Research Paper
Intellectual disability is associated with increased risk for obesity in a nationally representative sample of U.S. children

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Abstract

Background

Data on obesity prevalence in children with intellectual disability (ID) are scarce.

Objective

We estimated rates of obesity among children aged 10–17 years with and without ID in a nationally representative dataset that included measures of child weight and ID status, as well as family meal frequency, physical activity, and sedentary behavior.

Methods

Chi-square tests compared prevalence of obesity, demographic and behavioral characteristics between children with and without ID as reported in the 2011 National Survey of Children's Health. Tests for interaction in logistic regression models determined whether associations between obesity and behavioral characteristics were different between children with/without ID.

Results

Obesity prevalence for children with ID was 28.9% and 15.5% for children without ID. After adjusting for age, sex, race/ethnicity and poverty level, the odds ratio was significantly 1.89 times greater among children with ID than among those without ID (95% CI: 1.14 to 3.12). Among children with ID, 49.8% ate at least one meal with family members every day compared to 35.0% without ID (p < 0.002), and 49.5% with ID participated in frequent physical activity compared to 62.9% (p < 0.005). Prevalence of obesity was higher among all children who ate family meals every day compared to fewer days per week, and the effect was significantly more pronounced among those with ID (p = 0.05).

Conclusions

Prevalence of obesity among youth with ID was almost double that of the general population. Prospective studies are needed in this population to examine the impact of consistent family mealtimes and infrequent physical activity.

Section snippets

Methods

The 2011–2012 NSCH is a nationally representative survey conducted by the CDC's National Center for Health Statistics, administered as a module of the State and Local Area Integrated Telephone Survey. Households were sampled via random digit dialing of land-lines, supplemented with an independent sample of cell phone numbers. The survey screened households for the presence of children aged 0–17 years, and one child was randomly selected to be the survey subject. The questions were answered by a

Results

The number of children aged 10–17 years for whom both parent-reported ID and weight status were available was 43,818; of these, 672 children had ID and 43,146 did not. The prevalence of ID was 1.37% (95% CI: 1.11 to 1.63) or 1 in 73. A greater proportion of children with ID were male (68.4% of children with ID vs. 51.1% non-ID, p < 0.01, Table 1). A greater percentage were also poor: 27.6% of children with ID lived in households with incomes below the federal poverty level, compared to 18.3% of

Discussion

In this large nationally representative data set, 10–17 year old children with ID were almost twice as likely to be obese as their typically-developing peers, which is consistent with earlier non-representative studies.11, 13 Although children with ID were significantly more likely to live in poverty, a risk factor for obesity18 and severe obesity (>99th percentile),19 the elevated likelihood of obesity by ID status clearly persisted after adjusting for poverty as well as age, sex, and

Conclusions

This study, an analysis of the first U.S. dataset that includes measures of both ID and weight status in children, shows that prevalence of obesity in youth with ID aged 10–17 years is almost double that of the general population of the same age. The disparity persists after controlling for age, sex, race/ethnicity and poverty level. Psychological and behavioral characteristics as well as medical conditions associated with the diagnosis may contribute to the elevated prevalence of obesity, and

References (44)

  • A.Y. Chen et al.

    Prevalence of obesity among children with chronic conditions

    Obesity

    (2010)
  • Preventing Childhood Obesity: Health in the Balance (Report)

    (2005)
  • R.J. Deckelbaum et al.

    Childhood obesity: the health issue

    Obes Res

    (2001)
  • M. Krul et al.

    Musculoskeletal problems in overweight and obese children

    Ann Fam Med

    (2009)
  • R.C. Whitaker et al.

    Predicting obesity in young adulthood from childhood and parental obesity

    N Engl J Med

    (1997)
  • R.L. Schalock et al.

    Intellectual Disability: Definition, Classification, and Systems of Support (11th ed)

    (2010)
  • Diagnostic and Statistical Manual of Mental Disorders

    (2013)
  • J.L. Matson et al.

    Comorbid conditions in individuals with intellectual disabilities

  • L. Salaun et al.

    Physical fitness and fatness in adolescents with intellectual disabilities

    J Appl Res Intellect Disabil

    (2012)
  • L. Stewart et al.

    High prevalence of obesity in ambulatory children and adolescents with intellectual disability

    J Intellect Disabil Res

    (2009)
  • J.H. Rimmer et al.

    Obesity and obesity-related secondary conditions in adolescents with intellectual/developmental disabilities

    J Intellect Disabil Res

    (2010)
  • 2011/12 National Survey of Children's Health. Maternal and Child Health Bureau in collaboration with the National...
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    Disclosures: The authors do not have any relevant conflicts of interest to disclose. A similar analysis was presented in poster format at the 2014 annual meeting of The Obesity Society (TOS). The Secondary Data Analysis Core of the Healthy Weight Research Network for Children with Autism Spectrum Disorder and Developmental Disabilities (HWRN) (1 UA3MC25735-01-00) conducted this research as part of our larger research agenda on obesity and its correlates in this population. We thank the other members of the HWRN for their participation in the Network's efforts. Funding was also provided to the last author from NIHDK046200 and to the first author from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, grant R03HD076588.

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