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Blaess M, Eliot K. A Framework for RDN and SLP Collaboration: A Missing Piece in Autism Spectrum Disorder Treatment. J Acad Nutr Diet 2024; 124:939-946. [PMID: 38615995 DOI: 10.1016/j.jand.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/08/2024] [Accepted: 04/08/2024] [Indexed: 04/16/2024]
Affiliation(s)
- Martha Blaess
- Department of Nutrition and Dietetics, Department of Speech, Language, and Hearing Sciences, Saint Louis University, Saint Louis, MO.
| | - Kathrin Eliot
- Department of Nutritional Sciences, The University of Oklahoma Health Sciences, Oklahoma City, OK
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2
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Breda C, Santero S, Conti MV, Cena H. Programmes to manage food selectivity in individuals with autism spectrum disorder. Nutr Res Rev 2024:1-14. [PMID: 38385245 DOI: 10.1017/s0954422424000052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Autism spectrum disorder (ASD) is a complex group of neurodevelopmental disorders characterised by impaired social communication and restricted interests/repetitive behaviours. In this regard, sensory processing difficulties and delayed oral motor skills often predispose individuals with ASD to food selectivity (FS). It is usually associated with repetitive eating patterns that can lead to multiple malnutrition conditions. The objective of this narrative review is to present an overview about the existing nutritional interventions aiming at promoting a healthy eating pattern and addressing food selectivity among individuals with ASD. Regarding the interventions targeting nutrition education, the majority of the analysed studies failed to demonstrate their effectiveness. On the other hand, many educational interventions involving taste or cooking sessions, as well as behavioural interventions for FS, demonstrated effective results. Moreover, multidisciplinary in tailoring such programmes, including psychology speech therapy and nutritional skills, is acknowledged as a key approach.
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Affiliation(s)
- Chiara Breda
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Bassi 21, Pavia, Italy
| | - Sara Santero
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Bassi 21, Pavia, Italy
| | - Maria Vittoria Conti
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Bassi 21, Pavia, Italy
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Bassi 21, Pavia, Italy
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy
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3
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Kim J. Autism Spectrum Disorder and Eating Problems: The Imbalance of Gut Microbiota and the Gut-Brain Axis Hypothesis. Soa Chongsonyon Chongsin Uihak 2024; 35:51-56. [PMID: 38204735 PMCID: PMC10774563 DOI: 10.5765/jkacap.230063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 01/12/2024] Open
Abstract
This review explores the complexities of autism spectrum disorder (ASD), primarily focusing on the significant eating challenges faced by children and adolescents with this neurodevelopmental condition. It is common for individuals with ASD to exhibit heightened sensitivity to various sensory aspects of food such as taste, texture, smell, and visual appeal, leading to restricted and less diverse diets. These dietary limitations are believed to contribute to an imbalance in the gut microbiota. This review elaborates on how these eating problems, coupled with the distinctive characteristics of ASD, might be influenced by and, in turn, influence the gut-brain axis, a bidirectional communication system between the gastrointestinal tract and the brain. This discussion aims to shed light on the multifaceted interactions and potential implications of diet, gut health, and neurological development and function in children and adolescents with ASD.
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Affiliation(s)
- Jiyoung Kim
- NUSEUM Inc., Seoul, Korea
- Center for Food and Bioconvergence, Seoul National University, Seoul, Korea
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4
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Thorsteinsdottir S, Olafsdottir AS, Traustadottir OU, Njardvik U. Changes in Anxiety following Taste Education Intervention: Fussy Eating Children with and without Neurodevelopmental Disorders. Nutrients 2023; 15:4783. [PMID: 38004177 PMCID: PMC10675003 DOI: 10.3390/nu15224783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/10/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
Despite the surge in studies on fussy eating in recent years, anxiety as an associated factor is generally not considered, even though children with fussy eating and those with neurodevelopmental disorders, including Autism Spectrum Disorder or Attention Deficit/Hyperactivity Disorder (ADHD) often have higher levels of anxiety than typically developing children. The current study investigated changes in anxiety scores during a Taste Education intervention, a seven-week school-based intervention for 71 children with fussy eating. Comparisons were made based on neurodevelopmental status (between children with (n = 30) and without (n = 41) neurodevelopmental disorders). Participants were paired based on age, sex, and neurodevelopmental disorder. The Multidimensional Anxiety Scale for Children (MASC) was administered at delayed intervention (for those waiting 7 weeks before starting the intervention), pre-intervention, post-intervention, and at six-month follow-up. Results did not indicate elevated anxiety based on mean MASC T-scores. MASC Total T-scores ranged from slightly elevated to average, decreasing significantly between pre-intervention and post-intervention, plateauing at six-month follow-up. Significant reductions between measurement points were seen for the physical symptoms, social anxiety, and separation anxiety subscales, but not for harm avoidance. Repeated measures analysis of variance with neurodevelopmental disorders as between-subjects factors did not reveal a significant interaction effect between neurodevelopmental disorders and changes in MASC Total score or subscales. The results indicated that our food-based intervention did not elevate MASC scores in fussy eating children, with or without neurodevelopmental disorders.
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Affiliation(s)
- Sigrun Thorsteinsdottir
- Faculty of Health Promotion, Sport and Leisure Studies, School of Education, University of Iceland, Stakkahlid, 105 Reykjavik, Iceland;
| | - Anna S. Olafsdottir
- Faculty of Health Promotion, Sport and Leisure Studies, School of Education, University of Iceland, Stakkahlid, 105 Reykjavik, Iceland;
| | - Olof U. Traustadottir
- Faculty of Psychology, School of Health Sciences, University of Iceland, Saemundargata 12, 102 Reykjavik, Iceland; (O.U.T.); (U.N.)
| | - Urdur Njardvik
- Faculty of Psychology, School of Health Sciences, University of Iceland, Saemundargata 12, 102 Reykjavik, Iceland; (O.U.T.); (U.N.)
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5
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Schröder SS, Danner UN, Spek AA, van Elburg AA. Exploring the intersection of autism spectrum disorder and eating disorders: understanding the unique challenges and treatment considerations for autistic women with eating disorders. Curr Opin Psychiatry 2023; 36:419-426. [PMID: 37781983 DOI: 10.1097/yco.0000000000000894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
PURPOSE OF REVIEW Autistic women struggle with high levels of both autistic eating behaviours and disordered eating behaviours , which might make them particularly vulnerable to develop eating disorders. Research investigating the presence and characteristics of eating disorders in autistic women is however limited, as is research examining the role of autism in the treatment and recovery of an eating disorder in autistic women. RECENT FINDINGS The link between autism and eating disorders has mainly been investigated from the field of eating disorder research, with studies finding an overrepresentation of autism or autistic traits in eating disorders populations. Findings also suggest that autism or autistic traits are associated with a more serious presentation of the eating disorders, including a higher chance of a chronic course of the eating disorders. Most studies however lack comprehensive autism assessments, making it difficult to determine the actual prevalence of autism and its role in women with eating disorders. SUMMARY Autistic women with an eating disorder seem to suffer from more complex eating disorders and seem to not benefit from current treatment modalities. This could be partly related to specific autism characteristics such as sensory sensitivities, which are not being considered by current treatment protocols. Future research needs to shed light on what underlies the eating behaviours of autistic women with an eating disorder, in order to help to adapt current treatment modalities to meet the unique needs of these women.
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Affiliation(s)
- Sabrina S Schröder
- Altrecht Eating Disorders Rintveld, Zeist
- Department of Clinical Psychology, Utrecht University, Utrecht
| | - Unna N Danner
- Altrecht Eating Disorders Rintveld, Zeist
- Department of Clinical Psychology, Utrecht University, Utrecht
| | - Annelies A Spek
- Autism Expert Center, Goyergracht Zuid 39, Eemnes, The Netherlands
| | - Annemarie A van Elburg
- Altrecht Eating Disorders Rintveld, Zeist
- Department of Clinical Psychology, Utrecht University, Utrecht
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Pickard K, Burrell TL, Brasher S, Buckley D, Gillespie S, Sharp W, Scahill L. Examining adaptations necessary to support the implementation of a parent-mediated intervention for children with autism spectrum disorder and moderate feeding problems. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:2434-2445. [PMID: 37062908 DOI: 10.1177/13623613231166181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
LAY ABSTRACT Moderate feeding problems and disruptive mealtime behaviors are common in children with autism spectrum disorder. Although parent-mediated interventions are able to support feeding problems in autistic children, most research has occurred within specialty clinics when delivered by highly trained clinicians. Thus, the fit of these interventions within community settings is not clear. To address this limitation, this study explored adaptations to a parent-mediated intervention, Managing Eating Aversions and Limited Variety (i.e. MEAL Plan), to improve its fit and use within community settings. Participants were 14 multidisciplinary providers who attended one of the three intensive workgroups that included focus groups about the fit of MEAL Plan in their practice setting. Qualitative analysis was used to determine the main themes that came up within the focus groups. Specific themes included the appropriateness MEAL Plan for autistic and non-autistic children, how providers might adapt their delivery of MEAL Plan, billing and insurance considerations, administrator support for MEAL Plan, and the content and format of ongoing training and consultation. By proactively considering and responding to these factors, it may be possible to enhance MEAL Plan so that it is better able to be delivered and sustained within community practices that support autistic children.
