Introduction
Autism spectrum disorder (ASD) is a complex condition that affects how people communicate and behave. Many children with ASD also have problems with their diet and digestion, such as eating fewer fruits and vegetables, having less variety of food, and experiencing constipation or other gastrointestinal (GI) symptoms. But what causes these problems, and how are they related to autism traits?
A new study published in Nutrition Journal in 2024 tried to answer these questions by comparing the dietary intake and GI symptoms of 121 children with ASD and 121 typically developing children (TDC) in China. The study also measured the autism traits of the children with ASD, such as ASD symptom severity, restricted repetitive behaviors (RRBs), sensory profiles, and mealtime behaviors.
What did the study find?
The study found that children with ASD had poorer diets and more severe GI symptoms than TDC. Specifically, children with ASD:
- ate fewer vegetables and fruits
- had less variety of food
- had a higher degree of inadequate or unbalanced dietary intake
- had more severe constipation and total GI symptoms
The study also found that some autism traits contributed to the dietary and GI problems of children with ASD. For example:
- compulsive behavior (a type of RRB) was associated with lower vegetable consumption
- taste/smell sensitivity was associated with lower fruit consumption
- self-injurious behavior (a type of RRB) was associated with less variety of food
- limited variety and ASD symptom severity were the main contributors to inadequate dietary intake
- ASD symptom severity and limited variety were the main contributors to unbalanced dietary intake
However, the study also found that unbalanced dietary intake was the only factor that was significantly associated with constipation and total GI symptoms, and that autism traits did not contribute to these symptoms.
What does this mean?
The study suggests that ASD symptom severity and unbalanced diets are the most important factors that affect the dietary and GI problems of children with ASD. This means that improving these factors could provide the largest benefits for the health and well-being of children with ASD.
The study also highlights the need for early detection and optimal treatment of ASD symptom severity and unbalanced diets in children with ASD. This could involve:
- screening for ASD symptom severity and unbalanced diets in children with ASD
- providing individualized dietary guidance and intervention for children with ASD and their families
- educating children with ASD and their families about the importance of a balanced diet and its impact on gut health
- monitoring the dietary intake and GI symptoms of children with ASD and adjusting the intervention accordingly
What are the limitations of the study?
The study has some limitations that should be considered when interpreting the results. For example:
- the study was conducted in China, and the results may not be generalizable to other populations or cultures
- the study used self-reported questionnaires to measure the dietary intake and GI symptoms of the children, which may be subject to recall bias or social desirability bias
- the study did not measure the actual nutrient intake or the gut microbiota of the children, which may also influence the dietary and GI problems of children with ASD
- the study did not control for other factors that may affect the dietary and GI problems of children with ASD, such as medication use, physical activity, or stress levels
What are the implications of the study?
The study provides valuable insights into the relationship between autism traits, dietary intake, and GI symptoms in children with ASD. The study also identifies the potential targets and strategies for improving the dietary and GI problems of children with ASD. The study contributes to the growing body of evidence that supports the importance of nutrition for the health and development of children with ASD.
Faq
What is the difference between food groups intake and food variety?
Food groups intake refers to the amount and frequency of consumption of different food groups, such as grains, vegetables, fruits, meat, eggs, dairy, beans, nuts, oils, sweets, beverages, and condiments. Food variety refers to the number and diversity of different food items within and across the food groups. For example, a person who eats rice, bread, and noodles every day has a high food groups intake of grains, but a low food variety of grains. A person who eats rice, oats, quinoa, barley, and millet every day has a low food groups intake of grains, but a high food variety of grains.
What is the difference between inadequate dietary intake and unbalanced dietary intake?
Inadequate dietary intake refers to the intake of food groups or nutrients that are below the recommended levels. For example, a person who eats less than 300 grams of vegetables per day has an inadequate dietary intake of vegetables. Unbalanced dietary intake refers to the intake of food groups or nutrients that are above or below the recommended proportions. For example, a person who eats 70% of their calories from carbohydrates, 10% from protein, and 20% from fat has an unbalanced dietary intake of macronutrients.
What are some of the common dietary and gastrointestinal problems of children with ASD?
Some of the common dietary and gastrointestinal problems of children with ASD are:
- Low vegetable and fruit consumption
- Low variety of food
- Inadequate or unbalanced dietary intake
- Constipation
- Abdominal pain
- Bloating
- Diarrhea
- Reflux
- Nausea
- Vomiting
What are some of the possible causes of the dietary and gastrointestinal problems of children with ASD?
Some of the possible causes of the dietary and gastrointestinal problems of children with ASD are:
- Autism traits, such as ASD symptom severity, restricted repetitive behaviors, sensory profiles, and mealtime behaviors
- Unbalanced dietary intake, such as low fiber, high fat, or high sugar intake
- Gut microbiota imbalance, such as low diversity or dysbiosis
- Genetic factors, such as mutations or polymorphisms
- Environmental factors, such as medication use, physical activity, or stress levels
What are the possible mechanisms of the relationship between autism traits, dietary intake, and gastrointestinal symptoms in children with ASD?
The possible mechanisms of the relationship between autism traits, dietary intake, and gastrointestinal symptoms in children with ASD are not fully understood, but they may involve biological, psychological, and social factors. For example:
- Biological factors, such as genetic variations, gut microbiota imbalance, inflammation, oxidative stress, or neurotransmitter imbalance, may influence the expression of autism traits, the regulation of appetite and digestion, and the occurrence of gastrointestinal symptoms
- Psychological factors, such as anxiety, depression, or stress, may affect the perception and expression of autism traits, the motivation and preference for food, and the sensitivity and tolerance of gastrointestinal symptoms
- Social factors, such as family, school, or community environment, may shape the development and manifestation of autism traits, the availability and accessibility of food, and the support and coping of gastrointestinal symptoms
What are some of the possible consequences of the dietary and gastrointestinal problems of children with ASD?
