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Us Altay D, Esnafoglu E, Kocyigit E, Mataraci Değirmenci D, Noyan T. An Examination of the Effect of Parent-Centered Nutrition Education on the Oxidant-Antioxidant Parameters of Children Diagnosed With Autism Spectrum Disorder. Brain Behav 2025; 15:e70504. [PMID: 40360453 PMCID: PMC12074868 DOI: 10.1002/brb3.70504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2025] [Revised: 04/02/2025] [Accepted: 04/07/2025] [Indexed: 05/15/2025] Open
Abstract
BACKGROUND This study examined the effect of nutrition education given by dietitians to families of children aged 3-18 diagnosed with autism spectrum disorder (ASD) on meal consumption, eating behaviors, autism severity, serum oxidant/antioxidant marker levels, and total dietary antioxidant capacity. METHODS The project was carried out with 44 pediatric patients diagnosed with ASD and their parents. The ELISA method was used for antioxidant and oxidant measurements, and the oxygen radical absorbance capacity values of foods defined according to the BeBiS program were used to calculate the total dietary antioxidant capacity. The children's eating behavior questionnaire, childhood autism rating scale (CARS), and brief autism mealtime behavior inventory (BAMBI) were administered. RESULTS There was no significant difference in antioxidant and oxidant parameters between the experimental and control groups. At the end of eight weeks, superoxide dismutase and glutathione levels increased significantly in the experimental group. There was no significant difference in terms of the families of the autistic children in the experimental and control groups or their disease-specific knowledge. BAMBI scores were similar between the groups at baseline, while a significant decrease was observed in the experimental group at the end of the study. Daily energy, saturated fatty acid (SFA), carbohydrate, and omega-6 intake decreased, while protein, fat, mono- and poly-unsaturated fatty acid, and omega-3 intake increased in the experimental group following nutrition education. However, these results were not statistically significant. There was no significant difference in terms of micronutrient intake between children with ASD in experimental and control groups before and after nutrition education. CONCLUSION Improvements in eating habits and dietary patterns were noted after nutrition education, especially in the experimental group, even though there were no appreciable changes in oxidative stress indicators. These behavioral shifts imply that family nutrition education can be extremely important in encouraging better eating practices and improving the general well-being of kids with ASD and their families.
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Affiliation(s)
- Diler Us Altay
- Faculty of Health Sciences, Department of Nutrition and DieteticsOrdu UniversityOrduTurkey
| | - Erman Esnafoglu
- Faculty of Medicine, Department of Child and Adolescent Mental Health DısordersOrdu UniversityOrduTurkey
| | - Emine Kocyigit
- Faculty of Health Sciences, Department of Nutrition and DieteticsOrdu UniversityOrduTurkey
| | | | - Tevfik Noyan
- Faculty of Medicine, Department of Medical BiochemistryOrdu UniversityOrduTurkey
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Vasconcelos C, Perry IS, Gottfried C, Riesgo R, Castro K. Folic acid and autism: updated evidences. Nutr Neurosci 2025; 28:273-307. [PMID: 38968136 DOI: 10.1080/1028415x.2024.2367855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2024]
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that impairs communication, socialization, and behavior. The association of ASD with folic acid has been investigated due to the importance of this vitamin for neurological health. This study is an update of the publication 'Folic acid and autism: What do we know?' and aims to systematically review studies examining the relationship between folic acid and ASD. The search resulted in 2,389 studies on folic acid and ASD, which were selected by two reviewers based on their titles and abstracts. Studies meeting the inclusion criteria were fully read. The 52 included studies involved 10,429 individuals diagnosed with ASD and assessed the intake of vitamin B6, folic acid, and vitamin B12; serum levels of these vitamins, homocysteine, and methionine; therapeutic interventions using folic acid; and the association between maternal exposure to this vitamin and the risk of ASD. The evidence of insufficient folic acid intake in most individuals with ASD remains consistent in this update. No association was found between maternal exposure to folic acid and the risk of ASD in their children. Despite observed improvements in communication, socialization, and behavior in individuals with ASD following folic acid interventions, it is crucial to consider the individuality and complexity of ASD. Given the relevance of the topic, there remains a need for more high-quality research and clinical trials characterized by rigorous methodological designs.
