Effects of Vitamin D Supplementation on Children with Autism Spectrum Disorder: A Systematic Review and Meta-analysis

Abstract

The effect of vitamin D supplementation on individuals with autism spectrum disorder (ASD) is inconclusive. We aimed to conduct a meta-analysis of the available randomized controlled trials (RCTs) to explore whether vitamin D supplementation can improve core symptoms and coexisting conditions in children with ASD. Data were obtained by searching the PubMed, Embase, Web of Science, CINAHL and Cochrane Library databases up to February 2022 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Using a random-effects model, mean differences with 95% confidence intervals (CIs) were calculated through a meta-analysis. There were eight RCTs with 266 children with ASD in the present review, among which six RCTs were included in the meta-analysis. Children who received vitamin D supplementation showed a significant improvement in stereotypical behavior scores (pooled mean difference (MD): −1.39; 95% CI: −2.7, −0.07; p = 0.04) with low heterogeneity (I 2 = 34%), and there was a trend toward decreased total scores on the Social Responsiveness Scale (SRS) and Childhood Autism Rating Scale (CARS, p = 0.05); however, there were no other significant differences in the core symptoms of ASD and coexisting conditions between groups as measured by the Aberrant Behavior Checklist (ABC). Vitamin D supplementation appears to improve stereotypical behaviors but does not improve other core symptoms and coexisting conditions. Further randomized controlled trials with large sample sizes and individualized doses are needed.

The Role of Dietary Patterns and Nutritional Supplements in the Management of Mental Disorders in Children and Adolescents: An Umbrella Review of Meta-Analyses: Le rôle des habitudes alimentaires et des suppléments nutritionnels dans la prise en charge des troubles mentaux chez les enfants et les adolescents : une méta-revue de méta-analyses

“…Furthermore, vitamin D did not demonstrate improvement in other core ASD symptoms such as social interaction (pooled MD: −0.07; 95% CI, −1.70 to 1.57; p = 0.93; I 2 = 0%) and communication (pooled MD: −0.04; 95% CI, −1.19 to 1.10; p = 0.94; I 2 = 57). 49 However, Vitamin D supplementation indicated a small but significant improvement in coexisting hyperactivity scores (k = 3; n = 104; pooled MD: 3.20; 95% CI, 0.34 to 6.06; p = 0.03; I 2 = 10%). 50 Supplementation with L-carnosine for 8 weeks did not show any significant difference compared to the placebo groups in the Gilliam Autism Rating Scale scores (k = 2; n = 74; MD = −2.57; 95% CI, −10.30 to 5.16; p = 0.52; I 2 = 8%), including its socialization (k = 2; n = 74; MD = −1.51; 95% CI, −6.16 to 3.14; p = 0.53; I 2 = 0%), behaviour (k = 2; n = 74; MD = −0.48; 95% CI, −4.82 to 3.87; p = 0.83; I 2 = 0%), and communication (k = 2; n = 74; MD = −3.94; 95% CI, −10.00 to 2.11; p = 0.20) subscales, as well as the childhood autism rating scale (k = 2; n = 94; MD = −0.88; 95% CI, −6.96 to 5.20; p = 0.78; I 2 = 0%).…”

“…In the field of nutritional psychiatry in children and adolescents, the most extensively studied mental disorders are ASD, [43][44][45][46][47][48][49][50][51][52][53] followed by ADHD. [34][35][36][37][38][39][40][41][42] These results are consistent with the observed increase in the prevalence of these disorders.…”

“…Both meta-analyses included RCTs with small sample sizes, making it difficult to draw definitive conclusions. 49,50 Additionally, probiotic and prebiotic supplementation did not demonstrate a significant effect on ASD symptoms in a recent meta-analysis of 7 RCTs, though more extensive trials are necessary. 52 PUFAs have been the most widely evaluated dietary supplement in the treatment of paediatric mental disorders, particularly in the context of ADHD.…”

Vitamin D in tuberous sclerosis complex-associated tumors

“…Therefore, central nervous system vitamin D deficiency in TSC might be one of the drivers of impaired neural and synaptic maturation, as well as of tumorigenesis. Notably, blood levels of 25-D higher than 40 ng/ml can improve the autism spectrum disorder (ASD) rating ( 52 ). Thus, the same therapeutic effects can be expected in TSC.…”

Hypovitaminosis D in persons with Down syndrome and autism spectrum disorder

“…Although much more genetically diverse, individuals with ASD have some similar neurological and medical co-morbidities to individuals with DS which serves as a similar comparator group. Research on the role of vitamin D supplementation in this population is more advanced than in the DS literature although the results of such interventions have been mixed [ 15 , 16 ].…”