September is National Childhood Obesity Awareness Month

Dr. Acadia Buro, a recent USF College of Public Health PhD graduate, will present research on obesity in adolescents at the upcoming American Public Health Association (APHA) annual meeting. The APHA meeting will be held Oct. 24-27 in Denver. 

Buro will present two posters, “Obesity and Comorbidities Among Adolescents with Autism Spectrum Disorder” and “Obesity and Comorbidities in Adolescents Aged 10-17.” The research was funded through a grant from the Health Resources and Services Maternal and Child Health Bureau. The COPH’s Dr. Russell Kirby is the grant’s principal investigator. Other faculty involved with the project are Drs. Abraham Salinas (co-principal investigator), Jennifer Marshall (co-investigator) as well as Heewon Gray (Buro’s major professor).

Using 2017-2018 data from the National Survey of Children’s Health, Buro looked at 27,328 adolescents, 911 of whom had autism spectrum disorder (ASD). Buro found that the prevalence of obesity was 15.3 percent overall, but higher among those with ASD, learning disabilities, epilepsy/seizure disorder, depression and anxiety. Interestingly, those with ADHD, cerebral palsy and Tourette Syndrome (a neurological disorder characterized by sudden repetitive movements and sounds) did not have an increased risk of obesity. 

In her poster that looked specifically at obesity in adolescents with ASD, Buro found that roughly 25 percent of 10-to-17-year-olds on the autism spectrum were obese. 

“There are many behavioral and environmental obesity risk factors among youth with ASD, including unhealthy eating behaviors, sedentary behavior, sleep disturbances, social and behavioral impairments, and environmental challenges,” Buro said. “In particular, youth with ASD may exhibit food selectivity, or consumption of a very narrow range of foods, and an increased preference for energy-dense foods, such as highly processed foods.”

While many of the adolescents with ASD that Buro studied had co-occurring conditions, such as learning disabilities, developmental delays, speech problems, depression, anxiety and Tourette Syndrome, only some—depression and anxiety, in particular—seemed to be associated with a greater risk of obesity.

“We can’t say whether depression and anxiety increase the risk of obesity or vice versa, since the data are cross-sectional, but previous studies have found bidirectional associations between depression and obesity in adolescents with ASD,” Buro explained. “Reduced physical activity, overeating, psychosocial stress and social environmental factors could all play a role.”

So how can the problem of obesity in adolescents with and without ASD be countered? According to Buro, who is now an applied postdoctoral fellow in behavioral oncology at Moffitt Cancer Center, it will take more research—especially research exploring the association between obesity and co-occurring conditions—and interventions.

“The findings of these analyses highlight an increased need for obesity-prevention measures, including lifestyle behavior interventions, among adolescents with ASD, learning disabilities, epilepsy or seizure disorder, and depression,” Buro said.  “Among adolescents with ASD specifically, the findings indicate a need for interventions addressing mental health and lifestyle behaviors, including eating, physical activity, and sleep behaviors.” 

Story by Donna Campisano, USF College of Public Health