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Affiliation(s)
- Cristiane Vasconcelos
- Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Ingrid Schweigert Perry
- Food and Nutrition Research Center (CESAN), Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Carmem Gottfried
- Translational Research Group in Autism Spectrum Disorders-GETTEA, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Department of Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- National Institute of Science and Technology on Neuroimmunomodulation (INCT-NIM), Rio de Janeiro, Brazil
- Autism Wellbeing And Research Development (AWARD) Initiative, BR-UK- CA, Porto Alegre, Brazil
| | - Rudimar Riesgo
- Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Translational Research Group in Autism Spectrum Disorders-GETTEA, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Child Neurology Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Kamila Castro
- Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Food and Nutrition Research Center (CESAN), Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Translational Research Group in Autism Spectrum Disorders-GETTEA, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Child Neurology Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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de Souza Silva E, Castro K, Valle SC, dos Santos Vaz J. Dietary Assessment Methods Applied in Clinical and Epidemiological Studies in Children and Adolescents with Autism Spectrum Disorder: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2024; 11:581-594. [DOI: 10.1007/s40489-022-00353-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/26/2022] [Indexed: 01/11/2023]
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Holloway JM, Gray HL, Buro AW, Thomas J, Sauls R, Howard AM. Measurement Tools to Assess Usual Dietary Intake and Physical Activity in Individuals with Autism Spectrum Disorder: a Scoping Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2024; 11:504-524. [DOI: 10.1007/s40489-022-00349-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022]
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Gaier ED, Jaimes C, Gise RA, Armstrong-Javors AE, Kadzielski SM. Case 25-2024: A 12-Year-Old Boy with Autism and Decreased Vision. N Engl J Med 2024; 391:641-650. [PMID: 39141857 DOI: 10.1056/nejmcpc2309726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Affiliation(s)
- Eric D Gaier
- From the Departments of Ophthalmology (E.D.G., R.A.G.), Radiology (C.J.), Pediatrics (A.E.A.-J., S.M.K.), and Neurology (A.E.A.-J.), Harvard Medical School, the Department of Ophthalmology, Boston Children's Hospital (E.D.G., R.A.G.), the Department of Ophthalmology, Massachusetts Eye and Ear (E.D.G., R.A.G.), and the Departments of Radiology (C.J.), Pediatrics (A.E.A.-J., S.M.K.), and Neurology (A.E.A.-J.), Massachusetts General Hospital - all in Boston
| | - Camilo Jaimes
- From the Departments of Ophthalmology (E.D.G., R.A.G.), Radiology (C.J.), Pediatrics (A.E.A.-J., S.M.K.), and Neurology (A.E.A.-J.), Harvard Medical School, the Department of Ophthalmology, Boston Children's Hospital (E.D.G., R.A.G.), the Department of Ophthalmology, Massachusetts Eye and Ear (E.D.G., R.A.G.), and the Departments of Radiology (C.J.), Pediatrics (A.E.A.-J., S.M.K.), and Neurology (A.E.A.-J.), Massachusetts General Hospital - all in Boston
| | - Ryan A Gise
- From the Departments of Ophthalmology (E.D.G., R.A.G.), Radiology (C.J.), Pediatrics (A.E.A.-J., S.M.K.), and Neurology (A.E.A.-J.), Harvard Medical School, the Department of Ophthalmology, Boston Children's Hospital (E.D.G., R.A.G.), the Department of Ophthalmology, Massachusetts Eye and Ear (E.D.G., R.A.G.), and the Departments of Radiology (C.J.), Pediatrics (A.E.A.-J., S.M.K.), and Neurology (A.E.A.-J.), Massachusetts General Hospital - all in Boston
| | - Amy E Armstrong-Javors
- From the Departments of Ophthalmology (E.D.G., R.A.G.), Radiology (C.J.), Pediatrics (A.E.A.-J., S.M.K.), and Neurology (A.E.A.-J.), Harvard Medical School, the Department of Ophthalmology, Boston Children's Hospital (E.D.G., R.A.G.), the Department of Ophthalmology, Massachusetts Eye and Ear (E.D.G., R.A.G.), and the Departments of Radiology (C.J.), Pediatrics (A.E.A.-J., S.M.K.), and Neurology (A.E.A.-J.), Massachusetts General Hospital - all in Boston
| | - Sarah M Kadzielski
- From the Departments of Ophthalmology (E.D.G., R.A.G.), Radiology (C.J.), Pediatrics (A.E.A.-J., S.M.K.), and Neurology (A.E.A.-J.), Harvard Medical School, the Department of Ophthalmology, Boston Children's Hospital (E.D.G., R.A.G.), the Department of Ophthalmology, Massachusetts Eye and Ear (E.D.G., R.A.G.), and the Departments of Radiology (C.J.), Pediatrics (A.E.A.-J., S.M.K.), and Neurology (A.E.A.-J.), Massachusetts General Hospital - all in Boston
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Calisan Kinter R, Ozbaran B, Inal Kaleli I, Kose S, Bildik T, Ghaziuddin M. The Sensory Profiles, Eating Behaviors, and Quality of Life of Children with Autism Spectrum Disorder and Avoidant/Restrictive Food Intake Disorder. Psychiatr Q 2024; 95:85-106. [PMID: 38085408 DOI: 10.1007/s11126-023-10063-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2023] [Indexed: 02/29/2024]
Abstract
