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.
Autism Res. 2022 Oct;15(10):1824-1839. doi: 10.1002/aur.2798. Epub 2022 Aug 26.
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.
自闭症谱系儿童和青少年的饮食与非自闭症同龄人相比常常存在差异。大多数饮食研究受到样本量小的限制，并且很少评估自闭症的异质性。为了弥补这一空白，本研究比较了 154 名澳大利亚自闭症谱系儿童和青少年以及 213 名非自闭症儿童（71 名兄弟姐妹和 142 名无关对照）的人体测量学、饮食成分、饮食质量和食物多样性。除了病例对照方法外，组内比较还评估了自闭症临床表型和感觉加工方式对自闭症谱系个体的体重指数（BMI）和饮食摄入量的影响。在这项首次对饮食进行的研究中，包括了与非自闭症同龄人（兄弟姐妹和无关对照组）的组间比较以及自闭症组内比较，我们发现，自闭症谱系儿童的食物种类有限，食物质量较低，而非自闭症兄弟姐妹也摄入了更多高热量、低营养的食物和较少的乳制品。这可能是因为自闭症特征影响了家庭的饮食，或者共同的感官敏感性导致了饮食摄入。在自闭症组内，较高的自闭症特征与较低的 BMI 以及一种特定的饮食模式相关，该模式中简单碳水化合物含量较高，未加工蛋白质含量较低。相比之下，对感官刺激的敏感性越高，饮食越健康。年龄增长与饮食种类更加丰富有关，但也与饱和脂肪和高热量、低营养食物的摄入量增加有关。总的来说，这项研究强调了在评估自闭症人群的饮食时，需要考虑饮食摄入的潜在中介因素，如家庭影响、自闭症特征、感觉加工方式、年龄和性别。
