Gastrointestinal Symptoms and Feeding Problems and Their Associations with Dietary Interventions, Food Supplement Use, and Behavioral Characteristics in a Sample of Children and Adolescents with Autism Spectrum Disorders

Babinská, Katarína; Celušáková, Hana; Belica, Ivan; Szapuova, Zofia Janik; Waczulı́ková, Iveta; Nemcsicsova, Dagmar; Tomova, Aleksandra; Ostatníková, Daniela

doi:10.3390/ijerph17176372

Cited by 38 publications

(42 citation statements)

References 64 publications

(119 reference statements)

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“…FED is also associated with cognitive deficits, which in turn increased the risk of ID ( 29 , 30 ). Additionally, FED has associated with physical issues, such as neuromuscular disorders, gastrointestinal disorders, and food allergies, which contribute to the development of neurodevelopmental disorders ( 31 , 32 ). This study expands our understanding by indicating that children with FED have an increased risk of a wide range of neurodevelopmental disorders.…”

Section: Discussionmentioning

confidence: 99%

Feeding and Eating Disorder and Risk of Subsequent Neurodevelopmental Disorders: A Population-Based Cohort Study

Shan

Zhang

et al. 2021

Front. Pediatr.

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Background: There are limited data concerning the long-term mental health of children with feeding and eating disorder (FED). We aimed to investigate whether children with FED are at greater risks of developing emotional/behavioral disorders with onset usually during childhood, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID).Methods: We conducted a population-based cohort study, including all singleton births in Denmark from January 1, 1995, to December 31, 2015. For each child diagnosed with FED, 10 age- and sex-matched controls who did not meet the criteria for FED were randomly selected from the general population. Associations were estimated with Cox regression modes adjusting for other perinatal and maternal factors, and sibling analyses were performed for controlling potential confounding by shared familial (genetic or environmental) factors.Results: Of the 1,256,989 individuals in the cohort, there were 1967 (53.4% girls) children diagnosed with FED. Children with FED had higher risks for clinically diagnosed emotional/behavioral disorders with onset usually in childhood (hazard ratio [HR], 2.78; 95% CI, 2.34–3.31), ADHD (HR, 1.74; 95% CI, 1.33–2.26), ASD (HR, 3.05; 95% CI, 2.36–3.94), and ID (HR, 6.38; 95% CI, 4.48–9.11), compared with matched controls. Girls with FED are at greater risks for emotional/behavioral disorders and ID, but not ADHD and ASD. Alike, in sibling analysis, increased rates are also observed for other neurodevelopmental disorders, but not for ADHD.Conclusion: Children with FED are associated with substantially increased risks of emotional/behavioral disorders, ADHD, ASD, and ID. This study highlights the importance of carefully monitoring neurodevelopmental disorders in children with FED.

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Section: Discussionmentioning

confidence: 99%

Feeding and Eating Disorder and Risk of Subsequent Neurodevelopmental Disorders: A Population-Based Cohort Study

Shan

Zhang

et al. 2021

Front. Pediatr.

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“…Relevant studies from the current review include a report [ 15 ] of a higher frequency of constipation in children with ASD, a study [ 16 ] which found children with ASD and regression more often had abnormal stool than those without regression, and another experiment [ 17 ] which found GI symptoms to be more common in children and adolescents with ASD than in TD controls, and for these symptoms to be weakly correlated to behavioural measures. Correlations such as these have been documented elsewhere [ 18 , 19 , 20 ].…”

Section: Gastrointestinal Symptoms In Asdmentioning

confidence: 99%

“…Correlations such as these have been documented elsewhere [ 18 , 19 , 20 ]. These studies reference the often non-specific nature of GI symptoms with one explaining that “a GI pathology specific to ASD had not been established” (Babinska et al, 2020 [ 17 ]). Regardless, a notable body of literature has investigated for a comorbidity between ASD and specific GI conditions, often finding significant results.…”