Eating disorders frequently accompany autism spectrum disorder (ASD). One such novel eating disorder is avoidant/restrictive food intake disorder (ARFID). This study compares the eating attitudes, quality of life, and sensory processing of typically developing children (TDC), autistic children, and autistic children with ARFID. A total of 111 children aged 4-10 with a diagnosis of ASD and ARFID (n = 37), ASD without ARFID (n = 37), and typical development (n = 37) were recruited. After an interview in which Childhood Autism Rating Scale (CARS) was administered, Child Eating Behavior Questionnaire (CEBQ), Pediatric Quality of Life Inventory (PedsQL), Social Responsiveness Scale (SRS) and Sensory Profile (SP) were completed by caregivers. Autistic children with ARFID had higher scores in CEBQ subscales relating to low appetite and lower scores on the subscales associated with weight gain. Both groups of autistic children scored lower than TDC on all PedsQL subscales and autistic children with ARFID had lower social QL scores than both groups. SRS scores were highest in autistic children with ARFID, followed by autistic and typically developing children. CARS scores were similar in both groups of autistic children, but higher than TDC. Auditory, vision, touch, multi-sensory, oral processing scores; as well as all quadrant scores, were significantly lower in autistic children with ARFID. Oral sensory processing scores were found to be the most significant predictor of ARFID comorbidity in ASD and reliably predicted ARFID in autistic children in the clinical setting. Autistic children with ARFID demonstrate differences in social functioning, sensory processing, eating attitudes, and quality of life compared to autistic and TD children.
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Affiliation(s)
- Reyhan Calisan Kinter
- Department of Child and Adolescent Psychiatry, Faculty of Medicine Children's Hospital, Ege University, Kazimdirik Mh. Ankara Cd, Izmir, 35030, Turkey
| | - Burcu Ozbaran
- Department of Child and Adolescent Psychiatry, Faculty of Medicine Children's Hospital, Ege University, Kazimdirik Mh. Ankara Cd, Izmir, 35030, Turkey
| | - Ipek Inal Kaleli
- Department of Child and Adolescent Psychiatry, Faculty of Medicine Children's Hospital, Ege University, Kazimdirik Mh. Ankara Cd, Izmir, 35030, Turkey.
| | - Sezen Kose
- Department of Child and Adolescent Psychiatry, Faculty of Medicine Children's Hospital, Ege University, Kazimdirik Mh. Ankara Cd, Izmir, 35030, Turkey
| | - Tezan Bildik
- Department of Child and Adolescent Psychiatry, Faculty of Medicine Children's Hospital, Ege University, Kazimdirik Mh. Ankara Cd, Izmir, 35030, Turkey
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Li H, Huang S, Jing J, Yu H, Gu T, Ou X, Pan S, Zhu Y, Su X. Dietary intake and gastrointestinal symptoms are altered in children with Autism Spectrum Disorder: the relative contribution of autism-linked traits. Nutr J 2024; 23:27. [PMID: 38419087 PMCID: PMC10900601 DOI: 10.1186/s12937-024-00930-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/23/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Dietary and gastrointestinal (GI) problems have been frequently reported in autism spectrum disorder (ASD). However, the relative contributions of autism-linked traits to dietary and GI problems in children with ASD are poorly understood. This study firstly compared the dietary intake and GI symptoms between children with ASD and typically developing children (TDC), and then quantified the relative contributions of autism-linked traits to dietary intake, and relative contributions of autism-linked traits and dietary intake to GI symptoms within the ASD group. METHODS A sample of 121 children with ASD and 121 age-matched TDC were eligible for this study. The dietary intake indicators included food groups intakes, food variety, and diet quality. The autism-linked traits included ASD symptom severity, restricted repetitive behaviors (RRBs), sensory profiles, mealtime behaviors, and their subtypes. Linear mixed-effects models and mixed-effects logistic regression models were used to estimate the relative contributions. RESULTS Children with ASD had poorer diets with fewer vegetables/fruits, less variety of food, a higher degree of inadequate/unbalanced dietary intake, and more severe constipation/total GI symptoms than age-matched TDC. Within the ASD group, compulsive behavior (a subtype of RRBs) and taste/smell sensitivity were the only traits associated with lower vegetables and fruit consumption, respectively. Self-injurious behavior (a subtype of RRBs) was the only contributing trait to less variety of food. Limited variety (a subtype of mealtime behavior problems) and ASD symptom severity were the primary and secondary contributors to inadequate dietary intake, respectively. ASD symptom severity and limited variety were the primary and secondary contributors to unbalanced dietary intake, respectively. Notably, unbalanced dietary intake was a significant independent factor associated with constipation/total GI symptoms, and autism-linked traits manifested no contributions. CONCLUSIONS ASD symptom severity and unbalanced diets were the most important contributors to unbalanced dietary intake and GI symptoms, respectively. Our findings highlight that ASD symptom severity and unbalanced diets could provide the largest benefits for the dietary and GI problems of ASD if they were targeted for early detection and optimal treatment.
