ADHD and overweight in boys: cross-sectional study with birth weight as a controlled factor

Abstract

Population studies indicate a strong relationship between birth weight (BW) and body size in later life. However, BW as a variable was never accounted for in studies on the relationship between attention-deficit/hyperactivity disorder (ADHD) and overweight. This study aims to assess the relationship between ADHD and overweight with control of birth weight and other confounding factors. Prevalence of overweight was compared in clinical sample of 219 boys with ADHD and 396 boys without ADHD, aged 6–18 years. The following factors were controlled: BW, parents income and education level, place of residence, ADHD type, selected comorbid disorders and stimulant treatment. Overweight and obesity were diagnosed according to the criteria proposed by the International Obesity Task Force. Logistic regression analysis was used to estimate the association between ADHD and the prevalence of overweight and obesity. Boys with ADHD differed significantly from the control group in distribution of low BW (8.2 vs. 3.0 %, χ2 = 8.23, p = 0.02). Low BW was associated with a lower prevalence of overweight than normal and high BW (0 vs. 12.14 %, χ2 = 4.12, p = 0.04). Overweight was observed significantly more often in boys with ADHD (17.3 vs. 8.3 %, χ2 = 11.23, p < 0.001) even after adjustment for BW and other variables (OR = 2.44, 95 % CI 1.38–4.29, p = 0.002) and after controlling for ADHD type, stimulant treatment and selected comorbid disorders. Independently to applied analysis, obesity was not associated with ADHD. Lower birth weight is over twice more often observed in boys with ADHD than in control group. Although this phenomenon may reduce the rate of overweight in the studied group, ADHD remains strongly associated with increased prevalence of overweight.

Growth and nutritional status of children from dysfunctional families with alcohol addicted parents in Poland

“…On this basis the fetal programming hypothesis was formulated, according to which the adverse factors affecting the fetus can alter the physiology and metabolism of the child, adapting them to adverse environmental conditions. The consequence of this early programming may be accelerating the growth and maturation occurring in the postnatal phase (Ellison and Jasienska, 2007;Flinn, 2008;Baker et al, 2010;Hayward et al, 2013;Nettle et al, 2013;Hanć et al, 2015), which Gluckman and Hanson (2005) called predictive adaptive response. Another embodiment of the programming concept is prenatal trade-off hypothesis, according to which, for the organism being under unfavorable conditions is more important to invest energy and resources in the development of the nervous system than skeletal or muscle system, what may result in a small body size in post-natal phase (Baker et al, 2010).…”

Attention-Deficit/Hyperactivity Disorder is Related to Decreased Weight in the Preschool Period and to Increased Rate of Overweight in School-Age Boys

“…Parents gave written consent for participation of their child in the study. Details and justification of the methods applied in the study as well as the general results of cross-sectional analyses of the body height, BMI, and the incidence of overweight/obesity in boys with ADHD were described elswhere (Hanć et al 2015). At initial stage of this project, the growth in treatment-naive boys with ADHD was analyzed in comparison to the growth charts (Hanć et al 2012).…”

“…Next, the sample size was enlarged and compared with a community-based control group of children without symptoms of mental disorders. The following analyses were focused on the relationship between ADHD and nutritional status with controls for birth weight, stimulant treatment, comorbid disorders, and socioeconomic status (SES) (Hanć et al 2015). There were differences in data gathered in the survey in the first and second stages of the project.…”

“…Moreover, ADHD is associated with premature birth and low birth weight. Further, in Poland, ADHD is often diagnosed in large urban areas, in children whose parents are well educated and have higher income (Hanć et al 2015). Therefore, in order to exclude the potential effect of confounding factors on the results of current comparisons of boys with and without ADHD the rigorous method of selection of respondents was used.…”

“…Other research shows that stimulant-naïve children with ADHD are characterized by greater body size: they are taller (Swanson et al 2006(Swanson et al , 2007Hanć and Cieślik 2008b), and have higher body weight or BMI (Swanson 2006;Hanć and Cieślik 2008a;Hanć et al 2012) than children without ADHD. Also, numerous recent studies suggested that ADHD is a risk factor of overweight and obesity in children, adolescents, and adults (Hanć and Cieślik 2008a;Cortese et al 2013;Khalife et al 2014;Hanć et al 2015).…”