Some of the possible consequences of the dietary and gastrointestinal problems of children with ASD are:
- Poor growth and development
- Nutritional deficiencies or excesses
- Increased risk of chronic diseases, such as obesity, diabetes, or cardiovascular diseases
- Impaired cognitive and behavioral functioning, such as attention, memory, learning, or mood
- Reduced quality of life and well-being
- Increased burden and stress for the children and their families
How can nutrition help children with ASD?
Nutrition can help children with ASD by providing them with the essential nutrients and energy they need for their growth and development, as well as by preventing or alleviating some of the dietary and gastrointestinal problems they may have, such as:
- Improving their food variety and diet quality by introducing and encouraging them to eat more vegetables, fruits, whole grains, lean proteins, and healthy fats, and reducing their intake of processed foods, added sugars, and saturated fats
- Increasing their fiber intake by eating more fruits, vegetables, whole grains, beans, nuts, and seeds, and drinking enough water, to prevent or relieve constipation and promote regular bowel movements
- Balancing their omega-3 and omega-6 fatty acids intake by eating more fish, flaxseeds, walnuts, and soybeans, and limiting their intake of vegetable oils, margarine, and fried foods, to reduce inflammation and improve brain function
- Supplementing their vitamin and mineral intake by taking multivitamins, calcium, iron, zinc, or vitamin D, as recommended by their doctor or dietitian, to prevent or correct nutritional deficiencies or excesses
- Modifying their diet according to their specific needs and sensitivities, such as avoiding gluten, casein, or other allergens, or following a ketogenic, low-FODMAP, or elimination diet, as advised by their doctor or dietitian, to reduce gastrointestinal symptoms or improve behavioral outcomes
What are some of the common myths and misconceptions about nutrition and ASD?
Some of the common myths and misconceptions about nutrition and ASD are:
- That all children with ASD have the same dietary and gastrointestinal problems and need the same dietary interventions
- That certain foods or diets can cause or cure ASD, such as gluten, casein, sugar, or vaccines
- That dietary supplements or alternative therapies can replace conventional treatments for ASD, such as vitamins, herbs, or homeopathy
- That nutrition is not important or relevant for children with ASD, or that it is too difficult or expensive to improve their nutrition
What are the benefits of improving the dietary and gastrointestinal problems of children with ASD?
Improving the dietary and gastrointestinal problems of children with ASD may have various benefits, such as:
- Enhancing the growth and development of the children with ASD, such as height, weight, body mass index, bone density, or brain function
- Preventing or correcting the nutritional deficiencies or excesses of the children with ASD, such as anemia, obesity, or osteoporosis
- Reducing the risk of chronic diseases or complications of the children with ASD, such as diabetes, cardiovascular diseases, or cancer
- Improving the cognitive and behavioral functioning of the children with ASD, such as attention, memory, learning, or mood
- Increasing the quality of life and well-being of the children with ASD, such as happiness, satisfaction, or self-esteem
- Decreasing the burden and stress of the children and their families and caregivers, such as medical costs, time, or energy
What are the challenges of improving the dietary and gastrointestinal problems of children with ASD?
Improving the dietary and gastrointestinal problems of children with ASD may face various challenges, such as:
- The complexity and heterogeneity of ASD, which makes it difficult to identify and address the specific needs and goals of each individual with ASD
- The lack of awareness and knowledge of the dietary and gastrointestinal problems of children with ASD, which may lead to underdiagnosis, undertreatment, or misinformation
- The scarcity and inconsistency of the evidence and guidelines of the dietary interventions for children with ASD, which may limit the availability, accessibility, and effectiveness of the interventions
- The resistance and reluctance of the children with ASD and their families and caregivers to change their dietary habits and behaviors, which may hinder the implementation and maintenance of the interventions
- The barriers and difficulties of the environmental and social factors that affect the dietary and gastrointestinal problems of children with ASD, such as food availability, affordability, quality, or safety, or family, school, or community support, or stigma or discrimination
How can parents and caregivers help their children with ASD improve their diet and gut health?
Some of the ways that parents and caregivers can help their children with ASD improve their diet and gut health are:
- To screen for ASD symptom severity and unbalanced diets in their children with ASD and seek professional help if needed
- To provide individualized dietary guidance and intervention for their children with ASD based on their preferences, needs, and goals
- To educate their children with ASD and themselves about the importance of a balanced diet and its impact on gut health
- To monitor the dietary intake and gastrointestinal symptoms of their children with ASD and adjust the intervention accordingly
- To encourage their children with ASD to try new and healthy foods and to reward their efforts and achievements
- To create a positive and supportive mealtime environment for their children with ASD and to avoid pressure or coercion
- To consult with their children’s doctors, dietitians, or therapists for more advice and support
How can teachers and educators help their students with ASD improve their diet and gut health?
Some of the ways that teachers and educators can help their students with ASD improve their diet and gut health are:
- To be aware of the dietary and gastrointestinal problems of their students with ASD and to communicate with their parents and caregivers
- To provide individualized and flexible accommodations and modifications for their students with ASD based on their dietary and gastrointestinal needs
- To educate their students with ASD and their peers about the importance of a balanced diet and its impact on gut health
- To provide opportunities and resources for their students with ASD to learn about and practice healthy eating habits and skills
- To create a positive and supportive school environment for their students with ASD and to avoid stigma or discrimination
- To consult with their students’ parents, caregivers, doctors, dietitians, or therapists for more advice and support
Source:
https://nutritionj.biomedcentral.com/articles/10.1186/s12937-024-00930-8