Objectives To define food selectivity and compare indices of food selectivity among children with autism spectrum disorders (ASDs) and typically developing children, and to assess the impact of food selectivity on nutrient adequacy. Study design Food selectivity was operationalized to include food refusal, limited food repertoire, and high frequency single food intake using a modified food frequency questionnaire and 3-day food record. Food selectivity was compared between 53 children with ASDs and 58 typically developing children ages 3–11 years. Nutrient adequacy was assessed relative to the Dietary Reference Intakes. Results Children with ASDs exhibited more food refusal than typically developing children (41.7% vs. 18.9% of foods offered, p < 0.0001). A more limited food repertoire was reported for children with ASDs than typically developing children (19.0 vs. 22.5 foods, p < 0.001). Only four children with ASDs and one typically developing child were reported to demonstrate high frequency single food intake. Children with a more limited food repertoire had inadequate intakes of a greater number of nutrients. Conclusions Our findings suggest that food selectivity is more common in children with ASDs than in typically developing children, and that limited food repertoire may be associated with nutrient inadequacies.

To determine whether dietary patterns (juice and sweetened non-dairy beverages, fruits, vegetables, fruits & vegetables, snack foods, and kid’s meals) and associations between dietary patterns and body mass index (BMI) differed between 53 children with autism spectrum disorders (ASD) and 58 typically developing children, ages 3 to 11, multivariate regression models including interaction terms were used. Children with ASD were found to consume significantly more daily servings of sweetened beverages (2.6 versus 1.7, p=0.03) and snack foods (4.0 versus 3.0, p=0.01) and significantly fewer daily servings of fruits and vegetables (3.1 versus 4.4, p=0.006) than typically developing children. There was no evidence of statistical interaction between any of the dietary patterns and BMI z-score with autism status. Among all children, fruits and vegetables (p=0.004) and fruits alone (p=0.005) were positively associated with BMI z-score in our multivariate models. Children with ASD consume more energy-dense foods than typically developing children; however, in our sample, only fruits and vegetables were positively associated with BMI z-score.

Background To determine the validity of body mass index (BMI) to identify excess fatness in youth with Down syndrome (DS). Methods Using the CDC growth reference, we defined overweight (≥85th percentile) and obesity (≥95th percentile) based on participants’ age- and sex-specific BMI z-scores, calculated from measured height and weight. Percentage body fat (%BF) was measured by dual-energy X-ray absorptiometry. We determined sensitivity, specificity, positive predictive value, negative predictive value, and efficiency of BMI percentiles to identify excess adiposity relative to elevated %BF cut-offs developed from the Pediatric Rosetta Body Composition project (Freedman et al., 2009b) in 32 youth (20M/12F), ages 13–21 years with Down syndrome. Results For adolescents with Down syndrome using the cut-off points of 95th percentile for BMI (obesity), sensitivity and specificity were 71% and 96%, respectively. Positive predictive value was 83% and negative predictive value was 92%. Overall efficiency was 91%. Sensitivity and specificity for BMI cut-offs above the 85th percentile (overweight) were 100% and 60%, respectively. The positive predictive value was 41% and negative predictive value was 100%. Overall efficiency was 69%. Conclusion On the whole, the obesity (≥95th percentile) cut-off performs better than the overweight cut-off (85th–94th percentile) in identifying elevated fatness in youth with DS.