Section: Gastrointestinal Symptoms In Asdmentioning

confidence: 99%

Gluten and Autism Spectrum Disorder

2021

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An expanding body of literature is examining connections between Autism Spectrum Disorder (ASD) and dietary interventions. While a number of specialist diets have been suggested as beneficial in ASD, gluten has received particularly close attention as a potentially exacerbating factor. Reports exist suggesting a beneficial effect of the gluten-free diet (GFD) in ameliorating behavioural and intellectual problems associated with ASD, while epidemiological research has also shown a comorbidity between ASD and coeliac disease. However, both caregivers and clinicians have expressed an uncertainty of the value of people with ASD going gluten-free, and as the GFD otherwise receives considerable public attention a discussion which focuses specifically on the interaction between ASD and gluten is warranted. In this review we discuss the historical context of ASD and gluten-related studies, and expand this to include an overview of epidemiological links, hypotheses of shared pathological mechanisms, and ultimately the evidence around the use and adoption of the GFD in people with ASD.

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“…Currently, the physiological basis/es for eating difficulties in individuals with ASD is not well understood and is plagued by heterogeneity both in study design and how symptoms manifest across the spectrum (Margari et al, 2020). Recent studies show that while children with ASD are generally pickier about their food than neurotypical children (Babinska et al, 2020;Li C. et al, 2020), other symptoms may be unique to specific genetic forms of ASD. For example, in people with SYNGAP1 mutations, there is a correlation between eating and seizures (Vlaskamp et al, 2019).…”

Section: Setting the Stagementioning

confidence: 99%

The Gut-Brain-Microbiome Axis and Its Link to Autism: Emerging Insights and the Potential of Zebrafish Models

James

Davidson

Yanes

et al. 2021

Front. Cell Dev. Biol.

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Research involving autism spectrum disorder (ASD) most frequently focuses on its key diagnostic criteria: restricted interests and repetitive behaviors, altered sensory perception, and communication impairments. These core criteria, however, are often accompanied by numerous comorbidities, many of which result in severe negative impacts on quality of life, including seizures, epilepsy, sleep disturbance, hypotonia, and GI distress. While ASD is a clinically heterogeneous disorder, gastrointestinal (GI) distress is among the most prevalent co-occurring symptom complex, manifesting in upward of 70% of all individuals with ASD. Consistent with this high prevalence, over a dozen family foundations that represent genetically distinct, molecularly defined forms of ASD have identified GI symptoms as an understudied area with significant negative impacts on quality of life for both individuals and their caregivers. Moreover, GI symptoms are also correlated with more pronounced irritability, social withdrawal, stereotypy, hyperactivity, and sleep disturbances, suggesting that they may exacerbate the defining behavioral symptoms of ASD. Despite these facts (and to the detriment of the community), GI distress remains largely unaddressed by ASD research and is frequently regarded as a symptomatic outcome rather than a potential contributory factor to the behavioral symptoms. Allowing for examination of both ASD’s impact on the central nervous system (CNS) as well as its impact on the GI tract and the associated microbiome, the zebrafish has recently emerged as a powerful tool to study ASD. This is in no small part due to the advantages zebrafish present as a model system: their precocious development, their small transparent larval form, and their parallels with humans in genetics and physiology. While ASD research centered on the CNS has leveraged these advantages, there has been a critical lack of GI-centric ASD research in zebrafish models, making a holistic view of the gut-brain-microbiome axis incomplete. Similarly, high-throughput ASD drug screens have recently been developed but primarily focus on CNS and behavioral impacts while potential GI impacts have not been investigated. In this review, we aim to explore the great promise of the zebrafish model for elucidating the roles of the gut-brain-microbiome axis in ASD.

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Gastrointestinal Symptoms and Feeding Problems and Their Associations with Dietary Interventions, Food Supplement Use, and Behavioral Characteristics in a Sample of Children and Adolescents with Autism Spectrum Disorders

Cited by 38 publications

References 64 publications

Feeding and Eating Disorder and Risk of Subsequent Neurodevelopmental Disorders: A Population-Based Cohort Study

Feeding and Eating Disorder and Risk of Subsequent Neurodevelopmental Disorders: A Population-Based Cohort Study

Gluten and Autism Spectrum Disorder

The Gut-Brain-Microbiome Axis and Its Link to Autism: Emerging Insights and the Potential of Zebrafish Models

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