Fuentes-Albero Milagros, Mafla-España Mayra Alejandra, Martínez-Raga José, Cauli Omar
Clinica Ripalda, 46001 Valencia, Spain.
Nursing Department, University of Valencia, 46010 Valencia, Spain.
Pathophysiology. 2024 Jul 28;31(3):376-387. doi: 10.3390/pathophysiology31030028.
Autism spectrum disorder (ASD) is one of the most prevalent neurodevelopmental disorders. Many patients with ASD often show behavioral problems at mealtimes, including food selectivity and atypical feeding behaviors. The Mediterranean diet (MD) has a beneficial effect on mental health for the general population across different ages. There is evidence that good adherence to the MD is effective in reducing peripheral inflammatory markers, such as the cytokine interleukin-6 (IL-6). The present study was designed to evaluate adherence to the MD in children with ASD using age- and sex-matched, typically developing individuals (TDs) as a control group and to determine whether differences in adherence to the MD are associated with salivary IL-6 and IL-6 receptor concentration.
Twenty children and adolescents with ASD (mean age 9.95 ± 0.65 years) and twenty TDs (mean age: 9.85 ± 0.59 years) participated in this study (N = 16 males and N = 4 females in each group). Participants with ASD were enrolled in a psychiatric consultation in Valencia (Spain), and TDs were recruited from two public schools in Valencia. The parents of both ASD and TD groups answered the items in a validated Mediterranean Diet Quality Index for children and adolescents (KIDMED) questionnaire on their children's adherence to the MD.
The mean adherence to MD score was significantly lower in the ASD group (9.10 ± 0.42) (range 6-12) than in the TD group (10.35 ± 0.31) (range 8-12) ( = 0.02, Mann-Whitney U test). There was no statistically significant association between adherence to the MD and age or sex in both groups, but there was a significant correlation between the total KIDMED score and body mass index (BMI) in the ASD group. Regarding the concentration of Il-6 and the Il-6 receptor in saliva samples, there were no significant differences between the two groups; however, linear regression analysis by group revealed significant associations between the adherence to MD score and the concentration of IL-6 and its receptor in saliva in the ASD group ( = 0.003, OR = 0.68, 95% CI 0.007 to -0.02; = 0.009, OR = -0.64, 95% CI -0.01 to -0.00). In contrast, no significant associations were observed between the adherence to MD score and the concentration of IL-6 and its receptor in saliva in the TD group.
Children and adolescents with ASD showed significantly lower adherence to the MD, which can contribute to nutritional deficits described in ASD, and the role of BMI composition (fat versus lean mass) needs to be further investigated in this group. The concentration of IL-6 and its receptor in saliva is associated with adherence to the MD, suggesting a possible link between IL-6 and diet in ASD. Further studies to clarify the associations between IL-6, psychiatric alterations, and diet in ASD are needed.
自闭症谱系障碍（ASD）是最常见的神经发育障碍之一。许多自闭症谱系障碍患者在进餐时常常表现出行为问题，包括食物选择性和非典型喂养行为。地中海饮食（MD）对不同年龄段的普通人群的心理健康具有有益影响。有证据表明，良好地坚持地中海饮食可有效降低外周炎症标志物，如细胞因子白细胞介素-6（IL-6）。本研究旨在以年龄和性别匹配的发育正常个体（TDs）作为对照组，评估自闭症谱系障碍儿童对地中海饮食的依从性，并确定地中海饮食依从性的差异是否与唾液IL-6和IL-6受体浓度相关。
20名自闭症谱系障碍儿童和青少年（平均年龄9.95±0.65岁）和20名发育正常个体（平均年龄：9.85±0.59岁）参与了本研究（每组16名男性和4名女性）。自闭症谱系障碍参与者在西班牙瓦伦西亚的精神科门诊就诊，发育正常个体从瓦伦西亚的两所公立学校招募。自闭症谱系障碍组和发育正常个体组的父母均回答了一份经过验证的儿童和青少年地中海饮食质量指数（KIDMED）问卷中的项目，该问卷涉及他们孩子对地中海饮食的依从性。
自闭症谱系障碍组对地中海饮食的平均依从性得分（9.10±0.42）（范围6 - 12）显著低于发育正常个体组（10.35±0.31）（范围8 - 12）（P = 0.02，曼-惠特尼U检验）。两组中，地中海饮食依从性与年龄或性别之间均无统计学上的显著关联，但自闭症谱系障碍组的KIDMED总分与体重指数（BMI）之间存在显著相关性。关于唾液样本中IL-6和IL-6受体的浓度，两组之间无显著差异；然而，按组进行的线性回归分析显示，自闭症谱系障碍组中地中海饮食依从性得分与唾液中IL-6及其受体浓度之间存在显著关联（P = 0.003，OR = 0.68，95%CI 0.007至 - 0.02；P = 0.009，OR = - 0.64，95%CI - 0.01至 - 0.00）。相比之下，发育正常个体组中地中海饮食依从性得分与唾液中IL-6及其受体浓度之间未观察到显著关联。
自闭症谱系障碍儿童和青少年对地中海饮食的依从性显著较低，这可能导致自闭症谱系障碍中所描述的营养缺乏，并且该组中BMI组成（脂肪与瘦体重）的作用需要进一步研究。唾液中IL-6及其受体的浓度与地中海饮食依从性相关，表明IL-6与自闭症谱系障碍中的饮食之间可能存在联系。需要进一步研究以阐明IL-6、精神障碍和自闭症谱系障碍饮食之间的关联。