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Affiliation(s)
- Hailin Li
- Research Center of Children and Adolescent Psychological and Behavioral Development, Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, P.R. China
| | - Saijun Huang
- Department of Child Healthcare, Foshan Women and Children Hospital, Foshan, Guangdong, 528000, P.R. China
| | - Jin Jing
- Research Center of Children and Adolescent Psychological and Behavioral Development, Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, P.R. China
| | - Hong Yu
- Department of Child Healthcare, Foshan Women and Children Hospital, Foshan, Guangdong, 528000, P.R. China
| | - Tingfeng Gu
- Research Center of Children and Adolescent Psychological and Behavioral Development, Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, P.R. China
| | - Xiaoxuan Ou
- Research Center of Children and Adolescent Psychological and Behavioral Development, Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, P.R. China
| | - Shuolin Pan
- Research Center of Children and Adolescent Psychological and Behavioral Development, Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, P.R. China
| | - Yanna Zhu
- Research Center of Children and Adolescent Psychological and Behavioral Development, Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, P.R. China.
- Department of Maternal and Child Health, School of Public Health, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, Guangdong, 510080, P.R. China.
| | - Xi Su
- Department of Child Healthcare, Foshan Women and Children Hospital, Foshan, Guangdong, 528000, P.R. China.
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Kim J. Autism Spectrum Disorder and Eating Problems: The Imbalance of Gut Microbiota and the Gut-Brain Axis Hypothesis. Soa Chongsonyon Chongsin Uihak 2024; 35:51-56. [PMID: 38204735 PMCID: PMC10774563 DOI: 10.5765/jkacap.230063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 01/12/2024] Open
Abstract
This review explores the complexities of autism spectrum disorder (ASD), primarily focusing on the significant eating challenges faced by children and adolescents with this neurodevelopmental condition. It is common for individuals with ASD to exhibit heightened sensitivity to various sensory aspects of food such as taste, texture, smell, and visual appeal, leading to restricted and less diverse diets. These dietary limitations are believed to contribute to an imbalance in the gut microbiota. This review elaborates on how these eating problems, coupled with the distinctive characteristics of ASD, might be influenced by and, in turn, influence the gut-brain axis, a bidirectional communication system between the gastrointestinal tract and the brain. This discussion aims to shed light on the multifaceted interactions and potential implications of diet, gut health, and neurological development and function in children and adolescents with ASD.