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Affiliation(s)
| | - T Lindsey Burrell
- Atlanta Children's Center, Emory University, USA
- Children's Healthcare of Atlanta, USA
| | | | | | | | - William Sharp
- Emory University, USA
- Children's Healthcare of Atlanta, USA
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Panerai S, Catania V, Ingoglia S, Ruccella D, Ferri R, Zingale M, Fasciana D, Elia M. Eating and Sensory Features of Children With Autism Spectrum Disorder and Their Typically Developing Peers. Am J Occup Ther 2023; 77:7706205040. [PMID: 38018651 DOI: 10.5014/ajot.2023.050226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023] Open
Abstract
IMPORTANCE Impaired sensory processing is associated with eating problems. There seem to be no previous studies that compare those who have autism spectrum disorder (ASD) with eating problems (ASD-W) and those with ASD without eating problems (ASD-WO) with typically developing (TD) groups. Comparisons are expected to provide further knowledge to guide the intervention programs. OBJECTIVE To investigate differences among ASD-W, ASD-WO, and TD groups in eating and sensory features; to detect associations between sensory and eating behaviors and any most involved sensory dimensions; and to search for age-related differences in sensory and eating features in ASD. DESIGN Nonrandomized comparison study. SETTING Questionnaires administered as parent interviews. PARTICIPANTS A total of 165 children were recruited: 117 with ASD and 48 TD children. OUTCOMES AND MEASURES Standardized questionnaires: the Brief Autism Mealtime Behaviors Inventory for eating problems; the Short Sensory Profile and the Sensory Experience Questionnaire for sensory problems. RESULTS The ASD-W group showed generalized, impaired eating behaviors and turned out to be the most impaired with regard to sensory responsiveness. No differences in feeding behaviors were found between the ASD-WO and TD groups. All children with ASD showed sensory hyper- or hyporesponsiveness. Four main sensory dimensions were found to be associated with eating behaviors in ASD. No age differences were found in the eating and sensory behaviors of children with ASD. CONCLUSIONS AND RELEVANCE Differing eating and sensory profiles were found between the ASD and TD groups, especially in children with ASD-W. Early eating interventions using sensory stimulations are strongly recommended. What This Article Adds: This study reports novel information derived from the comparisons of children with ASD with eating problems and those with ASD without eating problems with typically developing groups of children.
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Affiliation(s)
- Simonetta Panerai
- Simonetta Panerai, PsyD, is Head Psychologist, Unit of Psychology, Department of Brain Aging, Oasi Research Institute, IRCCS, Troina, Italy;
| | - Valentina Catania
- Valentina Catania, PsyD, is Psychologist, Unit of Psychology, Department of Brain Aging, Oasi Research Institute, IRCCS, Troina, Italy
| | - Sonia Ingoglia
- Sonia Ingoglia, PsyD, is Full Professor, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Daniela Ruccella
- Daniela Ruccella, PsyD, is Psychologist, Psychoeducational Service for Children with Autism and Intellectual Disability, Società Cooperativa Sociale "I Corrieri dell'Oasi," Troina, Italy
| | - Raffaele Ferri
- Raffaele Ferri, MD, is Scientific Director, Oasi Research Institute, IRCCS, Troina, Italy
| | - Marinella Zingale
- Marinella Zingale, PsyD, is Psychologist, Unit of Psychology, Department of Mental Retardation, Oasi Research Institute, IRCCS, Troina, Italy
| | - Daniela Fasciana
- Daniela Fasciana, PsyD, is Coordinator Psychologist, Center for Diagnosis and Early Intensive Treatment of Autism Spectrum Disorder, Local Health Authority, Caltanissetta, Italy
| | - Maurizio Elia
- Maurizio Elia, MD, is Director, Unit of Neurology and Neurophysiology, Oasi Research Institute, IRCCS, Troina, Italy
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Kuschner ES, Sivathasan S, McQueen E, Berry RC, Pulver SL, Sharp WG, Klaiman C. Screening for Caregiver-Reported Feeding Concerns in Children with Autism Spectrum Disorder in a Tertiary-Care Clinic. J Dev Behav Pediatr 2023; 44:e559-e565. [PMID: 37590189 DOI: 10.1097/dbp.0000000000001208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 06/12/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVE Feeding concerns, primarily food selectivity, are commonly observed in children with autism spectrum disorder (ASD). Prevalence rates suggest that at least half of autistic youth have feeding difficulties. METHODS A retrospective chart review examining records of a large cohort of autistic children (N = 746) referred for ASD evaluation was conducted. Families completed a survey regarding feeding concerns in their children before a diagnostic evaluation. RESULTS Post hoc analyses based on retrospective chart review revealed approximately 30% of caregivers reported significant difficulty feeding their child. Young age, food selectivity, and concerns about weight were associated with increased likelihood of reported feeding difficulties. There was clear overlap between overall feeding difficulties and specific food selectivity; however, 1 in 5 children whose caregivers did not report feeding difficulties endorsed food selectivity. CONCLUSION Findings highlight the need for multipronged approaches to screening to facilitate service prioritization by pediatric providers.
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Affiliation(s)
- Emily S Kuschner
- Children's Hospital of Philadelphia, Philadelphia, PA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Shalini Sivathasan
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Emma McQueen
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - Rashelle C Berry
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA
| | - Stormi L Pulver
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - William G Sharp
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
| | - Cheryl Klaiman
- Marcus Autism Center, Children's Healthcare of Atlanta, Atlanta, GA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA
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9
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Conti MV, Breda C, Basilico S, Luzzi A, Voto L, Santero S, De Filippo G, Cena H. Dietary recommendations to customize canteen menus according to the nutritional and sensory needs of individuals with autism spectrum disorder. Eat Weight Disord 2023; 28:66. [PMID: 37526770 PMCID: PMC10393838 DOI: 10.1007/s40519-023-01590-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/13/2023] [Indexed: 08/02/2023] Open
Abstract
Individuals with autism spectrum disorders (ASD) are often characterized by food-selectivity, food-neophobia and a marked preference for mild flavor, semi-liquid foods with pale colors. Therefore, they adopt a monotonous dietary pattern, and they prefer ultra-processed food, leading to a high risk of developing malnutrition. In Italy, where 75,072 individuals are diagnosed with ASD, center-based services play a crucial role in their daily management. Despite the centrality of nutrition in maintaining a good state of health, even more for vulnerable subjects, no validated protocol at collective catering level has been developed yet. The manuscript presents customized dietary recommendations aimed at managing the meals for individuals with ASD at collective catering service, derived from a non-systematic literature review exploring food behaviors and nutritional needs in individuals with ASD. Simple practical tips for mealtimes, such as eating together, proper seating, lighting, smell control, presenting food in a simple manner and using the same type of tableware at each meal, to meet the needs of individuals with ASD, were described. The proposal could represent a starting point in developing official guidelines aimed at ASD individuals, in collective catering service.Level of Evidence: Level V.
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Affiliation(s)
- Maria Vittoria Conti
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Bassi 21, 27100, Pavia, Italy.
| | - Chiara Breda
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Bassi 21, 27100, Pavia, Italy
| | - Sara Basilico
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Bassi 21, 27100, Pavia, Italy
| | - Alessia Luzzi
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, 27100, Pavia, Italy
- Post Graduate Course in Food Science and Human Nutrition, Università Statale di Milano, 20122, Milan, Italy
| | - Luana Voto
- Department of Translational Medical Science, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- ImmunoNutritionLab at the CEINGE-Biotecnologie Avanzate s.c.ar.l Research Center, University of Naples Federico II, 80131, Naples, Italy
| | - Sara Santero
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Bassi 21, 27100, Pavia, Italy
| | - Giorgia De Filippo
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Bassi 21, 27100, Pavia, Italy
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Bassi 21, 27100, Pavia, Italy
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, 27100, Pavia, Italy
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10
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Reasons for Adding Different Tastes: An Example of Sprinkling Salt on Watermelon and Its Relation to Subjective Taste Perception, Taste Preference, and Autistic Traits. J FOOD QUALITY 2023. [DOI: 10.1155/2023/9945339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
Each basic taste can be perceived differently due to stored knowledge and differences in receptor properties. Depending on how these tastes are perceived, eating behavior may change. In this study, we examined the relationships between subjective feelings of taste perception, taste preferences, and autistic traits with the behavior of adding flavor to food using an example of sprinkling salt on watermelon. From an online questionnaire survey among a general Japanese population, we found that salty and sour tastes could be subjectively perceived more quickly than sweet and umami tastes, in line with our expectations. Moreover, the hedonic responses to watermelon with salt were negatively correlated with a preference for bitter taste, i.e., those participants who dislike bitter taste sensations tended to enjoy watermelon with salt more. There was no correlation between the hedonic response to watermelon with salt and the subjective feeling of taste perceptions and autistic traits and no correlation between autistic traits, and the subjective feeling of taste perceptions and taste preferences. These results suggest that adding different tastes could be influenced by taste preferences; thus, the addition of a different taste was thought to be related to an unconscious motivation to reduce bitterness.
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11
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Tsujiguchi H, Hara A, Miyagi S, Pham KO, Suzuki K, Nguyen TTT, Ono Y, Kambayashi Y, Shimizu Y, Nakamura H, Suzuki F, Shibata A, Hayashi K, Tsuboi H, Nakamura H. Prospective relationship between autistic traits and nutrient intakes among Japanese children: Results of the Shika study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:389-401. [PMID: 35652325 DOI: 10.1177/13623613221097487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT It is known about food selectivity among children with autism spectrum disorder. However, the nutritional inadequacy among children with ASD is not clear. Especially, long-term evaluation has not been studied. We examined the prospective relationship between autistic traits in children and subsequent nutrient intake in later childhood. We utilized data obtained at two time points from a study conducted in Japan. Participants were 759 Japanese children aged between 7 and 12 years at baseline and between 10 and 15 years in the follow-up. The results showed relatively lower intakes of sodium, calcium, magnesium, iron, vitamin D, vitamin B2, and vitamin B12 among children with than without autistic traits. Relatively lower intake of minerals and vitamins in children with autistic traits is more evident in later childhood. The results suggest the importance of screening the nutrient intake of children with autistic traits across childhood.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Koichi Hayashi
- Kanazawa University, Japan.,Mukogawa Women's University, Japan
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12
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Trinh NB, Phan NDT, Bui AT, Phan HT, Nguyen LTT, Nguyen LHT, Do KN, Dang AK. Nutritional status and eating behavior of children with autism spectrum disorders in Vietnam: A case-control study. Nutr Health 2023:2601060231152278. [PMID: 36706790 DOI: 10.1177/02601060231152278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background: Atypical eating behaviors and feeding issues are common in children with autism spectrum disorder (ASD). Aim: This study aims to evaluate the nutritional status and eating behavior of the ASD and typically developing groups. Methods: A case-control study was conducted from January to April 2019 in Nghe An, Vietnam. A total of 93 children in each group participated in the study with their main caregivers. We applied the Children's Eating Behavior Inventory (CEBI) to evaluate the eating behaviors of children. Results: Overweight and obesity in ASD children accounted for 41.9%. The CEBI score and %CEBI of the ASD group was higher than that of the control group (104.0 ± 14.2 and 91.3 ± 8.3; 24.1 ± 21.4 and 5.0 ± 11.8, respectively). Most of the adverse mealtime behaviors of ASD children focused on excessive duration (52.7%), distraction (40.9%), and food refusal (39.8%). In total 88.2% of caregivers had to comfort their ASD children at every meal, followed by threatening, scolding, or punishing children if they refused to eat (57.0%). Conclusion: Being overweight/obese and having eating behavior difficulties were prevalent among ASD children in Vietnam. Safer alternatives, such as lifestyle measures and seeking help from a nutritional therapist, can help ASD children reduce weight and modify their erroneous feeding habits.
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Affiliation(s)
- Ngoc Bao Trinh
- School of Preventive Medicine and Public Health, 106156Hanoi Medical University, Hanoi, Vietnam
| | | | - An Tuong Bui
- School of Preventive Medicine and Public Health, 106156Hanoi Medical University, Hanoi, Vietnam
| | - Hai Thanh Phan
- School of Preventive Medicine and Public Health, 106156Hanoi Medical University, Hanoi, Vietnam
| | - Lieu Thu Thi Nguyen
- School of Preventive Medicine and Public Health, 106156Hanoi Medical University, Hanoi, Vietnam
| | - Lan Huong Thi Nguyen
- School of Preventive Medicine and Public Health, 106156Hanoi Medical University, Hanoi, Vietnam
| | - Khanh Nam Do
- School of Preventive Medicine and Public Health, 106156Hanoi Medical University, Hanoi, Vietnam
| | - Anh Kim Dang
- School of Preventive Medicine and Public Health, 106156Hanoi Medical University, Hanoi, Vietnam
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13
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Harris HA, Derks IPM, Prinzie P, Louwerse A, Hillegers MHJ, Jansen PW. Interrelated development of autism spectrum disorder symptoms and eating problems in childhood: a population-based cohort. Front Pediatr 2023; 11:1062012. [PMID: 37205222 PMCID: PMC10185905 DOI: 10.3389/fped.2023.1062012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 04/11/2023] [Indexed: 05/21/2023] Open
Abstract
Eating problems, such as food selectivity or picky eating, are thought to be an epiphenomenon of autism spectrum disorders (ASD). Yet eating problems are also common in the general pediatric population and overlap with ASD symptoms. However, the temporal association between ASD symptoms and eating problems is poorly understood. This study examines the bidirectional association between ASD symptoms and eating problems across child development, and investigates whether these associations differ by child sex. Participants (N = 4,930) were from the population-based Generation R Study. Parents reported their child's ASD symptoms and eating problems using the Child Behavior Checklist at 5 assessments from toddlerhood to adolescence (1.5 to 14 years, 50% girls). A Random Intercept Cross-Lagged Panel Model was used to examine the lagged associations between ASD symptoms and eating problems at the within-person level, controlling for stable, trait-like differences at the between-person level. At the between-person level, there was a strong correlation between ASD symptoms and eating problems (β = .48, 95% CI: 0.38 to 0.57). Controlling for these between-person effects, there was limited evidence for consistent, predictive effects of ASD symptoms and eating problems at the within-person level. Associations did not differ by child sex. Findings suggest that ASD symptoms and eating problems may represent a cluster of traits that are highly stable from early childhood to adolescence, which have a minimal reciprocal effect at the individual-level. Future research could focus on these trait-like qualities to inform the development of supportive, family-focused interventions.
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Affiliation(s)
- Holly A. Harris
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
- Generation R Study, Erasmus MC, University Medical Center, Rotterdam, Netherlands
- Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
- Correspondence: Holly A. Harris
| | - Ivonne P. M. Derks
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
- Generation R Study, Erasmus MC, University Medical Center, Rotterdam, Netherlands
- Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Peter Prinzie
- Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Anneke Louwerse
- Sophia Children's Hospital, Department of General Pediatrics, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Manon H. J. Hillegers
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Pauline W. Jansen
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
- Generation R Study, Erasmus MC, University Medical Center, Rotterdam, Netherlands
- Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, Netherlands
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14
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de Almeida PC, Zandonadi RP, Nakano EY, Vasconcelos IAL, Botelho RBA. Food Neophobia in Children with Autistic Spectrum Disorder (ASD): A Nationwide Study in Brazil. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121907. [PMID: 36553350 PMCID: PMC9776952 DOI: 10.3390/children9121907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
Food neophobia (FN) is common among children with autistic spectrum disorder (ASD), potentially impairing their health and diet quality. This study aimed to investigate and classify the prevalence of FN among 4-to-11-year-old Brazilian children with ASD. This descriptive cross-sectional study was performed by applying online a validated instrument to identify FN in Brazilian children with ASD through their caregivers' responses for a national prevalence of FN in this group. The final sample included 593 children with ASD, 80.1% of boys, with a mean age of 6.72 ± 2.31 years, and 83% having only ASD. Almost 75% (n = 436) of the children with ASD had high food neophobia scores. The fruit neophobia domain had the lowest prevalence of high neophobia (63.7%). No significant difference in FN (total, fruit, and vegetable domains) was found, considering gender and age. There was no statistical difference in FN (all domains) by the number of residents in the same household, income, or the caregivers' educational level. FN did not decrease in older children with ASD. FN is a more complex problem, requiring a multidisciplinary trained team to face the problem.
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Affiliation(s)
- Priscila Claudino de Almeida
- Graduate Program in Human Nutrition, University of Brasília, Brasília 70910-900, Brazil
- Correspondence: ; Tel.: +55-61-98220-2078
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15
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Mathew NE, Mallitt KA, Masi A, Katz T, Walker AK, Morris MJ, Ooi CY. Dietary intake in children on the autism spectrum is altered and linked to differences in autistic traits and sensory processing styles. Autism Res 2022; 15:1824-1839. [PMID: 36054787 DOI: 10.1002/aur.2798] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 08/10/2022] [Indexed: 01/07/2023]
Abstract
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.
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Affiliation(s)
- Nisha E Mathew
- 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
| | - Kylie-Ann Mallitt
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Anne Masi
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Tamarah Katz
- Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.,Department of Nutrition and Dietetics, Sydney Children's Hospital, Sydney, New South Wales, Australia
| | - Adam K Walker
- Laboratory of ImmunoPsychiatry, Neuroscience Research Australia, Sydney, New South Wales, Australia.,Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.,Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Margaret J Morris
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Chee Y Ooi
- Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.,Department of Gastroenterology, Sydney Children's Hospital, Sydney, New South Wales, Australia
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16
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Ahumada D, Guzmán B, Rebolledo S, Opazo K, Marileo L, Parra-Soto S, Viscardi S. Eating Patterns in Children with Autism Spectrum Disorder. Healthcare (Basel) 2022; 10:healthcare10101829. [PMID: 36292276 PMCID: PMC9601475 DOI: 10.3390/healthcare10101829] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/13/2022] [Accepted: 09/19/2022] [Indexed: 12/04/2022] Open
Abstract
The purpose of this research was to analyze the eating patterns of preschool- and school-aged children with ASD, as provided by their families, in the La Araucanía Region of Chile. It involved a cross-sectional study with 72 families with children diagnosed with ASD aged between 2 and 12 years old. Food selectivity, appetite, body mass index (BMI) and frequency of food consumption were studied. The research determined that 97.67% present food selectivity, corresponding to alterations in the frequency of consumption of specific food groups. Moreover, 93.06%, 90.28%, 80.56% and 62.50% of children in the study do not meet the daily recommendations for fruit, fish, water and vegetable consumption, respectively. Therefore, it is important for these findings to be considered when designing and carrying out educational interventions regarding food in families with children with ASD for greater assertiveness and effectiveness in improving health.
