570 - Mealtime Behavior in Children With Autism Spectrum Disorder and Association with Weight.

Most children with autism spectrum disorder (ASD) have challenging mealtime behavior. They consume food of certain colors and textures. Due to behavior, body mass index (BMI) may be affected. Little is known about the effect on BMI in children with ASD having difficult mealtime behavior.

Objective:

To evaluate the association of mealtime behavior in children with ASD and BMI and gender-adjusted Z score.

  

Design/Methods:

This is a cross-sectional study on children with ASD in a pediatric developmental clinic at a community hospital in Brooklyn starting from April to December 2022. Children with ASD on medications that may affect weight and with GI concerns like GERD, a history of necrotizing enterocolitis, intestinal obstruction, and prior GI surgery were excluded. Parents were handed the 15-item Brief Autism Mealtime Behavior Inventory (BAMBI) questionnaire in English. A language interpreter was used for those with limited English proficiency. Independent variables were demographic data and mealtime behaviors (including food selectivity, disruptive/aggressive behaviors, food refusal, and mealtime rigidity) measured with BAMBI. An empirically derived cut-off score of 34 for the BAMBI total score was used to identify problematic feeders. The outcome variables were weight z score, weight percentile, BMI z scores, and BMI percentile recorded at diagnosis and at the time of visit, with the calculated change between these two timelines. Data analyzed using SPSS software; a comparison was done using an independent T-test, or Chi-squared test according to variables. A correlation was done using the Pearson correlation test.

Results:

A total of 50 children diagnosed with ASD met the inclusion criteria. Table 1 summarizes patient characteristics: mean age 5.6 ± 2.8, 78% males, 58% African American (AA). Table 2 shows comparison between subjects who scored >34 and those with < 34 with BAMBI. A significant difference was found in younger and AA children with higher BAMBI score. Also, the group with higher selectivity score had significantly negative change in their weight z score, p=0.044. This finding was confirmed with a negative trend in the correlation between the total BAMBI score and wt. z score change, p=0.075, r²= -0.257 (higher total BAMBI score selectivity BAMBI score makes negative wt. z score change).

 

Conclusion(s):

Younger and AA children diagnosed with ASD are more likely to have difficult mealtime behavior. Children with ASD and higher scores in mealtime behavior difficulties are associated with a negative change in weight z scores. Therefore, their nutritional status should be monitored.