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Affiliation(s)
- Jiyoung Kim
- NUSEUM Inc., Seoul, Korea
- Center for Food and Bioconvergence, Seoul National
University, Seoul, Korea
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Li H, Liu C, Huang S, Wang X, Cao M, Gu T, Ou X, Pan S, Lin Z, Wang X, Zhu Y, Jing J. Multi-omics analyses demonstrate the modulating role of gut microbiota on the associations of unbalanced dietary intake with gastrointestinal symptoms in children with autism spectrum disorder. Gut Microbes 2023; 15:2281350. [PMID: 38010793 PMCID: PMC10730204 DOI: 10.1080/19490976.2023.2281350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023] Open
Abstract
Our previous work revealed that unbalanced dietary intake was an important independent factor associated with constipation and gastrointestinal (GI) symptoms in children with autism spectrum disorder (ASD). Growing evidence has shown the alterations in the gut microbiota and gut microbiota-derived metabolites in ASD. However, how the altered microbiota might affect the associations between unbalanced diets and GI symptoms in ASD remains unknown. We analyzed microbiome and metabolomics data in 90 ASD and 90 typically developing (TD) children based on 16S rRNA and untargeted metabolomics, together with dietary intake and GI symptoms assessment. We found that there existed 11 altered gut microbiota (FDR-corrected P-value <0.05) and 397 altered metabolites (P-value <0.05) in children with ASD compared with TD children. Among the 11 altered microbiota, the Turicibacter, Coprococcus 1, and Lachnospiraceae FCS020 group were positively correlated with constipation (FDR-corrected P-value <0.25). The Eggerthellaceae was positively correlated with total GI symptoms (FDR-corrected P-value <0.25). More importantly, three increased microbiota including Turicibacter, Coprococcus 1, and Eggerthellaceae positively modulated the associations of unbalanced dietary intake with constipation and total GI symptoms, and the decreased Clostridium sp. BR31 negatively modulated their associations in ASD children (P-value <0.05). Together, the altered microbiota strengthens the relationship between unbalanced dietary intake and GI symptoms. Among the altered metabolites, ten metabolites derived from microbiota (Turicibacter, Coprococcus 1, Eggerthellaceae, and Clostridium sp. BR31) were screened out, enriched in eight metabolic pathways, and were identified to correlate with constipation and total GI symptoms in ASD children (FDR-corrected P-value <0.25). These metabolomics findings further support the modulating role of gut microbiota on the associations of unbalanced dietary intake with GI symptoms. Collectively, our research provides insights into the relationship between diet, the gut microbiota, and GI symptoms in children with ASD.
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Affiliation(s)
- Hailin Li
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Churui Liu
- School of Biological Engineering, Dalian Polytechnic University, Dalian, Liaoning, China
| | - Saijun Huang
- Department of Child Healthcare, Affiliated Foshan Maternity and Child Healthcare Hospital, Southern Medical University, Foshan, Guangdong, China
| | - Xin Wang
- Key Laboratory of Brain, Cognition and Education Science, Ministry of Education, Institute for Brain Research and Rehabilitation, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, Guangdong, China
| | - Muqing Cao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Tingfeng Gu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaoxuan Ou
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Shuolin Pan
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zongyu Lin
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiaotong Wang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yanna Zhu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
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Savino R, Medoro A, Ali S, Scapagnini G, Maes M, Davinelli S. The Emerging Role of Flavonoids in Autism Spectrum Disorder: A Systematic Review. J Clin Med 2023; 12:jcm12103520. [PMID: 37240625 DOI: 10.3390/jcm12103520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/29/2023] [Accepted: 05/13/2023] [Indexed: 05/28/2023] Open
Abstract
Although autism spectrum disorder (ASD) is a multifaceted neurodevelopmental syndrome, accumulating evidence indicates that oxidative stress and inflammation are common features of ASD. Flavonoids, one of the largest and best-investigated classes of plant-derived compounds, are known to exert antioxidant, anti-inflammatory, and neuroprotective effects. This review used a systematic search process to assess the available evidence on the effect of flavonoids on ASD. A comprehensive literature search was carried out in PubMed, Scopus, and Web of Science databases following the PRISMA guidelines. A total of 17 preclinical studies and 4 clinical investigations met our inclusion criteria and were included in the final review. Most findings from animal studies suggest that treatment with flavonoids improves oxidative stress parameters, reduces inflammatory mediators, and promotes pro-neurogenic effects. These studies also showed that flavonoids ameliorate the core symptoms of ASD, such as social deficits, repetitive behavior, learning and memory impairments, and motor coordination. However, there are no randomized placebo-controlled trials that support the clinical efficacy of flavonoids in ASD. We only found open-label studies and case reports/series, using only two flavonoids such as luteolin and quercetin. These preliminary clinical studies indicate that flavonoid administration may improve specific behavioral symptoms of ASD. Overall, this review is the first one to systematically report evidence for the putative beneficial effects of flavonoids on features of ASD. These promising preliminary results may provide the rationale for future randomized controlled trials aimed at confirming these outcomes.
