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 Child Healthcare, Foshan Women and Children Hospital, Foshan, Guangdong, 528000, P.R. China.
Nutr J. 2024 Feb 28;23(1):27. doi: 10.1186/s12937-024-00930-8.
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.
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.
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.
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.
饮食和胃肠道（GI）问题在自闭症谱系障碍（ASD）中经常被报道。然而，自闭症相关特征对 ASD 儿童饮食和 GI 问题的相对贡献尚不清楚。本研究首先比较了 ASD 儿童和典型发育儿童（TDC）的饮食摄入和 GI 症状，然后量化了自闭症相关特征对饮食摄入的相对贡献，以及自闭症相关特征和饮食摄入对 ASD 组中 GI 症状的相对贡献。
本研究纳入了 121 名 ASD 儿童和 121 名年龄匹配的 TDC，研究了饮食摄入指标，包括食物组摄入量、食物多样性和饮食质量。自闭症相关特征包括 ASD 症状严重程度、受限重复行为（RRBs）、感觉特征、用餐行为及其亚型。使用线性混合效应模型和混合效应逻辑回归模型来估计相对贡献。
与年龄匹配的 TDC 相比，ASD 儿童的饮食较差，蔬菜/水果摄入量较少，食物种类较少，饮食摄入不足/不均衡程度较高，便秘/总胃肠道症状更严重。在 ASD 组中，强迫行为（RRBs 的一个亚型）和味觉/嗅觉敏感是与蔬菜和水果摄入量较低相关的唯一特征。自我伤害行为（RRBs 的一个亚型）是食物种类较少的唯一贡献特征。食物种类有限（用餐行为问题的一个亚型）和 ASD 症状严重程度是饮食摄入不足的主要和次要贡献因素，分别。ASD 症状严重程度和食物种类有限是饮食摄入不平衡的主要和次要贡献因素，分别。值得注意的是，饮食摄入不平衡是便秘/总胃肠道症状的一个重要独立因素，自闭症相关特征没有表现出任何贡献。
ASD 症状严重程度和不平衡饮食是导致饮食和 GI 症状不平衡的最重要因素。我们的研究结果强调，如果针对 ASD 的早期发现和最佳治疗，ASD 症状严重程度和不平衡饮食可以为 ASD 的饮食和 GI 问题提供最大的益处。
