillips SM, Curtin C, et al. Comparison of sedentary behaviors between children with autism spectrum disorders and typically developing children. Autism. 2014;18(4):376-84.

Xiong N, Ji C, Li Y, et al. The physical status of children with autism in China. Res Dev Disabil. 2009;30(1):70-6.

Mei Z, Ogden CL, Flegal KM, et al. Comparison of the prevalence of shortness, underweight, and overweight among US children aged 0 to 59 months by using the CDC 2000 and the WHO 2006 growth charts. J Pediatr. 2008;153(5):622-8.

Pike KM, Dunne PE. The rise of eating disorders in Asia: a review. J Eat Disord. 2015;3(1):1-4.

Robinson E, Sutin AR. Parental perception of weight status and weight gain across childhood. Pediatrics. 2016;137(5).

Ha Y. The relationships between children's and parental risk factors, dietary patterns and weight status in children with intellectual disabilities in South Korea [Doctoral dissertation on the internet]. The University of North Carolina at Chapel Hill;2010. Available from: https://core.ac.uk/download/pdf/210597734.pdf

Hill JO, Wyatt HR, Reed GW, et al. Obesity and the environment: where do we go from here? Science. 2003;299(5608):853-5.

Adams AK, Quinn RA, Prince RJ. Low recognition of childhood overweight and disease risk among Native?American caregivers. Obes Res. 2005;13(1):146-52.

Seburg EM, Kunin-Batson A, Senso MM, et al. Concern about child weight among parents of children at-risk for obesity. Health Behav Policy Rev. 2014;1(3):197-208.

Pandey S, Rai S, Paudel N, et al. Parental child feeding practices and their relationship with children’s dietary intake and weight status in Nepal. J Multidiscip

Healthc. 2019; 12:325-33.

Tybor DJ, Eliasziw M, Kral TV, et al. Parental concern regarding obesity in children with autism spectrum disorder in the United States: National Survey of Children's Health 2016. Disabil Health J. 2019;12(1):126-30.

Birch LL, Fisher JO. Mothers' child-feeding practices influence daughters' eating and weight. Am J Clin Nutr. 2000;71(5):1054-61.

Fisher JO, Birch LL. Restricting access to palatable foods affects children's

behavioral response, food selection, and intake. Am J Clin Nutr. 1999;69(6):1264-7

Ma Y, He FJ, MacGregor GA. High salt intake: independent risk factor for obesity? Hypertension. 2015;66(4):843-9.

Rafie N, Mohammadifard N, Khosravi A, et al. Relationship of sodium intake with obesity among Iranian children and adolescents. ARYA atherosclerosis. 2017;13(1):1-6.

Abdul Majid H, Ramli L, Ying SP, et al. Dietary intake among adolescents in a middle-income country: an outcome from the Malaysian Health and Adolescents Longitudinal Research Team Study (the MyHeARTs Study). PloS one. 2016;11(5): e0155447.

Grimes CA, Riddell LJ, Campbell KJ, et al. 24-h urinary sodium excretion is

associated with obesity in a cross-sectional sample of Australian schoolchildren. Br J Nutr. 2016;115(6):1071-9.

Libuda L, Kersting M, Alexy U. Consumption of dietary salt measured by urinary sodium excretion and its association with body weight status in healthy children and adolescents. Public Health Nutr. 2012;15(3):433-41.

Zhu H, Pollock NK, Kotak I, et al. Dietary sodium, adiposity, and inflammation in healthy adolescents. Pediatrics. 2014;133(3): e635-42.

Grimes CA, Wright JD, Liu K et al. Dietary sodium intake is associated with total fluid and sugar-sweetened beverage consumption in US children and adolescents aged 2–18 y: NHANES 2005–2008. Am J Clin Nutr. 2013;98(1):189-96.

Granich J, Lin A, Hunt A, et al. Obesity and associated factors in youth with an autism spectrum disorder. Autism. 2016;20(8):916-26.

Tsujiguchi H, Miyagi S, Nguyen TT, et al. Relationship between autistic traits and nutrient intake among Japanese children and adolescents. Nutrients. 2020;12(8):2258.

Subar AF, Freedman LS, Tooze JA, et al. Addressing current criticism regarding the value of self-report dietary data. J Nutr. 2015;145(12):2639-45.

Picó C, Serra F, Rodríguez AM, et al. Biomarkers of nutrition and health: new tools for new approaches. Nutrients. 2019;11(5):1092

Downloads

Published

2023-09-08

How to Cite

Teoh Wan Jool, Law Leh Shii, & Cheah Whye Lian. (2023). FACTORS ASSOCIATED WITH BODY WEIGHT STATUS AMONG CHILDREN WITH AUTISM SPECTRUM DISORDER AGED 2-11 IN KUCHING DIVISION, SARAWAK. Malaysian Journal of Public Health Medicine, 23(2), 139–150. Retrieved from https://mjphm.org/index.php/mjphm/article/view/1860