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Affiliation(s)
- Rosa Savino
- Department of Woman and Child, Neuropsychiatry for Child and Adolescent Unit, General Hospital "Riuniti" of Foggia, 71122 Foggia, Italy
| | - Alessandro Medoro
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100 Campobasso, Italy
| | - Sawan Ali
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100 Campobasso, Italy
| | - Giovanni Scapagnini
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100 Campobasso, Italy
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Sergio Davinelli
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100 Campobasso, Italy
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Zhao G, Liu SJ, Gan XY, Li JR, Wu XX, Liu SY, Jin YS, Zhang KR, Wu HM. Analysis of Whole Blood and Urine Trace Elements in Children with Autism Spectrum Disorders and Autistic Behaviors. Biol Trace Elem Res 2023; 201:627-635. [PMID: 35305538 PMCID: PMC9849157 DOI: 10.1007/s12011-022-03197-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/09/2022] [Indexed: 01/22/2023]
Abstract
The relationship between trace elements and neurological development is an emerging research focus. We performed a case-control study to explore (1) the differences of 13 trace elements chromium (Cr), manganese (Mn), cobalt (Co), zinc (Zn), arsenic (As), selenium (Se), molybdenum (Mo), cadmium (Cd), stannum (Sn), stibium (Sb), mercury (Hg), titanium (TI), and plumbum (Pb) concentration in whole blood and urine between autism spectrum disorder (ASD) children and their typical development peers, and (2) the association between the 13 trace elements and core behaviors of ASD. Thirty ASD subjects (cases) and 30 age-sex-matched healthy subjects from Baise City, Guangxi Zhuang Autonomous Region, China, were recruited. Element analysis was carried out by inductively coupled plasma-optical emission spectrometry. Autistic behaviors were assessed using Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Children Neuropsychological and Behavior Scale (CNBS). The whole blood concentrations of Mo (p = 0.004), Cd (0.007), Sn (p = 0.003), and Pb (p = 0.037) were significantly higher in the ASD cases than in the controls. Moreover, Se (0.393), Hg (0.408), and Mn (- 0.373) concentrations were significantly correlated between whole blood and urine levels in ASD case subjects. There were significant correlations between whole blood Sb (0.406), Tl (0.365), Mo (- 0.4237), Mn (- 0.389), Zn (0.476), and Se (0.375) levels and core behaviors of ASD. Although the mechanism of trace element imbalance in ASD is unclear, these data demonstrate that core behaviors of ASD may be affected by certain trace elements. Further studies are recommended for exploring the mechanism of element imbalance and providing corresponding clinical treatment measures.
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Affiliation(s)
- Gang Zhao
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, 030001 China
- Department of Child Health Care, Maternity and Child Healthcare Hospital of Nanshan District, 1 Wanxia Road, Nanshan District, Shenzhen, 518067 China
| | - Si-jin Liu
- Department of Nursing, Harbin Medical University in Daqing, Daqing, 163319 China
| | - Xin-yu Gan
- Department of Rehabilitation of the Heilongjiang Province Land Reclamation Headquarters General Hospital, Harbin, 150081 China
- Harbin Medical University in Daqing, Daqing, 163319 Heilongjiang China
| | - Jun-ru Li
- Department of Nursing, Harbin Medical University in Daqing, Daqing, 163319 China
| | - Xiao-xue Wu
- Department of Nursing, Harbin Medical University in Daqing, Daqing, 163319 China
| | - Si-yan Liu
- Department of Nursing, Harbin Medical University in Daqing, Daqing, 163319 China
| | - Yi-si Jin
- Department of Rehabilitation, The Fifth Affiliated Hospital of Harbin Medical University, Daqing, 163000 China
| | - Ke-rang Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, 030001 China
| | - Hong-mei Wu
- Department of Nursing, Harbin Medical University in Daqing, Daqing, 163319 China
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12
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Rodrigues JVS, Poli MCF, Petrilli PH, Dornelles RCM, Turcio KH, Theodoro LH. Food selectivity and neophobia in children with autism spectrum disorder and neurotypical development: a systematic review. Nutr Rev 2023:6986143. [PMID: 36633300 DOI: 10.1093/nutrit/nuac112] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
CONTEXT Individuals with autism spectrum disorder (ASD) have common eating problems, including food refusal, dietary restrictions, and behavioral problems during eating. OBJECTIVE The aim of this systematic review was to find more clear evidence on the relationship between food selectivity or food neophobia (FN) and ASD in children up to age 14 years. The PECO-based question was: Are food selectivity and FN behaviors more prevalent in children with ASD than in children with neurotypical development (NTD)?, in which the P is children, E is ASD, C is children with NTD, and O is food selectivity and FN. DATA SOURCES Clinical studies in the databases PubMed, Embase and Web of Science, comparing children with ASD and those with NTD, were reviewed from October 1966 to October 2021. STUDY SELECTION AND DATA EXTRACTION A total of 122 studies were analyzed for summary reading, and only 17 of these were included in the descriptive qualitative analysis. In 9 studies, the analysis of food selectivity was performed via a questionnaire. RESULTS The results showed that children with ASD are more selective than those with NTD. Four studies evaluated FN through scales; however, only 2 found higher levels of FN in the ASD group than in children with NTD. The sensory profile was measured using questionnaires in 9 studies, and we found that altered sensory processing is more common in children with ASD. CONCLUSION Children with ASD present greater food selectivity than children with NTD. However, the occurrence of FN was higher in only 50% in which FN was investigated, which points to a need for studies that compare FN between siblings with ASD and those with NTD in the same family nucleus. In addition, atypical oral sensitivity seems to be a sensory characteristic most related to eating disorders. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021247880.
