Nutritional Status of Individuals with Autism Spectrum Disorders: Do We Know Enough?

Abstract

The incidence of individuals with autism spectrum disorders (ASDs) is on the rise; therefore, well-timed screening is important. Given that this is a nutritionally vulnerable population, it is imperative to conduct a detailed nutritional assessment so that timely and intensive interventions can be recommended. This review article summarizes the research, focusing on the nutritional status of individuals with ASDs based on their anthropometric measurements, biomarkers, and dietary assessments. Research examining anthropometric measurements reveals an abnormally accelerated rate of growth among children with autism but shows inconsistent findings on the prevalence of overweight/obesity in comparison with typically growing children. Although dysregulated amino acid metabolism, increased homocysteine, and decreased folate, vitamins B-6 and B-12, and vitamin D concentrations have been proposed as possible biomarkers for an early diagnosis of ASDs, research investigating their association with age, gender, severity, and other comorbid psychiatric/nonpsychiatric disorders is lacking. There is consensus that children with autism have selective eating patterns, food neophobia, limited food repertoire, and sensory issues. Although inadequate micronutrient but adequate macronutrient intakes are increasingly reported, there are inconsistent results about the extent and type of nutrient deficiencies. Identification and development of nutritional assessment indicators that serve as early warning signs during routine practice beginning at birth and extending throughout the child's growth are necessary. With this population aging, there is also a dire need to study the adult population. A more vigorous role by nutrition professionals is warranted because management of potential comorbidities and contributory factors may be particularly problematic.

The Genetic and Epigenetic Basis Involved in the Pathophysiology of ASD: Therapeutic Implications

“…Although inadequate micronutrient but adequate macronutrient intakes are increasingly reported, there are inconsistent results about the extent and type of nutrient deficiencies (for review see [265]). Micronutrient as essential amino acids, minerals, and vitamins are indispensable for human health, primarily due to their critical function as enzymatic cofactors for numerous reactions in the body, such as the production of neurotransmitters and fatty acid metabolism.…”

“…The prevalence of iron deficiency and anemia in subjects with autism is reported between 24 and 32% and 8 and 16%, respectively. Because iron deficiency, with or without anemia, results in impaired cognition and developmental defects, iron deficiency in children with autism could further compromise their communication and behavioral impairments [265]. Thus, ferritin levels should be measured in subjects with autism as a part of routine investigation [275].…”

Narratives of mothers of children with autism spectrum disorders: focus on eating behavior

“…3,6 The mothers' narratives reflect these difficulties that are intrinsic to ASD; however, they also indicate that these characteristics may not be determinant when adequate environmental stimulus successfully results in the introduction of new eating habits.…”

“…Some authors have suggested that children with autism tend to restrict their diet to an extremely narrow range of foods, with associated food neophobia and sensory problems. 3 Furthermore, sensory factors such as smell, texture, color and temperature may contribute to this behavior. [4][5][6] A literature review of seven descriptive studies found the prevalence of eating problems in children with ASD to range between 46 and 89% in the patients evaluated.…”

Emerging Clues and Altered Metabolic Findings in Autism: Breakthroughs and Prospects from Omics Studies

“…Further, inadequate micronutrient-but adequate macronutrient-intakes are increasingly reported. Thus, several lines of evidence implied that patients with ASD disorders are likely to display dysregulated amino acid metabolism, increased concentrations of homocysteine, and/or decreased levels of the vitamins folate, B-6, B-12 and vitamin-D, thereby suggesting possible biomarkers for an early diagnosis of ASDs [22]. Other studies have reported that supplemental nutrients such as omega-3 fatty acids, zinc, magnesium, and some phytochemicals may evoke moderate benefits, while avoidance of food allergens, chemicals, and chelation therapy can afford some aid to autism patients.…”