Meguid Nagwa A, Anwar Mona, Bjørklund Geir, Hashish Adel, Chirumbolo Salvatore, Hemimi Maha, Sultan Eman
Department of Research on Children with Special Needs, Medical Research Division, National Research Centre, Giza, Egypt.
Council for Nutritional and Environmental Medicine, Toften 24, 8610, Mo i Rana, Norway.
Metab Brain Dis. 2017 Apr;32(2):607-615. doi: 10.1007/s11011-016-9948-1. Epub 2017 Jan 10.
Although the etiology and pathology of autism spectrum disorder (ASD) is still poorly understood, a number of environmental, anthropological, neurobiological and genetic factors have been related to the pathophysiology of ASD, even the impact of oxidative stress response related to the environment and nutrition intake. Usual recommended dietary habits are based on the combination of behavioral and dietary or nutraceutical interventions together with pharmacotherapy. Investigations about a reliable relationship between diet and ASD are still lacking. The present study aimed at comparing dietary regimens and habits of normally developing apparently healthy children, without diagnosed ASD, with a pediatric population of individuals affected by autistic disorder. Assessments of nutritional and anthropometric data, in addition to biochemical evaluation for nutrient deficiencies, were performed. A total of 80 children with autistic disorder and 80 healthy, normally developing pediatric individuals were enrolled in the study. Parents were asked to complete the standardized questionnaire regarding the different types of food and the proportion of a serving for their children. Biochemical analysis of micro- and macronutrients were also done. Plotting on the Egyptian sex-specific anthropometric growth (auximetric) chart, absolute weights as well as weight-related for age classes, were significantly higher in cases than healthy controls. No differences between groups were observed in regard to total kilocalories (kcal), carbohydrates, and fat intake. A total of 23.8% of children with autistic disorder vs. 11.3% in the healthy control group had a nutrient intake with features below the Recommended Dietary Allowance (RDA) of protein. Children with autistic disorder showed low dietary intake of some micronutrients; calcium (Ca), magnesium (Mg), iron (Fe), selenium (Se) and sodium (Na), also they had significantly high intake of potassium (K) and vitamin C compared to healthy controls. Serum Mg, Fe, Ca, folate and vitamin B12 in children with autistic disorder were significantly low compared with healthy children. Significant positive correlations between serum Mg, Fe, Ca, vitamin B12 and folate and their levels in food were present. These results confirmed that different nutritional inadequacy was observed in Egyptian children with autistic disorder. The evidence reported in the present study should recommend screening of the nutritional status of ASD children for nutrient adequacy to reduce these deficiencies by dietary means or by administering appropriate vitamin and mineral supplements. Nutritional intervention plan should be tailored to address specific needs.
尽管自闭症谱系障碍(ASD)的病因和病理仍未被充分理解,但一些环境、人类学、神经生物学和遗传因素已被认为与ASD的病理生理学有关,甚至包括与环境和营养摄入相关的氧化应激反应的影响。通常推荐的饮食习惯是基于行为、饮食或营养补充干预与药物治疗相结合。关于饮食与ASD之间可靠关系的研究仍然缺乏。本研究旨在比较未被诊断为ASD的正常发育的明显健康儿童与患有自闭症谱系障碍的儿科人群的饮食方案和习惯。除了对营养缺乏进行生化评估外,还进行了营养和人体测量数据的评估。共有80名患有自闭症谱系障碍的儿童和80名健康、正常发育的儿科个体参与了该研究。研究要求家长填写关于其孩子不同类型食物和一份食物比例的标准化问卷。还对微量和常量营养素进行了生化分析。根据埃及特定性别的人体测量生长(辅助测量)图表绘制,病例组的绝对体重以及各年龄组与体重相关的数据均显著高于健康对照组。在总千卡(kcal)、碳水化合物和脂肪摄入量方面,两组之间未观察到差异。患有自闭症谱系障碍的儿童中有23.8%的人蛋白质摄入量低于推荐膳食摄入量(RDA),而健康对照组中这一比例为11.3%。患有自闭症谱系障碍的儿童某些微量营养素的饮食摄入量较低;钙(Ca)、镁(Mg)、铁(Fe)、硒(Se)和钠(Na),与健康对照组相比,他们的钾(K)和维生素C摄入量也显著较高。与健康儿童相比,患有自闭症谱系障碍的儿童血清中的镁、铁、钙、叶酸和维生素B12含量显著较低。血清中的镁、铁、钙、维生素B12和叶酸与其在食物中的含量之间存在显著的正相关。这些结果证实,埃及患有自闭症谱系障碍的儿童存在不同程度的营养不足。本研究报告的证据应建议对ASD儿童的营养状况进行筛查,以确保营养充足,通过饮食手段或补充适当的维生素和矿物质来减少这些不足。营养干预计划应根据具体需求进行定制。