The role of adverse childhood experiences in obesity among adolescents with autism spectrum disorder: National survey of Children's health 2018-2019

Disabil Health J. 2024 Apr;17(2):101550. doi: 10.1016/j.dhjo.2023.101550. Epub 2023 Nov 8.

Abstract

Background: Adolescents with autism spectrum disorder (ASD) are at an increased risk of overweight/obesity and adverse childhood experiences (ACEs).

Objective: This study examined whether ACEs increased the odds of overweight/obesity in adolescents with ASD.

Methods: This cross-sectional study used National Survey of Children's Health (NSCH) 2018-2019 data (N = 31,533 children ages 10-17 years, including n = 480 children with mild ASD and n = 423 children with moderate/severe ASD with normal or overweight/obese BMI). Parent-reported body mass index (BMI) was coded as overweight/obesity vs. normal weight. The independent variable was the count of nine ACEs. Binary logistic regression was conducted, controlling for social ecological factors.

Results: The odds of overweight/obesity in adolescents with ASD with 1-2 ACEs (OR 1.3, CI 1.1-1.4) and 3+ ACEs (OR 1.6, CI 1.3-2.0) were higher than those with 0 ACEs; odds increased with higher counts of ACEs. Household income level was the most significant sociodemographic influence on odds of obesity in adolescents with ASD (0-99 % Federal Poverty Level: OR 1.9, CI 1.6-2.3). Adolescents with moderate/severe ASD (OR 1.7, CI 1.2-2.5) and mild ASD (OR 1.6, CI 1.0-2.4) had higher odds of overweight/obesity after accounting for ACEs, race/ethnicity, sex, household income, and physical activity.

Conclusion: Findings indicated ACEs are associated with ASD, which calls for integration of ACEs information within trauma-informed care practices for obesity prevention and intervention for adolescents with ASD. Persistent disparities of overweight/obesity exist by race/ethnicity, sex, and household income within this population, which indicates the need for tailoring trauma-informed approaches to the unique needs of this population.

Keywords: Adverse childhood experiences; Autism spectrum disorder; National survey of Children's health; Obesity; Sociodemographic determinants of health.

MeSH terms

  • Adolescent
  • Adverse Childhood Experiences*
  • Autism Spectrum Disorder* / complications
  • Autism Spectrum Disorder* / epidemiology
  • Child
  • Child Health
  • Cross-Sectional Studies
  • Disabled Persons*
  • Humans
  • Overweight / complications
  • Pediatric Obesity* / complications
  • Pediatric Obesity* / epidemiology