Nutrient intake and adequacy in children with autism spectrum disorder: EPINED epidemiological study

Abstract

This article assesses nutritional intake and adequacy in children with autism spectrum disorder (ASD), subdiagnostic autistic symptoms and children with typical development (TD). In total, 77 children diagnosed with ASD, 40 with subdiagnostic autistic symptoms and 333 children with TD were assessed. A validated food frequency questionnaire was used. Very few nutritional differences were found between ASD and TD groups. Preschool children with ASD and subdiagnostic autistic symptoms had slightly lower intake of monounsaturated fatty acids (MUFA), vitamin D and vitamin B12, and primary school children with ASD and subdiagnostic autistic symptoms had slightly higher intake of protein, cholesterol, thiamine and niacin, and a higher percentage of obesity than children with TD. All samples had an unbalanced energy intake (high in added sugars, fats and saturated fatty acids (SFAs); extremely inadequate intake (80%–100%) of vitamins D and E; high intake (50%–80%) of fibre, b-carotene (except preschool children with TD), calcium (except preschool children) and magnesium). The fact that differences between diagnoses are scarce may be related to the low level of ASD severity in this school sample. Lay abstract Children with autism spectrum disorder (ASD) have a fivefold elevated risk of developing eating problems, which predisposes them to nutritional deficiencies. This study assesses nutritional intake and adequacy in children with ASD, subdiagnostic autistic symptoms and typically developing (TD) children. Preschool children with ASD and subdiagnostic symptoms had slightly lower intake of monounsaturated fatty acids (MUFA), vitamin D and vitamin B12. Primary school children with ASD and subdiagnostic symptoms had slightly higher intake of protein, cholesterol, thiamine and niacin, and a higher percentage of obesity than children with TD. All children had a high intake in sugars, fats and saturated fatty acids; a very highly inadequate intake of vitamins (vitamins D and E), fibre, b-carotene, calcium and magnesium; and a moderately inadequate intake of vitamin C, folate and iron. However, although all children need nutrition advice, children with ASD and subdiagnostic autistic symptoms had a poorer quality diet than those with TD.

Health follow-up visits of children with autism

“…It has been suggested that children with ASD experience many vitamin and mineral deficiencies as a result of their poor intake of daily energy sources, carbohydrates, fats, and protein, as well as their extremely permeable intestines and highly selective diets. 22, 23 Another study found that children with autism have a higher rate of food rejection compared to healthy children, resulting in nutritional inadequacies caused by their limited dietary preferences. 24 In addition, nutritional treatments applied to prevent the symptoms of autism, such as glutenfree and casein-free diets, may cause vitamin and mineral deficiencies.…”

Interrelated development of autism spectrum disorder symptoms and eating problems in childhood: a population-based cohort

“…On the other hand, Bandini et al ( 6 ) showed that some aspects of eating problems, such as food refusal or frequency of problematic mealtime behaviors (e.g., tantrums about food), improved over a longer time period from childhood to adolescence (6.8 to 13.2 years, n = 18). Eating problems may predispose children with diagnosed and even subclinical ASD symptoms to poor diet quality ( 7 ) and suboptimal nutritional intake ( 8 ). While eating problems are presumed to be an epiphenomenon of ASD, eating problems may also modulate diet to influence the severity of ASD-associated symptoms ( 9 , 10 ).…”