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Affiliation(s)
- Danay Ahumada
- Carrera de Nutrición y Dietética, Departamento de Procesos Diagnóstico y Evaluación, Facultad de Ciencias de la Salud, Campus San Francisco, Universidad Católica de Temuco, Temuco 4813302, Chile
- Programa de Magister en Epidemiología Clínica, Facultad de Medicina, Universidad de la Frontera, Temuco 4813115, Chile
| | - Barbara Guzmán
- Carrera de Nutrición y Dietética, Departamento de Procesos Diagnóstico y Evaluación, Facultad de Ciencias de la Salud, Campus San Francisco, Universidad Católica de Temuco, Temuco 4813302, Chile
| | - Soledad Rebolledo
- Carrera de Nutrición y Dietética, Departamento de Procesos Diagnóstico y Evaluación, Facultad de Ciencias de la Salud, Campus San Francisco, Universidad Católica de Temuco, Temuco 4813302, Chile
| | - Karol Opazo
- Carrera de Nutrición y Dietética, Departamento de Procesos Diagnóstico y Evaluación, Facultad de Ciencias de la Salud, Campus San Francisco, Universidad Católica de Temuco, Temuco 4813302, Chile
| | - Luis Marileo
- Programa de Doctorado en Ciencias Agropecuarias, Facultad de Recursos Naturales, Universidad Católica de Temuco, Temuco 4813302, Chile
- Biotechnology of Functional Foods Laboratory, Camino Sanquilco, Padre Las Casas 4850827, Chile
| | - Solange Parra-Soto
- School of Health & Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK
- School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow G12 8TA, UK
- Departamento de Nutrición y Salud Publica, Universidad del Bio-Bio, Chillan 3780000, Chile
| | - Sharon Viscardi
- Biotechnology of Functional Foods Laboratory, Camino Sanquilco, Padre Las Casas 4850827, Chile
- Laboratorio de Investigación en Salud de Precisión, Departamento de Procesos Diagnóstico y Evaluación, Facultad de Ciencias de la Salud, Campus San Francisco, Universidad Católica de Temuco, Temuco 4813302, Chile
- Núcleo de Investigación en Producción Alimentaria, Universidad Católica de Temuco, Temuco 4813302, Chile
- Correspondence:
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17
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Wang X, Song X, Jin Y, Zhan X, Cao M, Guo X, Liu S, Ou X, Gu T, Jing J, Cai L, Li X. Association between dietary quality and executive functions in school-aged children with autism spectrum disorder. Front Nutr 2022; 9:940246. [PMID: 35990364 PMCID: PMC9386179 DOI: 10.3389/fnut.2022.940246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/18/2022] [Indexed: 11/15/2022] Open
Abstract
Background It is well known that children with autism spectrum disorder (ASD) had executive functions deficit. However, it is still unclear whether the poor dietary quality is related to the impairment of executive functions. The current study aimed to explore the association between dietary quality and executive functions in children with ASD. Methods A total of 106 children with ASD (7.7 ± 1.3 years) and 207 typically developing (TD) children (7.8 ± 1.3 years) were enrolled from Guangzhou, China. The Chinese version of Behavior Rating Scale of Executive function (BRIEF), the working memory subscales of the Chinese version of Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV), and the Stroop Color-Word Test (SCWT) were used to measure the participant's executive functions. The food frequency questionnaire (FFQ) was used to collect the dietary intake information, and the Chinese Diet Balance Index (DBI_16) was used to evaluate the dietary quality. Generalized linear models were used to estimate the association between dietary quality and executive functions. Results In children with ASD, Low Bound Score (LBS) was positively correlated with the working memory subscale score of BRIEF (β = 0.23, 95% CI: 0.02–0.44, P < 0.05), while High Bound Score (HBS) and LBS were positively correlated with the organizable subscale score of BRIEF (β = 0.44, 95% CI: 0.11–0.77, P < 0.01; β = 0.19, 95% CI: 0.01–0.37, P < 0.05). Compared to TD children, children with ASD had a higher proportion of moderate and high levels of insufficient dietary intake (moderate level, 37.7% vs. 23.2%, high level, 4.7% vs. 1.4%) and moderate level of unbalanced dietary intake (36.8% vs.21.3%), higher scores on all subscales of BRIEF (P < 0.01), and lower score on the working memory (81.3 ± 32.3 vs. 104.6 ± 12.5, P < 0.01), while there was no difference on the SCWT. Conclusion Poor dietary quality was associated with the impairment of working memory and organizational capacity in children with ASD. This study emphasized the importance of dietary quality in executive functions among children with ASD, and attention should be paid to improving their dietary quality.
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Affiliation(s)
- Xin Wang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Xiaojing Song
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Yuying Jin
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Xiaoling Zhan
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Muqing Cao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Xuning Guo
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Siyu Liu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Xiaoxuan Ou
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Tingfeng Gu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Xiuhong Li
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
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18
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Zhang R, Birgegård A, Fundín B, Landén M, Thornton LM, Bulik CM, Dinkler L. Association of autism diagnosis and polygenic scores with eating disorder severity. EUROPEAN EATING DISORDERS REVIEW 2022; 30:442-458. [PMID: 35855524 PMCID: PMC9544642 DOI: 10.1002/erv.2941] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/28/2022] [Accepted: 07/02/2022] [Indexed: 12/18/2022]
Abstract
Among individuals with eating disorders (ED), those with co‐occurring autism are often considered to have more severe presentations and poorer prognosis. However, previous findings have been contradictory and limited by small sample size and/or cross‐sectional assessment of autistic traits. We examine the hypothesis that autism diagnosis and autism polygenic score (PGS) are associated with increased ED severity in a large ED cohort using a broad range of ED severity indicators. Our cohort included 3189 individuals (64 males) born 1977–2000 with current or previous anorexia nervosa who participated in the Anorexia Nervosa Genetics Initiative‐Sweden (ANGI‐SE) and for whom genotypes and linkage to national registers were available. We identified 134 (4.2%) individuals with registered autism diagnoses. Individuals with confirmed autism diagnosis had significantly more severe ED across three sets of severity indicators. Some of the largest effects were found for the proportion of individuals who attempted suicide and who received tube feeding (higher in autism), and for the time spent in inpatient care (longer in autism). Results for autism PGS were not statistically significant. Adapting ED treatment to the needs of individuals with co‐occurring autism is an important research direction to improve treatment outcome in this group. Among 3189 Swedish individuals with current or previous anorexia nervosa, those with confirmed autism diagnosis (4.2%) experienced higher eating disorder severity across 27 out of 29 indicators. Some of the highest risk increases were found for having attempted suicide, having received tube feeding, and time spent in inpatient care for eating disorders. Repeating the analyses with autism polygenic score instead of autism diagnosis yielded non‐statistically significant results for all 29 eating disorder severity indicators.
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Affiliation(s)
- Ruyue Zhang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Birgegård
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Bengt Fundín
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Laura M Thornton
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lisa Dinkler
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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19
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Babb C, Brede J, Jones CRG, Serpell L, Mandy W, Fox J. A comparison of the eating disorder service experiences of autistic and non-autistic women in the UK. EUROPEAN EATING DISORDERS REVIEW 2022; 30:616-627. [PMID: 35775728 PMCID: PMC9544670 DOI: 10.1002/erv.2930] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/25/2022] [Accepted: 05/28/2022] [Indexed: 11/22/2022]
Abstract
Objective Qualitative studies report that autistic women have poor experiences when being treated for an eating disorder (ED) and express that ED services are not appropriately tailored to meet their needs. It is unclear whether their experience differs to other women accessing ED services. The aim of the current study was to compare autistic and non‐autistic women's ED illness history and experiences in ED services. Method An online survey about ED illness history and their experience with ED treatment was completed by 46 autistic women with a restrictive ED and 110 non‐autistic women with a restrictive ED. Results Despite some similarities, there were three key differences in the experiences reported by autistic and non‐autistic women. First, autistic women reported a longer duration of ED and being diagnosed with an ED at a younger age than non‐autistic women. Second, autistic women reported accessing a broader range of healthcare settings and ED treatments than non‐autistic women when being treated for an ED. Finally, autistic women rated their experiences of inpatient care, dietetic input, and cognitive behavioural therapy (CBT) as significantly less beneficial than non‐autistic women when being treated for an ED. Conclusion These findings increase understanding of autistic women's ED experience and can help to shape ED services and treatments to better accommodate the needs of their autistic clients. The current study is the first to compare the eating disorder (ED) illness history and treatment experiences of autistic and non‐autistic women. Autistic women with EDs are diagnosed at a younger age and report longer illness duration than non‐autistic women. Autistic women with EDs tend to access a broader range of healthcare settings and ED treatments than non‐autistic women, but report these to be less beneficial.
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Affiliation(s)
| | | | | | | | | | - John Fox
- University of Cardiff, Cardiff, UK
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20
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Nimbley E, Golds L, Sharpe H, Gillespie-Smith K, Duffy F. Sensory processing and eating behaviours in autism: A systematic review. EUROPEAN EATING DISORDERS REVIEW 2022; 30:538-559. [PMID: 35737818 PMCID: PMC9545673 DOI: 10.1002/erv.2920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/03/2022] [Accepted: 05/05/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES The aim of this study was to assess the relationship between sensory processing and a broad range of eating behaviours across the lifespan. METHODS Five electronic databases of published and unpublished quantitative studies were systematically searched, evaluated for risk of bias and synthesised according to identified eating outcomes. RESULTS Across 25 studies, there was consistent evidence of a relationship between sensory processing and a range of eating behaviours. There was early evidence for the particular role of taste/smell sensitivities, as well as hypersensitivities, although future research is needed looking at different sensory patterns and modalities. There was also tentative evidence to suggest this relationship extends across development. DISCUSSION Study findings are discussed in relation to implications for sensory-based eating and feeding interventions and the development of eating disorders. Methodological and conceptual limitations are discussed and suggestions for future research are made to address these limitations. A broader investigation of multi-sensory issues and clearly defined eating behaviours, including disordered eating in clinically diagnosed samples, will allow for a more comprehensive and robust understanding of the relationship between sensory processing and eating behaviours in autism.
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Affiliation(s)
- Emy Nimbley
- School of Health in Social Sciences, University of Edinburgh, Edinburgh, UK
| | - Lisa Golds
- School of Health in Social Sciences, University of Edinburgh, Edinburgh, UK
| | - Helen Sharpe
- School of Health in Social Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Fiona Duffy
- School of Health in Social Sciences, University of Edinburgh, Edinburgh, UK.,NHS Lothian Child and Adolescent Mental Health Services, Royal Edinburgh Hospital, Edinburgh, UK
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21
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Chen N, Watanabe K, Kobayakawa T, Wada M. Relationships between autistic traits, taste preference, taste perception, and eating behaviour. EUROPEAN EATING DISORDERS REVIEW 2022; 30:628-640. [PMID: 35690923 PMCID: PMC9545735 DOI: 10.1002/erv.2931] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/13/2022] [Accepted: 05/28/2022] [Indexed: 11/23/2022]
Abstract
Individuals with autism spectrum disorder exhibit atypical taste perception and eating behaviours. However, little is known about the effect of autistic traits on eating behaviours in the general population. This study explored the relationships between autistic traits, taste preferences, taste perceptions, and eating behaviours among Japanese population using an online questionnaire survey. The results showed significant effect of autistic traits on eating behaviours, that people with higher autistic traits tended to have higher selective eating behaviours, such as increased sensitivity to food texture and mixed flavours. Moreover, selective eating behaviours were correlated with the preference for sour taste and aftertaste sensitivity. Those results suggest that eating behaviours can be influenced by the relationship between autistic traits, taste perceptions, and taste preferences. We discuss these results in the context of previous findings, and future investigations into the possibility of solving selective eating problems in individuals with autism. Autistic traits were significantly correlated with eating behaviours. People with higher autistic traits tended to have higher selective eating behaviours, such as increased sensitivity to food texture and mixed flavours. People who like sour tastes tended to have less selective eating behaviours. People who are sensitive to aftertaste perception tended to have greater selective eating behaviours. Autistic traits, taste perceptions, and taste preferences play a role in the development of a number of selective eating behaviours.
