Maastricht University, Nutrition, Toxicology and Metabolism Research Institute (NUTRIM), Faculty of Health, Medicine and Life Sciences (FHML), Department of Human Biology,PO Box 616,6200MD,Maastricht,The Netherlands.
Nutr Res Rev. 2014 Dec;27(2):199-214. doi: 10.1017/S0954422414000110. Epub 2014 Jul 8.
Autism spectrum disorder (ASD) is characterised by deficits in the ability to socialise, communicate and use imagination, and displays of stereotypical behaviour. It is widely accepted that ASD involves a disorder in brain development. However, the real causes of the neurodevelopmental disorders associated with ASD are not clear. In this respect, it has been found that a majority of children with ASD display gastrointestinal symptoms, and an increased intestinal permeability. Moreover, large differences in microbiotic composition between ASD patients and controls have been reported. Therefore, nutrition-related factors have been hypothesised to play a causal role in the aetiology of ASD and its symptoms. Through a review of the literature, it was found that abnormalities in carbohydrate digestion and absorption could explain some of the gastrointestinal problems observed in a subset of ASD patients, although their role in the neurological and behavioural problems remains uncertain. In addition, the relationship between an improved gut health and a reduction of symptoms in some patients was evaluated. Recent trials involving gluten-free diets, casein-free diets, and pre- and probiotic, and multivitamin supplementation show contradictive but promising results. It can be concluded that nutrition and other environmental influences might trigger an unstable base of genetic predisposition, which may lead to the development of autism, at least in a subset of ASD patients. Clear directions for further research to improve diagnosis and treatment for the different subsets of the disorder are provided.
自闭症谱系障碍（ASD）的特征是社交、沟通和想象力方面的能力缺陷，以及刻板行为的表现。人们普遍认为 ASD 涉及大脑发育障碍。然而，与 ASD 相关的神经发育障碍的真正原因尚不清楚。在这方面，已经发现大多数 ASD 儿童表现出胃肠道症状和肠道通透性增加。此外，ASD 患者和对照组之间的微生物组成存在很大差异。因此，营养相关因素被假设在 ASD 及其症状的发病机制中起因果作用。通过对文献的回顾，发现碳水化合物消化和吸收的异常可以解释一部分 ASD 患者观察到的胃肠道问题，尽管它们在神经和行为问题中的作用仍不确定。此外，还评估了改善肠道健康与某些患者症状减轻之间的关系。最近的一些涉及无麸质饮食、无酪蛋白饮食、益生菌和多种维生素补充剂的试验显示出相互矛盾但有希望的结果。可以得出结论，营养和其他环境影响可能引发不稳定的遗传易感性基础，这可能导致自闭症的发展，至少在一部分 ASD 患者中如此。为改善该疾病不同亚组的诊断和治疗提供了明确的进一步研究方向。
