title: ADHD is a risk factor for overweight and obesity in children.
abstract: OBJECTIVE
  Although hyperactivity would seem to increase energy expenditure, attention-deficit hyperactivity disorder (ADHD) appears to increase the risk for being overweight. This study examined the body mass index (BMI) in children with ADHD and its relationship with age, gender, ADHD and comorbid symptom severity, inhibitory control, developmental coordination disorder, sleep duration, and methylphenidate use.
  
  
  METHODS
  Participants were 372 Dutch children with ADHD combined type aged 5 to 17 years participating in the International Multicenter ADHD Genetics (IMAGE) study. We categorized BMI according to international age- and gender-specific reference values and calculated BMI-standard deviation scores (BMI-SDS). The control population was matched for age, gender, and ethnicity and originated from the same birth cohort as the ADHD group. Inhibitory control was measured by the computerized Stop-signal task. Prevalence differences of underweight, overweight, and obesity between groups were expressed in odds ratios. We used linear regression analyses with gender, age, parent- and teacher-rated ADHD and comorbid scores, inhibitory control, sleep duration, motor coordination, and methylphenidate use to predict BMI-SDS.
  
  
  RESULTS
  Boys with ADHD aged 10 to 17 years and girls aged 10 to 12 years were more likely to be overweight than children in the general Dutch population. Younger girls and female teenagers, however, seemed to be at lower risk for being overweight. Higher oppositional behavior and social communication problems related to higher BMI-SDS scores, whereas more stereotyped behaviors related to lower BMI-SDS scores. We found no effects of the other examined associated risk factors on BMI-SDS.
  
  
  CONCLUSIONS
  Attention-deficit hyperactivity disorder in boys is a risk factor for overweight. In girls with ADHD, the prevalence of overweight is age dependent and most pronounced in girls aged 10 to 12 years. They have a 4-fold risk of being obese. Higher oppositional and social communication problems pose an increased risk for overweight, whereas sleep duration, motor coordination problems, and methylphenidate use do not.
authors.affiliation: *Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; †Yulius Academy, Rotterdam, the Netherlands; ‡Departments of Neuroscience and Psychiatry, SUNY Upstate Medical University, Syracuse, NY; §Departments of Human Genetics and Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; ‖Karakter, Child and Adolescent Psychiatry University Centre, Nijmegen, the Netherlands; ¶Department of Psychiatry, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Ellen A
authors.initials: EA
authors.lastname: Fliers
authors.forename: Jan K
authors.initials: JK
authors.lastname: Buitelaar
authors.forename: Athanasios
authors.initials: A
authors.lastname: Maras
authors.forename: Kim
authors.initials: K
authors.lastname: Bul
authors.forename: Esther
authors.initials: E
authors.lastname: Höhle
authors.forename: Stephen V
authors.initials: SV
authors.lastname: Faraone
authors.forename: Barbara
authors.initials: B
authors.lastname: Franke
authors.forename: Nanda N J
authors.initials: NN
authors.lastname: Rommelse
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D050177:Overweight / Q000175:diagnosis / Q000453:epidemiology*; D063766:Pediatric Obesity / Q000175:diagnosis / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors