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Feeding Problems and Nutrient Intake in Children with and without Autism: A Comparative Study

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Abstract

Objective

To compare parent reported feeding difficulties and nutritional adequacy of children with Autism Spectrum Disorders (ASD) to an age and socio-economically matched group of typically developing children.

Methods

The scores on Children’s Eating Behavior Inventory (CEBI), three-day food records, anthropometric measures and adequacy of micro- and macro- nutrients were compared for 63 children diagnosed with ASD and 50 typically developing children enrolled from the department of pediatrics of a tertiary care teaching hospital from North India.

Results

The majority (79%) of the parents of ASD children reported some concern regarding their feeding behavior as compared to 64% of the parents of typically developing children. As compared to controls, ASD children had significantly higher CEBI scores (97.28 vs. 89.48, t = 3.15, P = 0.002) and more feeding problems (6.42 vs. 2.70, t = 3.74, P = 0.001). Relative to controls, ASD children consumed fewer number of food items (P = 0.022), particularly fruits (P = 0.004), vegetables (P = 0.011), and proteins (P = 0.015); had significantly lower daily intake of potassium (P = 0.001), copper (P = 0.007), and folate (P = 0.001). Although children with autism did not differ significantly from controls on intake of calories, height, weight, or body mass index, significantly greater proportion of ASD children failed to meet the estimated average requirement of thiamine (P = 0.039), vitamin C (P = 0.013), and copper (P = 0.005).

Conclusions

The findings underscore the need for comprehensive assessment and empirically-supported interventions for eating problems and dietary deficiencies found in ASD children.

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References

  1. Schreck KA, Williams K, Smith AFA. Comparison of eating behaviors between children with and without autism. J Autism Dev Disord. 2004;34:433–8.

    Article  Google Scholar 

  2. Schmitt L, Heiss CJ, Campbell EEA. Comparison of nutrient intake and eating behavior of boys with and without autism. Top Clin Nutr. 2008;23:23–31.

    Article  Google Scholar 

  3. Nadon G, Feldman DE, Dunn W, Gisel E. Mealtime problems in children with autism spectrum disorder and their typically developing siblings. A comparison study. Autism. 2011;15:98–113.

    Article  Google Scholar 

  4. Postorino V, Sanges V, Giovagnoli G, et al. Clinical differences in children with autism spectrum disorder with and without food selectivity. Appetite. 2015;92:126–32.

    Article  Google Scholar 

  5. Aponte CA, Romanczykb RG. Assessment of feeding problems in children with autism spectrum disorder. Res Autism Spectr Disord. 2016;21:61–72.

    Article  Google Scholar 

  6. Sharp WG, Berry RC, McCracken C, et al. Feeding problems and nutrient intake in children with autism spectrum disorders: meta-analysis and comprehensive review of the literature. J Autism Dev Disord. 2013;43:2159–73.

    Article  Google Scholar 

  7. Dovey TM, Farrow CV, Martin CI, Isherwood E, Halford JCG. When does food refusal require professional intervention? Curr Nutr Food Sci. 2009;5:160–71.

    Article  Google Scholar 

  8. Micali N, Rask CU, Olsen EM, Skovgaard AM. Early predictors of childhood restrictive eating: a population-based study. J Dev Behav Pediatr. 2016;37:314–21.

    Article  Google Scholar 

  9. Cermak SA, Curtin C, Bandini LG. Food selectivity and sensory sensitivity in children with autism spectrum disorders. J Acad Nutr Dietetics. 2010;110:238–46.

    Google Scholar 

  10. Archer LA, Rosenbaum PL, Streiner DL. The children’s eating behavior inventory. J Pediatr Psychol. 1991;16:629–42.

    Article  CAS  Google Scholar 

  11. Kaur G. Dietcal - a tool for dietary assessment and planning. New Delhi: Profound Tech Solutions; 2015.

    Google Scholar 

  12. Institute of Medicine Dietary Reference Intakes: Applications and Dietary Assessment. Washington, DC: National Academy Press; 2000.

  13. Ledford JR, Gast DL. Feeding problems in children with autism spectrum disorders: a review. Focus Autism Other Dev Disabl. 2006;21:153–66.

    Article  Google Scholar 

  14. Bandini LG, Anderson SE, Curtin C, et al. Food selectivity in children with autism spectrum disorders and typically developing children. J Pediatr. 2010;157:259–64.

    Article  Google Scholar 

  15. Wright CM, Parkinson KN, Shipton D, Drewett RF. How do toddler eating problems relate to their eating behavior, food preferences, and growth? Pediatrics. 2007;120:e1069–75.

    Article  Google Scholar 

  16. Emond A, Emmett P, Steer C, Golding J. Feeding symptoms, dietary patterns, and growth in young children with autism spectrum disorders. Pediatrics. 2010;126:337–42.

    Article  Google Scholar 

  17. Evans EW, Must A, Anderson SE, et al. Dietary patterns and body mass index in children with autism and typically developing children. Res Autism Spectr Disord. 2012;6:399–405.

    Article  Google Scholar 

  18. Graf-Myles J, Farmer C, Thurm A, et al. Dietary adequacy of children with autism compared with controls and the impact of restricted diet. J Dev Behav Pediatr. 2013;34:449–59.

    Article  Google Scholar 

  19. Liu X, Liu J, Xiong X, et al. Correlation between nutrition and symptoms: nutritional survey of children with autism spectrum disorder in Chongqing, China. Nutrients. 2016;8:294.

    Article  Google Scholar 

  20. Hubbard KL, Anderson SE, Curtin C, Must A, Bandini LG. A comparison of food refusal related to characteristics of food in children with autism spectrum disorder and typically developing children. J Acad Nutr Diet. 2014;114:1981–7.

    Article  Google Scholar 

  21. Mazurek MO, Vasa RA, Kalb LG, et al. Anxiety, sensory over-responsivity, and gastrointestinal problems in children with autism spectrum disorders. J Abnorm Child Psychol. 2013;41:165–76.

    Article  Google Scholar 

  22. Johnson CR, Turner K, Stewart PA, et al. Relationships between feeding problems, behavioral characteristics and nutritional quality in children with ASD. J Autism Dev Disord. 2014;44:2175–84.

    Article  Google Scholar 

  23. Vissoker RE, Latzer Y, Gal E. Eating and feeding problems and gastrointestinal dysfunction in autism spectrum disorders. Res Autism Spectr Disord. 2015;12:10–21.

    Article  Google Scholar 

  24. Xia W, Zhou Y, Sun C, Wang J, Wu LA. Preliminary study on nutritional status and intake in Chinese children with autism. Eur J Pediatr. 2010;169:1201–6.

    Article  Google Scholar 

  25. Bicer AH, Alsaffar AA. Body mass index, dietary intake and feeding problems of Turkish children with autism spectrum disorder (ASD). Res Dev Disabil. 2013;34:3978–87.

    Article  Google Scholar 

  26. Meguid N, Anwar M, Zaki S, Kandeel W, Ahmed N, Tewfik I. Dietary patterns of children with autism spectrum disorder: a study based in Egypt. Open Access Maced J Med Sci. 2015;3:262–7.

    Article  Google Scholar 

  27. Sahu SK, Kumar SG, Bhat BV, et al. Malnutrition among under-five children in India and strategies for control. J Nat Sci Biol Med. 2015;6:18–23.

    Article  Google Scholar 

  28. Marí-Bauset S, Llopis-González A, Zazpe I, Marí-Sanchis A, Suárez-Varela MM. Comparison of nutritional status between children with autism spectrum disorder and typically developing children in the Mediterranean region (Valencia, Spain). Autism. 2016; doi:10.1177/1362361316636976.

    Article  PubMed  Google Scholar 

  29. Williams-Hooker R, George EO, Levy M, Morgan C, Smith TL, Bittle JB. Calcium and vitamin D intake of boys who have autism. Child Obesity Nutr. 2013;5:113–7.

    Google Scholar 

  30. Stewart PA, Hyman SL, Schmidt BL, et al. Dietary supplementation in children with autism spectrum disorders: common, insufficient and excessive. J Acad Nutr Diet. 2015;115:1237–48.

    Article  Google Scholar 

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Contributions

PM, BB, and PS designed the study. PM and PS jointly made the diagnosis of ASD. PM wrote the manuscript. BB analyzed the nutrition data. LV collected the data and helped in the analysis. All the authors approved the manuscript. PM will act as guarantor for the paper.

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Correspondence to Prahbhjot Malhi.

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Malhi, P., Venkatesh, L., Bharti, B. et al. Feeding Problems and Nutrient Intake in Children with and without Autism: A Comparative Study. Indian J Pediatr 84, 283–288 (2017). https://doi.org/10.1007/s12098-016-2285-x

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  • DOI: https://doi.org/10.1007/s12098-016-2285-x

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