80 Implications of Body Mass Index on Executive Functioning in Clinically Diagnosed Neurodiverse Children

Abstract

Objective:

Childhood obesity is a serious health epidemic affecting the world today. Children who are obese earlier in life are more likely to stay obese and have an increased risk of poorer health outcomes later in life, such as diabetes and cardiovascular diseases. Obesity is also associated with deficits in executive function. Executive function (EF) is comprised of several distinct but interrelated abilities including working memory, planning, inhibition, and flexibility. Prior research suggests that obesity drives brain changes which implicate executive function structures. Our aim is to examine the relationship between childhood obesity and executive function in children with neurodevelopmental disorders.

Participants and Methods:

These data are from an ongoing study on neural and behavioral phenotypes of executive functioning in children with developmental disabilities, primarily Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). Only study participants with complete BMI and BRIEF data were included in these analyses (n = 184). 134 representing (72.8%) of the participants were Male, 49 representing (26.6%) were Female, and 1 representing (.5%) were Gender nonconforming. 50 representing (27.2%) of the participants were between 8-9 years, 55 representing (29.9%) were between 10-11 years, and 80 representing (43.0%) were between 12-13 years. Average age was 11 years. 11 representing (6.0%) of the participants were underweight, 115 representing (62.5%) were healthy, 29 representing (15.8%) were overweight, and 29 representing (15.8%) were obese. Average BMI was 19.0, ranging from 13.2 to 36.3. 106 representing (57.6%) of the participants identified as White, 65 representing (35.3%) identified as BIPOC (2 Asian, 31 Hispanic/Latinx, 32 Black) and 13 representing (4.4%) identified as other/unspecified. 114 representing (61.9%) of the participants had a diagnosis of ADHD, ASD, or comorbid ASD and ADHD, 70 representing (38.1%) had a diagnosis of other. Average FSIQ-2 score was 106.98. Parents were asked to complete the Behavior Rating Inventory of Executive Function (BRIEF-2) and the Inhibit, Shift, Working Memory (WM), Planning, and Global Executive Composite (GEC) scales were used as the dependent measure in analyses. BMI (kg/m^A2) was calculated based on CDC 2000 growth charts and classified into 4 mutually exclusive categories—underweight, healthy, overweight, and obese. There was a prediction that higher BMI would be associated with lower executive function.

Results:

A one-way ANOVA revealed a statistically significant difference between groups (F(3,180) = 3.649, p = .014). A Tukey post hoc test revealed more Shift problems in the obese group (74.55 ± 11.7) compared to the overweight group (65.79 ± 11.6, p = .026). There was no statistically significant difference between the underweight/healthy and obese groups (p = .999/p = .054). There was no statistically significant difference in mean T-scores for the Inhibit, WM, Planning, or GEC scales.

Conclusions:

Childhood obesity and executive function deficits are significant risk factors for adult health outcomes. Obesity and elevated executive function T-scores for flexibility are related in a group of children with neurodevelopmental disorders. Future investigation will explore the role of cortical thickness and medication in these data.