@article{Nor2019,
title = {Prevalence of overweight and obesity among children and adolescents with autism spectrum disorder and associated risk factors},
author = {N K Nor and A H Ghozali and J Ismail},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85064414280&doi=10.3389%2ffped.2019.00038&partnerID=40&md5=4bb61b1df043a4adf79618e223d77f26},
doi = {10.3389/fped.2019.00038},
issn = {22962360},
year = {2019},
date = {2019-01-01},
journal = {Frontiers in Pediatrics},
volume = {7},
number = {FEB},
publisher = {Frontiers Media S.A.},
abstract = {Introduction: Prevalence of obesity in Autism Spectrum Disorder (ASD) has been reported to be higher than in the general population. Determining prevalence may help increase awareness of obesity in ASD and potentially lead to initiatives to reduce obesity. In order to understand obesity in ASD children, common risk factors were assessed including physical activity, feeding problems and sleep disturbances. Methods: This is a cross-sectional study performed at the Child Development Center at Universiti Kebangsaan Malaysia Medical Center on 151 ASD children aged 2-18 years. Anthropometric and demographic information were obtained and parents completed three questionnaires; Children Sleep Habits Questionnaire (CSHQ), Physical Activity for Older Children Questionnaire (PAQ-C) and Brief Autism Mealtime Behavior Questionnaire (BAMBI). Results: For ASD children in our sample, the prevalence of overweight (BMI ≥85th to < 95th percentiles) was 11.3% and the prevalence of obesity (BMI ≥95th percentile) was 21.9%. The overweight/obese ASD children's median age was higher at 8.5 years (IQR 5.81-10.13) compared to the normal/underweight group of 6.33 years (IQR 4.75-7.7) with a p-value of 0.001. The two groups also differed significantly for maternal BMI and paternal age. The median maternal BMI in the overweight/obese group was 26.05 (IQR 23.35-32.25), statistically significantly higher (p = 0.003) than in the non-overweight/obese group, 24.7 (IQR 21-27.9). The median paternal age of 40 years (IQR 37-44) was statistically significantly higher (p = 0.039) in the overweight/obese group, compared to the median paternal age in the non-overweight/obese group of 38 (IQR 35-42). The male overweight/obese children had median PAQ-C score of 2.44 (IQR 2.00-3.00) vs. 2.89 (IQR 2.35-3.53) in the counterpart group with a p-value of 0.01. Using the multiple linear regression stepwise method, three predictors associated with BMI percentiles reached a statistical level of significance; PAQ-C score in males (p < 0.001), the BAMBI domains of Food Refusal (p = 0.001) and Limited Variety of Food (p = 0.001). Conclusions: The prevalence of obesity and overweight is high among Malaysian ASD children and adolescents. Older child age, high maternal BMI, older paternal age, low physical activity, low likelihood of food refusal and high likelihood of food selectivity were found to be risk factors for high BMI in these children. © 2019 Kamal Nor, Ghozali and Ismail.},
note = {cited By 5},
keywords = {Adolescent, Adult, Article, Autism, Body Mass, Brief Autism Mealtime Beahavior Questionnaire, Child Development, Childhood Obesity, Children, Children Sleep Habits Questionnaire, Controlled Study, Cross-Sectional Study, Feeding Difficulty, Female, Food Refusal, Human, Major Clinical Study, Malaysian, Male, Mother, Paternal Age, Physical Activity, Physical Activity for Older Children Questionnaire, Prevalence, Questionnaires, Risk Factor, Sleep Disorder, Underweight},
pubstate = {published},
tppubtype = {article}
}

@article{Pandi-Perumal2007995,
title = {Role of the melatonin system in the control of sleep: Therapeutic implications},
author = {S R Pandi-Perumal and V Srinivasan and D W Spence and D P Cardinali},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-36248949004&doi=10.2165%2f00023210-200721120-00004&partnerID=40&md5=489ee976fa444beb95b26cdb77b722c2},
doi = {10.2165/00023210-200721120-00004},
issn = {11727047},
year = {2007},
date = {2007-01-01},
journal = {CNS Drugs},
volume = {21},
number = {12},
pages = {995-1018},
abstract = {The circadian rhythm of pineal melatonin secretion, which is controlled by the suprachiasmatic nucleus (SCN), is reflective of mechanisms that are involved in the control of the sleep/wake cycle. Melatonin can influence sleep-promoting and sleep/wake rhythm-regulating actions through the specific activation of MT1 (melatonin 1a) and MT2 (melatonin 1b) receptors, the two major melatonin receptor subtypes found in mammals. Both receptors are highly concentrated in the SCN. In diurnal animals, exogenous melatonin induces sleep over a wide range of doses. In healthy humans, melatonin also induces sleep, although its maximum hypnotic effectiveness, as shown by studies of the timing of dose administration, is influenced by the circadian phase. In both young and elderly individuals with primary insomnia, nocturnal plasma melatonin levels tend to be lower than those in healthy controls. There are data indicating that, in affected individuals, melatonin therapy may be beneficial for ameliorating insomnia symptoms. Melatonin has been successfully used to treat insomnia in children with attention-deficit hyperactivity disorder or autism, as well as in other neurodevelopmental disorders in which sleep disturbance is commonly reported. In circadian rhythm sleep disorders, such as delayed sleep-phase syndrome, melatonin can significantly advance the phase of the sleep/wake rhythm. Similarly, among shift workers or individuals experiencing jet lag, melatonin is beneficial for promoting adjustment to work schedules and improving sleep quality. The hypnotic and rhythm-regulating properties of melatonin and its agonists (ramelteon, agomelatine) make them an important addition to the armamentarium of drugs for treating primary and secondary insomnia and circadian rhythm sleep disorders. © 2007 Adis Data Information BV. All rights reserved.},
note = {cited By 90},
keywords = {Absence of Side Effects, Acetylserotonin Methyltransferase, Advanced Sleep Phase Syndrome, Agomelatine, Alpha Tocopherol, Alzheimer Disease, Animals, Ascorbic Acid, Beta Adrenergic Receptor Blocking Agent, Biosynthesis, Circadian Rhythm, Circadian Rhythm Sleep Disorder, Clinical Trial, Confusion, Delayed Sleep Phase Syndrome, Drowsiness, Drug Dose Comparison, Drug Efficacy, Drug Half Life, Drug Mechanism, Fatigue, Fluvoxamine, Headache, Hormone Metabolism, Human, Hypnosis, Hypothalamus, Insomnia, Jet Lag, Macaca, Melatonin, Melatonin Receptor, Muscle Cramp, Nausea, Non-24-Hour Sleep-Wake Syndrome, Nonhuman, Noradrenalin, Pineal Body, Priority Journal, Protein Expression, Ramelteon, Rat Strain, Receptor Density, Receptors, REM Sleep, Retina Ganglion Cell, Review, Serotonin, Shift Worker, Sleep, Sleep Disorder, Sleep Waking Cycle, Smith Magenis Syndrome, Suprachiasmatic Nucleus, Sustained Drug Release, Vomiting},
pubstate = {published},
tppubtype = {article}
}