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Affiliation(s)
- Na Chen
- Department of Rehabilitation for Brain Functions, Research Institute of National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
| | - Katsumi Watanabe
- Faculty of Science and Engineering, Waseda University, Tokyo, Japan
| | - Tatsu Kobayakawa
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| | - Makoto Wada
- Department of Rehabilitation for Brain Functions, Research Institute of National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
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22
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Carter Leno V, Micali N, Bryant-Waugh R, Herle M. Associations between childhood autistic traits and adolescent eating disorder behaviours are partially mediated by fussy eating. EUROPEAN EATING DISORDERS REVIEW 2022; 30:604-615. [PMID: 35388530 PMCID: PMC9542277 DOI: 10.1002/erv.2902] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 12/12/2022]
Abstract
Objective Previous literature shows an increased risk for eating disorders in autistic individuals. This study tested whether fussy eating contributes to the association between childhood autistic traits and adolescent eating disorder behaviours. Method Using data from the Avon Longitudinal Study of Parents and Children, we estimated the intercept and slope of parent‐rated autistic traits and fussy eating between 7 and 14 years (N = 8982) and their association with self‐reported eating disorder behaviours at age 14 years, including the indirect path from autistic traits to eating disorder behaviours via fussy eating. Analyses were adjusted for child sex, maternal age at delivery, maternal body mass index and maternal education. Results Analyses found a small indirect pathway from autistic traits intercept to eating disorder behaviours via fussy eating slope (b = 0.017, 95% CI = 0.002–0.032, p = 0.026), with higher levels of autistic traits at age 7 years being associated with a shallower decline in fussy eating, which in turn was associated with greater eating disorder behaviours. Conclusion Findings point towards fussy eating as a potential link between childhood autistic traits and later disordered eating. Addressing fussy eating patterns before they become entrenched may decrease risk for eating disorders later in development. There is evidence that high levels of autistic traits are associated with an increased likelihood of experiencing an eating disorder. The current study sought to test whether the link between autism and eating disorders could in part be explained by variation in fussy eating. In a large prospective cohort study, we found a significant indirect effect of fussy eating, such that higher childhood autistic traits were associated with a shallower decline in fussy eating between childhood and adolescence, which in turn was associated with higher levels of eating disorder behaviours in adolescence.
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Affiliation(s)
- Virginia Carter Leno
- Department of Biostatistics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Nadia Micali
- Department of Pediatrics, Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Rachel Bryant-Waugh
- Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Moritz Herle
- Department of Biostatistics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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23
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Demir AÇ, Özcan Ö. The nutritional behavior of children with autism spectrum disorder, parental feeding styles, and anthropometric measurements. Nord J Psychiatry 2022; 76:64-70. [PMID: 34151723 DOI: 10.1080/08039488.2021.1934109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Although autism spectrum disorder (ASD) is known to include problems relating to nutrition, information about nutritional behavior, caregiver feeding styles, and anthropometric measurements is still limited. AIMS We aimed to assess the nutritional behavior, anthropometric measurements, and caregiver feeding styles of children with ASD. METHOD One hundred and four children with ASD and 100 controls were enrolled in the study. Children's weight and height were measured and recorded by the researchers. The Children's Eating Behavior Questionnaire, Parental Feeding Style Questionnaire, Development Assessment Form, and Sociodemographic Data Form were conducted by their caregivers. RESULTS Children with ASD were difficult to feed as babies, experienced more problems in the transition to supplementary food, were more selective about food, and were fed diets with a more limited variety than the control group. The BMI z-scores for children with ASD were higher than those for children without ASD, while their height z-scores were lower. Children with ASD displayed more responsiveness to food, emotional overeating, enjoyment of food, desire for drinks, emotional undereating, and food selectivity behaviors, while the parents of these children were found to use more emotional feeding, instrumental feeding, and tolerance-controlled feeding styles than the parents of the controls. CONCLUSIONS Children with ASD are more selective about foods and have greater difficulty in switching to supplementary food. The BMI-z score for children with ASD is higher and the height-z score is lower. Children with ASD have different eating and feeding styles compared to children in the control group.
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Affiliation(s)
- Arzu Çalışkan Demir
- Department of Child and Adolescent Psychiatry, Inonu University School of Medicine, Malatya, Turkey
| | - Özlem Özcan
- Department of Child and Adolescent Psychiatry, Inonu University School of Medicine, Malatya, Turkey
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24
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Saure E, Lepistö-Paisley T, Raevuori A, Laasonen M. Atypical Sensory Processing Is Associated With Lower Body Mass Index and Increased Eating Disturbance in Individuals With Anorexia Nervosa. Front Psychiatry 2022; 13:850594. [PMID: 35432034 PMCID: PMC9008215 DOI: 10.3389/fpsyt.2022.850594] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/11/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Elevated autism spectrum disorder (ASD) traits are associated with anorexia nervosa (AN). Conversely, eating disturbances, which are core characteristics of AN, are common in ASD. Among individuals with ASD, atypical sensory processing is associated with eating disturbance. Because AN and ASD appear to overlap, it would be crucial to understand whether sensory processing atypicality exist also in AN. Further, it would be essential to find if atypical sensory processing is associated with eating disturbances in individuals with AN, since treatment modifications may be needed. We therefore aimed to examine whether atypical sensory processing is associated with AN and its core characteristics. METHODS Participants of the current study included 42 individuals with AN and 40 healthy controls (HCs). All participants were adult women. Sensory processing, other ASD traits, and eating disorder symptoms were assessed with self-report questionnaires. RESULTS Individuals with AN reported lower registration, decreased sensation seeking, increased sensory sensitivity, and increased sensation avoiding compared to HCs. When analyzing groups with restrictive AN (AN-R) and binge-purge type AN (AN-BP) separately, only individuals with AN-R exhibited decreased sensation seeking, and only those with AN-BP exhibited lower registration. After controlling for body mass index as a covariate, group differences remained significant only in sensory sensitivity between individuals with AN and HCs. Increased atypical sensory processing predicted lower body mass index and increased disordered eating. CONCLUSION Results suggest that sensory processing appears to differ between AN and HC women, and AN subtypes may exhibit distinct sensory processing atypicality. Sensory sensitivity may be stable traits whereas other aspects of atypical sensory processing may be related to acute AN. Atypical sensory processing may contribute to the severity of AN, and thus it is crucial to recognize sensory processing differences when treating individuals with AN.
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Affiliation(s)
- Emma Saure
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tuulia Lepistö-Paisley
- Child Neurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Anu Raevuori
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland.,Department of Adolescent Psychiatry, Helsinki University Hospital, Helsinki, Finland
| | - Marja Laasonen
- Logopedics, Philosophical Faculty, School of Humanities, University of Eastern Finland, Joensuu, Finland
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Smith BL, Gutierrez R, Ludlow AK. A comparison of food avoidant behaviours and sensory sensitivity in adults with and without Tourette syndrome. Appetite 2022; 168:105713. [PMID: 34563498 DOI: 10.1016/j.appet.2021.105713] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 02/06/2023]
Abstract
Food selectivity has been shown to be more persistent and severe in children with Tourette syndrome (TS) compared to their typically developing peers. The current study aimed to examine differences in food selectivity, food neophobia and Avoidant Restrictive Food Intake Disorder (ARFID)-associated behaviours, between adults with and without TS. Fifty-three adults diagnosed with TS were compared to 53 neurotypical adults and completed the following measures online: Adult Eating Behaviour Questionnaire (AEBQ), Nine-Item Avoidant/Restrictive Food Intake disorder screen (NIAS), Food Neophobia Scale (FNS) and the Sensory Perception Quotient (SPQ). Higher levels of food avoidant behaviours, in terms of food fussiness, food neophobia and ARFID-associated behaviours, were identified in adults with TS compared to adults without TS. While heightened sensory sensitivity failed to predict food fussiness, greater sensitivity to taste was found to be predictive of food neophobia in TS. These are the first findings to suggest that food avoidant behaviours are more prevalent for adults with TS and signal a need to address health implications.
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Affiliation(s)
- Bobbie L Smith
- Department of Psychology, Sport and Geography, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK.
| | - Roberto Gutierrez
- Department of Psychology, Sport and Geography, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK.
| | - Amanda K Ludlow
- Department of Psychology, Sport and Geography, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB, UK.
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26
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Danforth A. Psychedelic-Assisted Therapy for Social Adaptability in Autistic Adults. Curr Top Behav Neurosci 2021; 56:71-92. [PMID: 34761363 DOI: 10.1007/7854_2021_269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Access to the Internet has upended long-standing myths and misconceptions about autism as autistic individuals are enabled through technology increasingly to influence the dialog around neurodiversity, the experience of being autistic, and the effectiveness of mental health interventions for autistic adults. Autistic self-advocates are speaking up in support of including neurodivergent adults as a population that might benefit from the burgeoning psychedelic medicine field, in an absence of many other mental health treatment options that have been researched and shown to be effective for them. Autism is a genetically-determined neurocognitive variant with considerable heterogeneity across the broad autistic phenotype spectrum. Therefore, enthusiasm for investigating psychedelics to cure or alter the course of autism is most likely ill-informed and misdirected; psychiatric and psychopharmacological interventions do not alter the genome. However, autism frequently co-occurs with clinical conditions such as anxiety, depression, obsessive-compulsive disorder, and trauma that have been investigated as indications for clinical trials with classic and atypical psychedelics. The purpose of this chapter will be to inform researchers and clinicians on the history of clinical research with classic psychedelics with autistic minors, recent and current clinical trials of atypical psychedelics with autistic adults, and considerations for providing psychedelic-assisted psychotherapies that are compatible with autism.