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Affiliation(s)
- João Victor S Rodrigues
- Department of Diagnostic and Surgery, School of Dentistry of Araçatuba, São Paulo State University, Araçatuba, São Paulo, Brazil
| | - Maria Clara F Poli
- Department of Diagnostic and Surgery, School of Dentistry of Araçatuba, São Paulo State University, Araçatuba, São Paulo, Brazil
| | - Pedro H Petrilli
- Department of Diagnostic and Surgery, School of Dentistry of Araçatuba, São Paulo State University, Araçatuba, São Paulo, Brazil
| | - Rita Cássia M Dornelles
- Department of Basic Sciences, School of Dentistry, São Paulo State University, Araçatuba, Brazil
| | - Karina H Turcio
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University, Araçatuba, São Paulo, Brazil
| | - Leticia H Theodoro
- Department of Diagnostic and Surgery, School of Dentistry of Araçatuba, São Paulo State University, Araçatuba, São Paulo, Brazil
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Mathew NE, Mallitt KA, Masi A, Katz T, Walker AK, Morris MJ, Ooi CY. Dietary intake in children on the autism spectrum is altered and linked to differences in autistic traits and sensory processing styles. Autism Res 2022; 15:1824-1839. [PMID: 36054787 DOI: 10.1002/aur.2798] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 08/10/2022] [Indexed: 01/07/2023]
Abstract
Diets of children and adolescents on the autism spectrum often differ when compared to their non-autistic peers. Most dietary studies have been limited by small sample sizes and rarely assess the heterogeneity of autism. Addressing this gap, this study compared the anthropometrics, dietary composition, dietary quality, and food variety of 154 Australian children and adolescents on the spectrum and 213 non-autistic children (71 siblings and 142 unrelated controls). Beyond the case-control approach, within-group comparisons assessed the influence of autism clinical presentations and sensory processing styles on body mass index (BMI) and measures of dietary intake among those on the spectrum. In this word first study of diet that included between-group comparisons with non-autistic peers (siblings and an unrelated comparison group) and within-autism group comparisons, we found that children on the spectrum consumed limited variety and lower quality of food and non-autistic siblings also ate comparably higher levels of energy-dense, nutrient poor food, and less diary. This may be due to autistic traits influencing family's diets or shared sensory sensitivities driving dietary intake. Within the autism group, higher autistic traits were associated with lower BMIs and a specific dietary pattern higher in simple carbohydrates and lower in unprocessed protein. Contrastingly, greater sensitivity to sensory stimuli was associated with a healthier diet. Increased age was linked to more varied diets but also diets higher in saturated fats and energy-dense, nutrient poor foods. Overall, this research highlights that potential mediators of dietary intake, such as familial influences, autistic traits, sensory processing styles, age and sex, need to be considered when assessing diet in the autistic population. LAY SUMMARY: In this study of dietary differences linked to autism, children, and teenagers on the spectrum ate fewer different foods and were less likely to eat recommended amounts of fruits and vegetables when compared to non-autistic siblings and unrelated children and teenagers. There were also family differences, in that those on the spectrum and their siblings ate more unhealthy foods and less dairy. Among those on the spectrum, dietary differences were linked to age, sex, autistic traits and sensory processing styles.
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Affiliation(s)
- Nisha E Mathew
- Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.,Laboratory of ImmunoPsychiatry, Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Kylie-Ann Mallitt
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Anne Masi
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Tamarah Katz
- Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.,Department of Nutrition and Dietetics, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Adam K Walker
- Laboratory of ImmunoPsychiatry, Neuroscience Research Australia, Sydney, New South Wales, Australia.,Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.,Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Margaret J Morris
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Chee Y Ooi
- Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.,Department of Gastroenterology, Sydney Children's Hospital, Sydney, New South Wales, Australia
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14
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Association between Diet Quality and Health Outcomes among Children in Rural Areas of Northwest China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137803. [PMID: 35805462 PMCID: PMC9265919 DOI: 10.3390/ijerph19137803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 12/10/2022]
Abstract
This study aims to examine the relationship between diet quality and health outcomes among children in rural remote areas of China. We draw on a cross-sectional dataset of 1216 children from two counties in the Gansu Province in Northwest China. Child health outcomes were assessed with both anthropometric measurements and reports by primary caregivers of the children. Child diet quality was assessed with the diet quality score (DQS) using information from a food frequency questionnaire (FFQ). Our data show the prevalence of stunting and underweight among sample children were 12% and 11%, respectively; 27% of children were reported by their caregivers as unhealthy, and 60% of children had at least one of the seventeen selected non-communicable diseases (NCDs) over the past 14 days. Overall, 780 (72%) children have at least one of the four above-mentioned health problems. Results from logistic regression models show that a higher DQS was significantly associated with a lower likelihood of being stunted and a higher likelihood of being reported healthy after adjusting for confounders. These findings imply that improving child diet quality might be an option when designing interventions to improve child health.
