The impact of abnormal feeding behaviors reported for children with autism spectrum disorders (ASDs) on their nutritional status is unknown. We compared nutrient intake from food consumed by children with and without ASD and examined nutrient deficiency and excess.
Prospective 3-day food records and BMI for children (2–11 years) with ASD participating in the Autism Treatment Network (Arkansas, Cincinnati, Colorado, Pittsburgh, and Rochester) were compared with both the National Health and Nutrition Examination Survey data and a matched subset based on age, gender, family income, and race/ethnicity (N = 252 analyzed food records).
Children with ASD and matched controls consumed similar amounts of nutrients from food. Only children with ASD aged 4 to 8 years consumed significantly less energy, vitamins A and C, and the mineral Zn; and those 9 to 11 years consumed less phosphorous. A greater percentage of children with ASD met recommendations for vitamins K and E. Few children in either group met the recommended intakes for fiber, choline, calcium, vitamin D, vitamin K, and potassium. Specific age groups consumed excessive amounts of sodium, folate, manganese, zinc, vitamin A (retinol), selenium, and copper. No differences were observed in nutritional sufficiency of children given restricted diets. Children aged 2 to 5 years with ASD had more overweight and obesity, and children 5 to 11 years had more underweight.
Children with ASD, like other children in America, consume less than the recommended amounts of certain nutrients from food. Primary care for all children should include nutritional surveillance and attention to BMI.
Comments
Dietary Vitamin Deficiency in Children with Autism
This elegant study is invaluable in the understanding of nutritional insufficiencies in children with autism spectrum disorders (ASD). However, practitioners who treat this population should be aware of the possibilty of significant adverse health consequences which can be irreversible in children with ASD who have the most restrictive diets. These children are often older, have more severe intellectual impairment and have had the restricted diet over a prolonged period. Both temporary and permanent visual loss attributed to deficiencies in Vitamin B12 and A, rickets and hypogonadism attributed to Vitamin D deficiency and scurvy attributed to Vitamin C deficiency have been reported in children with ASD. A history of such a restricted diet should prompt investigation into vitamin levels and initiation of vitamin supplementation especially in the context of suspected visual loss, growth and pubertal delay, behavioral changes or muscle atrophy (suggesting protein deficiency).
for related references, see 1) Pineles SL, Avery RA, Liu GT. Vitamin B12 optic neuropathy in autism. Pediatrics 2010;126:e967-970. 2) McAbee GN, Prieto DM, Kirby J et al. Permanent visual loss due to dietary Vitamin A deficiency in an autistic adolescent. J Child Neurol 2009;10:1288-89.
Conflict of Interest:
None declared