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27
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Volkert VM, Burrell L, Berry RC, Waddle C, White L, Bottini S, Murphy M, Sharp WG. Intensive multidisciplinary feeding intervention for patients with avoidant/restrictive food intake disorder associated with severe food selectivity: An electronic health record review. Int J Eat Disord 2021; 54:1978-1988. [PMID: 34505302 DOI: 10.1002/eat.23602] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Expert consensus increasingly recognizes intensive multidisciplinary intervention (IMI) as the standard of care to address chronic and severe feeding problems in pediatric populations. In this study, we examined the clinical presentation, intervention characteristics, and treatment outcomes for young children receiving IMI for avoidant restrictive rood intake disorder (ARFID) involving nutritional insufficiencies associated with severe food selectivity. METHOD We followed the Strengthening the Reporting of Observational Studies in Epidemiology statement to conduct this retrospective chart review. The review focused on consecutive patients (birth to age 21 years) admitted to the IMI program over a 5-year period (June 2014 to June 2019). Inclusion criteria required micronutrient insufficiencies (vitamins A, B12, C, D, E; folic acid; calcium; iron; and zinc) and chronic mealtime refusal behavior (e.g., turning head away from food/spoon, pushing or throwing spoon, crying, screaming, and leaving the table) associated with severe food selectivity. RESULTS Over the 5-year period, 63 of the patients met study entry requirements. Of these, 60 patients (50 boys and 10 girls; mean age = 72 ± 39 months; range = 23-181) completed intervention (95% treatment completion rate). At discharge, dietary diversity improved by 16 new therapeutic foods (range: 8-22), rapid acceptance and swallowing of new foods exceeded clinical benchmarks (80% or > bites), and risk for nutritional inadequacies declined for this patient cohort. DISCUSSION Results of the current study support the benefits of IMI to increase dietary variety, improve mealtime behaviors, and enhance nutritional intake for children with ARFID presenting with severe food selectivity.
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Affiliation(s)
- Valerie M Volkert
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.,Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Lindsey Burrell
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.,Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | | | | | - Lydia White
- Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Summer Bottini
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.,Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Meredith Murphy
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.,Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - William G Sharp
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA.,Children's Healthcare of Atlanta, Atlanta, Georgia, USA
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28
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Treatment of Food Selectivity in an Adult With Autism Spectrum Disorder. Behav Anal Pract 2021; 15:796-803. [DOI: 10.1007/s40617-021-00650-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2021] [Indexed: 10/20/2022] Open
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29
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Chaware SH, Dubey SG, Kakatkar V, Jankar A, Pustake S, Darekar A. The Systematic Review and Meta-analysis of Oral Sensory Challenges in Children and Adolescents with Autism Spectrum Disorder. J Int Soc Prev Community Dent 2021; 11:469-480. [PMID: 34760790 PMCID: PMC8533039 DOI: 10.4103/jispcd.jispcd_135_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 04/28/2021] [Accepted: 05/01/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES The purpose of the systematic review was to provide a summary and evaluation of oral sensory challenges in children and adolescents with autism spectrum disorder (ASD). MATERIALS AND METHODS The review evaluated 19 studies that met the inclusion and search criteria. The review is registered in Prospero Database (CRD42020179852). The 14 studies (8 case-control, 4 cohort, 1 observational, and 1 randomized clinical trial) were related to speech disorders and five studies (case-control studies) were associated with feeding and eating behavior in ASD. The meta-analysis of speech and feeding behavior was analyzed by using risk ratios (RRs) and standardized mean difference (SMD), with 95% confidence interval (CI). RESULTS The meta-analysis found a statistically significant difference of speech disorder between children and adolescents of ASD when compared with typically developed or other neurotypical children of similar age [0.4891 (95% CI = -2.4580; 1.4799), fixed effect; -0.1726 (95% CI = -14.2925; 7.5697), random effect]. Feeding and eating behavior reported a statistically significant difference between ASD children and adolescents with similar age group of typically developed controls [0.0433 (95% CI = -0.3531; 0.4398), fixed-effect; 0.3711 (95% CI = -3.0751; 3.8172), random effect]. CONCLUSION The speech errors and feeding behavior were more consistent in ASD than in typically developed controls. The oral sensory challenges such as speech disorder and feeding behavior were more prevalent in ASD children and adolescents than in typically developed children and adolescents of the same age group. There was a significant lack in oral sensory-motor synchronization, incomplete motor planning, and poor oral neuromuscular coordination.
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Affiliation(s)
- Sachin Haribhau Chaware
- Department of Prosthodontics and Crown and Bridge, Sharad Pawar Dental College, DMIMS, Swangi (M), Wardha, Maharashtra, India
| | - Surekha Godbole Dubey
- Department of Prosthodontics and Crown and Bridge, Sharad Pawar Dental College, DMIMS, Swangi (M), Wardha, Maharashtra, India
| | - Vinay Kakatkar
- Department of Prosthodontics and Crown and Bridge, SMBT IDSR Dental College Dhamangaon, Nashik, Maharashtra, India
| | - Ajit Jankar
- Department of Prosthodontics and Crown and Bridge, MIDSR Dental College and Hospital, Latur, Maharashtra, India
| | - Swati Pustake
- Department of Prosthodontics and Crown and Bridge, MGV KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - Abhishek Darekar
- Department of Prosthodontics and Crown and Bridge, MIDSR Dental College and Hospital, Latur, Maharashtra, India
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30
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Thorsteinsdottir S, Njardvik U, Bjarnason R, Olafsdottir AS. Taste education - A food-based intervention in a school setting, focusing on children with and without neurodevelopmental disorders and their families. A randomized controlled trial. Appetite 2021; 167:105623. [PMID: 34371121 DOI: 10.1016/j.appet.2021.105623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 07/10/2021] [Accepted: 08/02/2021] [Indexed: 10/20/2022]
Abstract
Children with neurodevelopmental disorders (ND) such as Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactive Disorder (ADHD) have high levels of fussy eating. However, no school-based food interventions exist for children with ASD and ADHD. To investigate the effect of Taste Education, 81 children with ND (n = 33), and without (n = 48), aged 8-12 years, and their parents, participated in a 7-week food intervention. Children were matched on age, ND, and sex, and randomized into Immediate-intervention and Delayed-intervention groups. Parents completed the Children's Eating Behaviour Questionnaire (CEBQ), and a food-variety questionnaire. After adjusting for baseline measures, repeated-measures analysis-of-variance with time-points, and condition as factors (Immediate intervention and Delayed intervention) were used to examine changes in CEBQ-scores, with a robust linear mixed-model fitted. Changes in percentage of accepted foods were tested using a logistic-regression model adjusting for baseline acceptance. Results showed superior results for Intervention compared to waiting, on Food fussiness, but not Enjoyment of food, with stable effects through six-months follow-up. There were non-significant differences between children with and without ND. Results also showed increased odds of accepting vegetables by a factor of 1.6 (95% Confidence Interval [CI]: 1.33-1.93, p < .001); nuts and seeds by a factor of 1.4 (95% CI: 1.27-1.6, p < .001), but no significant association for fruit (OR 1.12, 95% CI: 0.92-1.34, p = .244). Trends were similar for children regardless of ND-status. The Taste Education program, shows promise, as a simple, non-invasive way to decrease fussy eating and increase food variety in the long-term.
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Affiliation(s)
| | - Urdur Njardvik
- School of Health Sciences, University of Iceland, Iceland.
| | - Ragnar Bjarnason
- School of Health Sciences, University of Iceland, Iceland; Department of Paediatrics, National University Hospital, Iceland.
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31
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Baraskewich J, von Ranson KM, McCrimmon A, McMorris CA. Feeding and eating problems in children and adolescents with autism: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1505-1519. [PMID: 33653157 PMCID: PMC8323334 DOI: 10.1177/1362361321995631] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
LAY ABSTRACT Feeding problems, such as picky eating and food avoidance, are common in youth with autism. Other, broader difficulties with feeding and eating (eating disorder symptoms such as restricting food intake or preoccupation with body shape or weight and insistence on specific food presentation) are also common in autistic individuals. Here, we describe the nature and extent of feeding and eating problems in youth with autism. We found no common characteristics (such as severity of autism symptoms) that best describe autistic youth who experience problems with feeding or eating. Almost all studies we reviewed focused on problems with feeding (selective or picky eating), and only a few studies focused on eating disorder symptoms (concern with weight, shape, and/or body image). However, some researchers reported that eating disorder symptoms may occur more often in autistic individuals compared to their peers without autism. Many studies used the terms "feeding" and "eating" problems interchangeably, but understanding the difference between these problems is important for researchers to be consistent, as well as for proper identification and treatment. We suggest future researchers use "eating problems" when behaviors involve preoccupation with food, eating, or body image, and "feeding problems" when this preoccupation is absent. We highlight the importance of understanding whether feeding or eating problems are separate from autism traits, and the role of caregivers and other adults in the child's treatment. Considerations for health-care providers to assist with diagnosis and treatment are also provided.
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Affiliation(s)
- Jessica Baraskewich
- University of Calgary, Canada
- Alberta Children's Hospital Research Institute, Canada
| | - Kristin M von Ranson
- University of Calgary, Canada
- Alberta Children's Hospital Research Institute, Canada
| | - Adam McCrimmon
- University of Calgary, Canada
- Alberta Children's Hospital Research Institute, Canada
| | - Carly A McMorris
- University of Calgary, Canada
- Alberta Children's Hospital Research Institute, Canada
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32
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Lundin Remnélius K, Neufeld J, Isaksson J, Bölte S. Eating Problems in Autistic Females and Males: A Co-twin Control Study. J Autism Dev Disord 2021; 52:3153-3168. [PMID: 34292489 PMCID: PMC9213283 DOI: 10.1007/s10803-021-05198-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2021] [Indexed: 11/29/2022]
Abstract
This study investigated the association between autism and self-reported eating problems and the influence of gender on the association, in a sample of adolescent and adult twins (N = 192). Autistic traits and autism diagnosis were associated with both total and specific eating problems, including selective eating and sensory sensitivity during mealtimes. Interaction effects indicated a stronger association between autistic traits and total eating problems in females, as well as more difficulties with eating in social contexts among autistic females. In within-pair analyses, where unmeasured confounders including genes and shared environment are implicitly controlled for, the association was lost within monozygotic pairs, which might further indicate a genetic influence on the relationship between autism and eating problems.
