Autism and family health: stress, eating behavior, and health in young children with ASD and their parents

Lubbe, A.L. van der (2026)

Doctoral Thesis

In this dissertation it is examined whether stress, eating behavior, and health are interrelated in young children with ASD and their parents, using an integrated, family-based approach combining questionnaires, physical assessments (BMI, blood pressure, waist circumference), and physiological measures (blood tests, hair cortisol). Parents of young children with ASD report elevated parenting stress, associated with parental mental health problems. Mothers show higher rates of obesity and metabolic syndrome than women from the general population, and maternal stress is associated with disinhibited eating. These patterns are not observed in fathers. Parent and child hair cortisol levels, indicating chronic stress, are positively associated, suggesting shared family stress. Children with ASD have higher obesity rates than their peers, and child BMI relates to food-approach behavior and maternal BMI, indicating contributions of shared environment, genetics, and family dynamics. Children with ASD also show elevated hair cortisol compared to peers. Maternal hair cortisol relates to child behavioral problems and reported parenting stress relates to child autism symptoms and child problem behavior. The findings support family-centered clinical care integrating mental and physical health monitoring, promotes healthy lifestyle, and assessment of parental stress, while highlighting the need for longitudinal research and inclusion of both mothers and fathers.

• Autism
• Family health
• Parenting stress
• Hair cortisol concentration (HCC)
• Chronic stress
• Eating behavior
• Obesity
• Childhood obesity
• Metabolic syndrome

• All authors: Lubbe, A.L. van der
• Supervisor: Swaab, H.; Vermeiren, R.R.J.M.
• Co-supervisor: Ester, W.A.
• Committee: Bos, P.A.: Charman, T.; Jansen, P.W.; Jonge, M.V. de; Staal, W.G.; Vos, H.M.M.
• Qualification: Doctor (dr.)
• Awarding Institution: Institute of Education and Child Studies, Faculty of Social and Behavioural Sciences, Leiden University
• Date: 2026-02-05
• Sponsorship: Stichting Korczak Foundation; Stichting tot Steun VCVGZ; Youz Kinder- en Jeugdpsychiatrie; Parnassia Groep Academie (onderdeel van Parnassia Groep)