Evaluation of a Pilot Healthy Eating and Exercise Program for Young Adults with Autism Spectrum Disorder and Intellectual Disabilities

Food and Nutrition in Autistic Adults: Knowledge Gaps and Future Perspectives

Proper nutrition is a critical component in supporting the overall health and development of individuals with autism spectrum disorder (ASD) who experience eating difficulties associated with their autistic traits. Evidence regarding the prevalence, origins, and consequences of eating issues related to ASD is largely derived from studies on autistic children, while information pertaining to adults remains scarce. It is therefore essential to critically review existing research focusing on autistic adults to draw robust conclusions and identify clear research gaps. A computer-aided search in PubMed, Science Direct, Scopus, and Web of Science databases spanning the years 2013-2024 using the search terms covering ASD/Autism, Adult, Nutrition/Nutritional Status, and Diet yielded 43 full-text articles. In our literature review, we explored three critical aspects of nutrition in adults with ASD: their food preferences and sensory processing patterns, studies on nutritional status, and whether dietary and nutritional interventions have improved their adherence to healthier diets. Autistic adults appear to select food based on sensory perceptions. This selection pattern can affect their nutritional status, with a tendency toward overweight and nutritional deficiencies. The most promising intervention strategies incorporate sensory adaptation and structured meal planning. Further research should apply rigorous methodologies that account for this population's specific characteristics.

The Effects of a Ball Combination Training Program Combined with a Continuous Theta Burst Stimulation Intervention on Eating Behaviors in Autistic Children with Accompanying Intellectual Disabilities: A Preliminary Study

Background: Eating behavior problems significantly affect the physical health and quality of life of children with autism spectrum disorder and intellectual disabilities (co-occurring ASD/ID). This study aimed to evaluate the effects of a 12-week Ball Combination Training Program (BCTP), continuous theta burst stimulation (cTBS), and an intervention combining both (in the CIG) on the eating behaviors of children with co-occurring ASD/ID. Methods: A total of 48 participants were assigned into one of four groups: the BCTP (n = 13), cTBS (n = 12), the CIG (n = 11), and a control group (n = 12). The intervention groups received their respective treatments in addition to the routine institutional rehabilitation, whereas the control group only received the standard institutional rehabilitation. The intervention outcomes were assessed using the parent-reported Children's Eating Behavior Questionnaire (CEBQ). Results: The results indicated that all three intervention methods led to improvements in their eating behavior after 12 weeks. Specifically, the BCTP group and the CIG demonstrated significantly reduced Food Fussiness behavior, while the children's Enjoyment of Food was markedly enhanced in the cTBS group and the CIG. Furthermore, the CIG experienced a particularly notable effect in terms of the improvement in the Satiety Responsiveness dimension of their eating behavior. Among the three approaches, the CIG demonstrated a clear advantage over the single interventions in terms of both the breadth and magnitude of its improvements. Conclusions: This study confirmed the effectiveness of these three intervention strategies in addressing dietary behavior problems among children with co-occurring ASD/ID. Future research should focus on exploring the combined intervention approach further, particularly its potential synergy, while delving deeper into the neural mechanisms underlying these behavioral improvements.

A Short-Term Evaluation of the Eat and Exercise to Win Program for Adults with Intellectual and Developmental Disabilities

(1) Study Aim: Adults with intellectual and developmental disabilities (IDD) face a multitude of chronic health risks related to obesity, including diabetes and heart disease. Day adult service programs offer unique opportunities for improving and monitoring the health of this vulnerable group. To promote exercise and healthy eating habits among adults with IDD, the Eat and Exercise to Win Program (EE-2-Win) was offered weekly at two locations over 8-9 months. (2) Methods: Using daily logs, staff assessed outcomes of 26 program participants, including changes in knowledge, eating and exercise habits, and water consumption. Participants' weights were measured, and their lunches were photographed at baseline and 3 months. (3) Results: While participants' weights did not significantly differ at 3 months, assessing photographs indicated that participants' lunches included more fruits and vegetables. Staff surveys indicated that participants had greater knowledge of MyPlate and were consuming more water at three months. Survey responses indicated that staff perceived the program to be valuable overall, and challenges in learning and assessment were reported given differences in the cognitive abilities of adults with IDD. Staff also suggested engaging home caregivers in the program, as they often make dietary decisions. (4) Conclusions: Overall, results confirmed that the EE-2-Win Program positively impacted healthy eating and exercise. Future work, however, with both staff and caregivers is needed to further optimize the program.

Effects of physical activity and exercise-based interventions in young adults with autism spectrum disorder: A systematic review

LAY ABSTRACT

Young adults with autism spectrum disorder over 18 years of age are an underserved population, and there is presently limited evidence examining the effects of physical activity programs in this population. Our review synthesizes the evidence to date from studies that have assessed the effects of physical activity/exercise programs in young adults with autism spectrum disorder between 19 and 30 years. We reviewed 22 studies that included a total of 763 young adults with autism spectrum disorder. There is the strongest evidence for improvements in physical fitness, followed by motor skills, psychological function, and quality of life following physical activity interventions in young adults with autism spectrum disorder. Specifically, aerobic and resistance training as well as programs focused on movement skill and sport-specific training lead to improved physical fitness and movement performance. Holistic interventions focusing on physical activity, dietary changes, and lifestyle modifications lead to improvements in body composition and quality of life of young adults with autism spectrum disorder. There is presently limited evidence to support the use of exercise/activity programs to improve physical activity levels and core autism symptoms in young adults with autism spectrum disorder. Based on our review results, we also provide practical recommendations for clinicians working with young adults with autism spectrum disorder.