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Affiliation(s)
- Karl Lundin Remnélius
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Gävlegatan 22B, Floor 8, 113 30, Stockholm, Sweden.
| | - Janina Neufeld
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Gävlegatan 22B, Floor 8, 113 30, Stockholm, Sweden
| | - Johan Isaksson
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Gävlegatan 22B, Floor 8, 113 30, Stockholm, Sweden.,Department of Neuroscience, Child and Adolescent Psychiatry Unit, Uppsala University, Uppsala, Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Gävlegatan 22B, Floor 8, 113 30, Stockholm, Sweden.,Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.,Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
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Stankovic J, Hove Thomsen P, Ovesen T. Food preferences, food neophobia and chemosensation among adolescents with ADHD. Acta Paediatr 2021; 110:2187-2199. [PMID: 33534932 DOI: 10.1111/apa.15790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 11/30/2022]
Abstract
AIM It has been suggested that adolescents diagnosed with ADHD have an unhealthier diet compared to their peers without ADHD. The association between chemosensation (smell and taste) and dietary patterns remains unknown. The aim is to investigate unhealthy food preferences and food neophobic behaviour among adolescents diagnosed with ADHD. Additionally, it is to investigate the relationship between dietary patterns and chemosensory function. METHODS We enrolled 36 adolescents with and without ADHD to complete a food item and a food neophobia questionnaire and to undergo chemosensory testing. RESULTS Adolescents with ADHD performed significantly worse on both chemosensory tests compared to the non-ADHD group. No difference in food preferences nor food neophobia was found between the two groups. CONCLUSION Adolescents with ADHD have a lower score on chemosensory tests compared to their peers, suggesting impaired chemosensory function. No differences in dietary preferences nor food neophobia were seen between the two groups.
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Affiliation(s)
| | - Per Hove Thomsen
- Department of Clinical Medicine Psychiatric Hospital for Children and Adolescents Aarhus University Hospital Risskov Denmark
| | - Therese Ovesen
- Department of Otorhinolaryngology Region Hospital Holstebro Holstebro Denmark
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34
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Nadeem MS, Murtaza BN, Al-Ghamdi MA, Ali A, Zamzami MA, Khan JA, Ahmad A, Rehman MU, Kazmi I. Autism - A Comprehensive Array of Prominent Signs and Symptoms. Curr Pharm Des 2021; 27:1418-1433. [PMID: 33494665 DOI: 10.2174/1381612827666210120095829] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 12/06/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Autism Spectrum Disorder (ASD) is a multifaceted neurodevelopmental condition characterized by multiple psychological and physiological impairments in young children. According to the recent reports, 1 out of every 58 newly-born children is suffering from autism. The aetiology of the disorder is complex and poorly understood, hindering the adaptation of targeted and effective therapies. There are no well- established diagnostic biomarkers for autism. Hence the analysis of symptoms by the pediatricians plays a critical role in the early intervention. METHODS In the present report, we have emphasized 24 behavioral, psychological and clinical symptoms of autism. RESULTS Impaired social interaction, restrictive and narrow interests, anxiety, depression; aggressive, repetitive, rigid and self-injurious behavior, lack of consistency, short attention span, fear, shyness and phobias, hypersensitivity and rapid mood alterations, high level of food and toy selectivity; inability to establish friendships or follow the instructions; fascination by round spinning objects and eating non-food materials are common psychological characteristics of autism. Speech or hearing impairments, poor cognitive function, gastrointestinal problems, weak immunity, disturbed sleep and circadian rhythms, weak motor neuromuscular interaction, lower level of serotonin and neurotransmitters, headache and body pain are common physiological symptoms. CONCLUSION A variable qualitative and quantitative impact of this wide range of symptoms is perceived in each autistic individual, making him/her distinct, incomparable and exceptional. Selection and application of highly personalized medical and psychological therapies are therefore recommended for the management and treatment of autism.
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Affiliation(s)
- Muhammad Shahid Nadeem
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Bibi Nazia Murtaza
- Department of Zoology, Abbottabad University of Science and Technology (AUST), Abbottabad, Pakistan
| | - Maryam A Al-Ghamdi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Akbar Ali
- College of Pharmacy, Northern Border University Rafha 1321, Saudi Arabia
| | - Mazin A Zamzami
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Jalaluddin A Khan
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Aftab Ahmad
- College of Pharmacy, Northern Border University Rafha 1321, Saudi Arabia
| | - Mujaddad Ur Rehman
- Department of Zoology, Abbottabad University of Science and Technology (AUST), Abbottabad, Pakistan
| | - Imran Kazmi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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35
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Rancaño KM, Bandini LG, Curtin C, Eliasziw M, Odoms-Young A, Must A. Gender and racial/ethnic differences in food selectivity in children with intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:1511-1520. [PMID: 33998122 DOI: 10.1111/jar.12895] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 03/03/2021] [Accepted: 04/23/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND We examined differences in food selectivity by gender and parent race/ethnicity in children with intellectual disabilities. METHOD A convenience sample of 56 children with intellectual disabilities was analysed. A modified Youth/Adolescent Food Frequency Questionnaire and a 3-day food record were used to measure child food refusal rate and food repertoire, respectively. RESULTS Boys were about twice as likely to refuse total foods (rate ratio = 2.34, 95%CI = 1.34-4.09) and fruits (rate ratio = 2.03, 95%CI = 1.04-3.95) and 54% more likely to refuse vegetables (rate ratio = 1.54, 95%CI = 0.93-2.54). Children with Hispanic parents were twice as likely to refuse vegetables compared to children with non-Hispanic White parents (rate ratio = 2.00, 95%CI = 1.03-3.90). In analyses stratified by the presence or absence of co-occurring probable autism spectrum disorder, boys had greater food selectivity than girls. CONCLUSIONS This study expands our understanding of food selectivity in children with intellectual disabilities.
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Affiliation(s)
- Katherine M Rancaño
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Linda G Bandini
- Eunice Kennedy Shriver Center/University of Massachusetts Medical School, Worcester, MA, USA.,Department of Health Sciences, Programs in Nutrition, Boston University, Boston, MA, USA
| | - Carol Curtin
- Eunice Kennedy Shriver Center/University of Massachusetts Medical School, Worcester, MA, USA
| | - Misha Eliasziw
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Angela Odoms-Young
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
| | - Aviva Must
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
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36
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Weir E, Allison C, Ong KK, Baron-Cohen S. An investigation of the diet, exercise, sleep, BMI, and health outcomes of autistic adults. Mol Autism 2021; 12:31. [PMID: 33964967 PMCID: PMC8106173 DOI: 10.1186/s13229-021-00441-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/27/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Studies of autistic children suggest that restricted eating, reduced physical activity, and sleep disorders are common; however, no studies attempt to broadly describe the diet, exercise, and sleep patterns of autistic adults or consider relationships between lifestyle behaviors and the widely reported increased risks of obesity and chronic conditions. To address this, the authors developed the largest study of lifestyle patterns of autistic adults and assessed their relationships to body mass index, health outcomes, and family history. METHODS We administered an anonymized, online survey to n = 2386 adults (n = 1183 autistic) aged 16-90 years of age. We employed Fisher's exact tests and binomial logistic regression to describe diet, exercise, and sleep patterns; mediation of seizure disorders on sleep; body mass index (BMI); relationships of lifestyle factors to BMI, cardiovascular conditions, and diabetic conditions; and sex differences among autistic adults. RESULTS Autistic adults, and particularly autistic females, exhibit unhealthy diet, exercise, and sleep patterns; they are also more likely to be underweight or obese. Limited sleep duration and high rates of sleep disturbances cannot be accounted for by epilepsy or seizure disorders. Lifestyle factors are positively related to higher risk of cardiovascular conditions among autistic males, even more than family history. LIMITATIONS Our sample may not be representative of all autistic and non-autistic people, as it primarily comprised individuals who are white, female, have a high school education or higher, and reside in the UK. Our sampling methods may also exclude some individuals on the autism spectrum, and particularly those with moderate to severe intellectual disability. This is a cross-sectional sample that can test for relationships between factors (e.g., lifestyle factors and health outcomes) but cannot assess the direction of these relationships. CONCLUSIONS Autistic adults are less likely to meet minimal health recommendations for diet, exercise, and sleep-and these unhealthy behaviors may relate to excess risk of cardiovascular conditions. Although the present study can only provide preliminary, correlational evidence, our findings suggest that diet, exercise, and sleep should be considered and further investigated as key targets for reducing the now widely reported and dramatically increased risks of health comorbidity and premature death among autistic individuals compared to others. Physicians should work cooperatively with patients to provide health education and develop individualized strategies for how to better manage challenges with diet, exercise, and sleep.
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Affiliation(s)
- Elizabeth Weir
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge, England, CB2 8AH.
| | - Carrie Allison
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge, England, CB2 8AH
| | - Ken K Ong
- MRC Epidemiology Unit and Department of Pediatrics, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus,, Cambridge, England, CB2 0QQ
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Douglas House, 18B Trumpington Road, Cambridge, England, CB2 8AH.
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The Combination of Food Approach and Food Avoidant Behaviors in Children with Autism Spectrum Disorder: "Selective Overeating". J Autism Dev Disord 2021; 52:987-994. [PMID: 33846897 DOI: 10.1007/s10803-021-04945-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2021] [Indexed: 01/29/2023]
Abstract
Based on parent questionnaires, we demonstrate the presence of an eating pattern among children with autism spectrum disorder (ASD) that is characterized by both food selectivity and eating in the absence of hunger. Children with ASD were categorized as engaging in eating patterns of selective overeating, selective eating only, overeating only, or typical eating. Group differences were found in the areas of diet composition, body mass index, and behavioral flexibility. Both the selective overeating group and selective eating only group were prone to favor calorie-dense, nutrient-deficient diets as compared to other groups. Eating groups also presented with differing profiles of everyday behavioral flexibility. These results suggest that selective overeating in ASD may present unique challenges and require tailored interventions.