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Seiverling L, Felber J, Howard M, Williams K, Hendy HM. The Lunchbox Study: A Pilot Examination of Packed Lunches of Children with Autism Spectrum Disorder. Nutrients 2022; 14:1338. [PMID: 35405951 PMCID: PMC9003332 DOI: 10.3390/nu14071338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 03/19/2022] [Accepted: 03/21/2022] [Indexed: 02/01/2023] Open
Abstract
Background: This study examined foods packed and consumed by children with autism spectrum disorder (ASD) and calculated the percentage of packed school lunches meeting National School Lunch Program (NSLP) standards. Fruit and vegetable (FV) consumption was further examined by investigating its association with the number and type of foods packed. Methods: Participants included 59 private school students observed for five school meals. Servings of foods and beverages packed and consumed and the percentages of correspondence between food packed and consumed were calculated. Next, the percentages of lunches meeting NSLP guidelines were calculated. Finally, mealtime means were calculated for the number of foods packed, FVs packed, and FVs consumed. Results: There was a high correspondence between foods packed and consumed. Fresh fruits and sugar-added drinks were most often packed and consumed. The percentage of meals meeting NSLP guidelines was higher than previous non-ASD samples. More FV consumption was associated with more FVs packed and fewer total foods packed. FV consumption was highest with 4 < 5 foods packed, including 2+ FVs. Conclusions: Future studies should compare foods packed and consumed by children with and without ASD. The FV consumption findings suggest parents may increase children’s FV consumption by packing approximately four total foods with two FVs.
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Affiliation(s)
- Laura Seiverling
- Special Education Department, Ball State University, 2000 W University Avenue, Muncie, IN 47306, USA
| | - Jennifer Felber
- The Summit Center, 150 Stahl Road, Getzville, NY 14068, USA;
| | - Monica Howard
- The ELIJA School, 11 Laurel Lane, Levittown, NY 11756, USA;
| | - Keith Williams
- Penn State Hershey Medical Center, 905 West Governor Road, Hershey, PA 17033, USA;
| | - Helen M. Hendy
- Psychology Program, Schuylkill Campus, Penn State University, 200 University Drive, Schuylkill Haven, PA 17972, USA;
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Adams SN. Feeding and Swallowing Issues in Autism Spectrum Disorders. Neuropsychiatr Dis Treat 2022; 18:2311-2321. [PMID: 36276431 PMCID: PMC9579053 DOI: 10.2147/ndt.s332523] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/05/2022] [Indexed: 11/06/2022] Open
Abstract
Children with autism spectrum disorder (ASD) often experience difficulties related to communication and behaviour. However, their feeding issues are most distressing to their families and healthcare professionals as they impact on the children's adaptive function and health. In comparison to typically developing children, those with ASD experience significantly more feeding difficulties. Children with ASD may display distinctive feeding difficulties and atypical feeding behaviours that include picky eating, limited independent feeding, need for increased feeding times, and a highly restrictive food repertoire. Many of these feeding difficulties continue into childhood, persist in adolescence, and even spill over into adulthood. This proves to be a formidable challenge, as feeding is an essential component for healthy nutrition, growth, and development. This article will highlight how particular food items that are eaten and preferred by affected children may be contributing to their exhibited feeding difficulties. Next, it will be shown how the children's restrictive diets supplant more healthy food options. When this is combined with the children's noted reduced physical activity, the consequences are especially serious, as they include not only malnutrition but also give rise to childhood obesity. In sum, it will be demonstrated that feeding difficulties in young children with ASD are not well understood nor managed. The dearth of knowledge about feeding issues in this population affects both assessment choices and, specifically, management practices - aspects that will be elaborated on in this article. Conclusions will include suggested future directions for enhancing and complementing knowledge of these issues for stakeholders.
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Affiliation(s)
- Skye Nandi Adams
- Department of Speech Pathology and Audiology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
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