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Panossian C, Lyons-Wall P, Whitehouse A, Oddy WH, Lo J, Scott J, O'Sullivan TA. Young Adults with High Autistic-Like Traits Displayed Lower Food Variety and Diet Quality in Childhood. J Autism Dev Disord 2021; 51:685-696. [PMID: 32617793 PMCID: PMC7835288 DOI: 10.1007/s10803-020-04567-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This study explored the association between autistic-like traits in young adults and dietary intake in early childhood in the Gen2 Raine Study cohort. Data were available from 811 participants at years 1, 2 and 3 for the assessment of dietary intake, and at year 20 for measurement of autistic-like traits. Results showed as autistic-like traits increased, total food variety, core food variety and dairy variety decreased (p < 0.05), with a lower consumption of citrus fruits and yoghurt (both p = 0.04). As autistic-like traits increased, diet quality decreased, this trend was significant at 2 years (p = 0.024). Our results suggest that young adults with higher autistic-like traits were more likely to have had lower food variety and diet quality in early childhood.
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Affiliation(s)
- Catherine Panossian
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
| | - Philippa Lyons-Wall
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Andrew Whitehouse
- Telethon Kids Institute, The University of Western Australia, Perth Children's Hospital, Northern Entrance, 15 Hospital Avenue, Nedlands, WA, 6009, Australia
| | - Wendy H Oddy
- Menzies Institute for Medical Research, University of Tasmania, Churchill Avenue, Hobart, TAS, 7005, Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
| | - Jane Scott
- School of Public Health, Curtin University, Kent Street, Bentley, WA, 6102, Australia
| | - Therese A O'Sullivan
- School of Medical and Health Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia
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39
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van Dijk MWG, Buruma ME, Blijd-Hoogewys EMA. Detecting Feeding Problems in Young Children with Autism Spectrum Disorder. J Autism Dev Disord 2021; 51:4115-4127. [PMID: 33452969 PMCID: PMC8510969 DOI: 10.1007/s10803-021-04869-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2021] [Indexed: 02/07/2023]
Abstract
Feeding problems are prevalent in children with ASD. We investigated whether the Montreal Children’s Hospital Feeding Scale (MCH-FS, Ramsay et al. in Pediatrics and Child Health 16:147–151, 2011) can be used for young children with ASD. Participants (1–6 years) were selected from a clinical ASD sample (n = 80) and a general population sample (n = 1389). Internal consistency was good in both samples. In general, parents of children with ASD reported more feeding problems than those from the population sample. The response patterns on the individual items was highly similar. There was a slight increase in symptoms with age in the population sample, but not in the ASD sample. These results suggest that the MCH-FS can be used in populations that include children with ASD.
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Affiliation(s)
- M W G van Dijk
- Department of Developmental Psychology at Heymans Institute for Psychological Research, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands.
| | - M E Buruma
- INTER-PSY, Verlengde Meeuwerderweg 7, 9723 ZM, Groningen, the Netherlands
| | - E M A Blijd-Hoogewys
- Department of Developmental Psychology at Heymans Institute for Psychological Research, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, the Netherlands.,INTER-PSY, Verlengde Meeuwerderweg 7, 9723 ZM, Groningen, the Netherlands
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40
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Koomar T, Thomas TR, Pottschmidt NR, Lutter M, Michaelson JJ. Estimating the Prevalence and Genetic Risk Mechanisms of ARFID in a Large Autism Cohort. Front Psychiatry 2021; 12:668297. [PMID: 34177659 PMCID: PMC8221394 DOI: 10.3389/fpsyt.2021.668297] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/07/2021] [Indexed: 12/27/2022] Open
Abstract
This study is the first genetically-informed investigation of avoidant/restrictive food intake disorder (ARFID), an eating disorder that profoundly impacts quality of life for those affected. ARFID is highly comorbid with autism, and we provide the first estimate of its prevalence in a large and phenotypically diverse autism cohort (a subsample of the SPARK study, N = 5,157 probands). This estimate, 21% (at a balanced accuracy 80%), is at the upper end of previous estimates from studies based on clinical samples, suggesting under-diagnosis and potentially lack of awareness among caretakers and clinicians. Although some studies suggest a decrease of disordered eating symptoms by age 6, our estimates indicate that up to 17% (at a balanced accuracy 87%) of parents of autistic children are also at heightened risk for ARFID, suggesting a lifelong risk for disordered eating. We were also able to provide the first estimates of narrow-sense heritability (h2) for ARFID risk, at 0.45. Genome-wide association revealed a single hit near ZSWIM6, a gene previously implicated in neurodevelopmental conditions. While, the current sample was not well-powered for GWAS, effect size and heritability estimates allowed us to project the sample sizes necessary to more robustly discover ARFID-linked loci via common variants. Further genetic analysis using polygenic risk scores (PRS) affirmed genetic links to autism as well as neuroticism and metabolic syndrome.
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Affiliation(s)
- Tanner Koomar
- Department of Psychiatry, The University of Iowa, Iowa City, IA, United States
| | - Taylor R Thomas
- Department of Psychiatry, The University of Iowa, Iowa City, IA, United States
| | - Natalie R Pottschmidt
- Department of Psychology, Pennsylvania State University, State College, PA, United States
| | - Michael Lutter
- Eating Recovery Center of San Antonio, San Antonio, TX, United States
| | - Jacob J Michaelson
- Department of Psychiatry, The University of Iowa, Iowa City, IA, United States
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41
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Brede J, Babb C, Jones C, Elliott M, Zanker C, Tchanturia K, Serpell L, Fox J, Mandy W. "For Me, the Anorexia is Just a Symptom, and the Cause is the Autism": Investigating Restrictive Eating Disorders in Autistic Women. J Autism Dev Disord 2020; 50:4280-4296. [PMID: 32274604 PMCID: PMC7677288 DOI: 10.1007/s10803-020-04479-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Autistic women are overrepresented among people in treatment for Anorexia Nervosa (AN). The current study aimed to: (1) better understand how AN develops and persists in autistic individuals from the perspective of autistic women, parents and healthcare professionals; (2) derive a theoretical model of restrictive eating difficulties in autism. We conducted 44 semi-structured interviews and used Thematic Analysis to identify patterns of meaning across the data. Themes related to sensory sensitivities, social interaction and relationships, sense of self and identity, difficulties with emotions, thinking styles, and a need for control and predictability. We developed a model of potential autism-specific mechanisms underlying restrictive eating difficulties. This study generated novel insights, which have the potential to inform treatment adaptations following empirical testing.
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Affiliation(s)
- Janina Brede
- Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 6BT UK
| | - Charli Babb
- School of Psychology, Cardiff University, Park Place, Cardiff, CF10 3AT UK
| | - Catherine Jones
- School of Psychology, Cardiff University, Park Place, Cardiff, CF10 3AT UK
| | - Mair Elliott
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, London, SE5 8AF UK
| | | | | | - Lucy Serpell
- Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 6BT UK
| | - John Fox
- School of Psychology, Cardiff University, Park Place, Cardiff, CF10 3AT UK
| | - Will Mandy
- Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 6BT UK
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42
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Folta SC, Curtin C, Must A, Pehrson A, Ryan K, Bandini L. Impact of Selective Eating on Social Domains Among Transition-Age Youth with Autism Spectrum Disorder: A Qualitative Study. J Autism Dev Disord 2020; 50:2902-2912. [PMID: 32034651 DOI: 10.1007/s10803-020-04397-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Food selectivity is a common feeding problem among autistic children. The objective of this qualitative study was to explore the impact of selective eating on key social domains-with family, peers, and in other social situations-of transition-age autistic youth who self-identified as being food selective. Interviews were conducted with 20 autistic youth ages 18-23 years. Data were analyzed using descriptive and thematic coding. Participants had developed a range of strategies to cope with their food selectivity, and although some expressed concerns, they did not feel that it had a major impact on social situations. A responsive approach to supporting such youth would likely involve recognizing the effort and skills that the youth have already developed around this issue.
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Affiliation(s)
- Sara C Folta
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, 02111, USA.
| | - Carol Curtin
- E.K. Shriver Center and the Departments of Family Medicine & Community Health and Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Aviva Must
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Ave, Boston, MA, 02111, USA
| | - Annie Pehrson
- Department of Health Sciences, Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Boston, MA, 02215, USA
| | - Kate Ryan
- Eunice Kennedy Shriver Center, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA, 01655, USA
| | - Linda Bandini
- Department of Pediatrics, Eunice Kennedy Shriver Center, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA, 01655, USA
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43
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Margari L, Marzulli L, Gabellone A, de Giambattista C. Eating and Mealtime Behaviors in Patients with Autism Spectrum Disorder: Current Perspectives. Neuropsychiatr Dis Treat 2020; 16:2083-2102. [PMID: 32982247 PMCID: PMC7504729 DOI: 10.2147/ndt.s224779] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/07/2020] [Indexed: 12/17/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired social and communication skills and repetitive and restrictive behaviors. Children and adolescents with ASD are more likely to present feeding problems than their typically developing peers are. The present narrative review of literature aims to highlight the most recent evidence about epidemiology and presentations of eating and mealtime behavioral abnormalities in ASD from infancy to adolescence. Abnormalities in breastfeeding and acceptance of complementary foods have been described by most of the studies evaluating ASD early feeding history. Among the various eating and mealtime behaviors identified in ASD children and adolescents, the most common was food selectivity. The present review also provides brief overviews of the various aspects of food that may influence food acceptance by ASD patients and of the correlation between eating problems and ASD core symptoms, as well as with cognitive level, language skills, and family environment. However, studies evaluating eating problems in ASD children and adolescents are very heterogeneous and they show methodological differences. Moreover, the absence of unique definitions of eating and mealtime behaviors in ASD further limits the comparability of studies.
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Affiliation(s)
- Lucia Margari
- Child Neuropsychiatric Unit, University of Bari Aldo Moro, Bari, Italy
| | - Lucia Marzulli
- Child Neuropsychiatric Unit, University of Bari Aldo Moro, Bari, Italy
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Usher LV, DaWalt LS, Hong J, Greenberg JS, Mailick MR. Trajectories of Change in the Behavioral and Health Phenotype of Adolescents and Adults with Fragile X Syndrome and Intellectual Disability: Longitudinal Trends Over a Decade. J Autism Dev Disord 2020; 50:2779-2792. [PMID: 32040800 PMCID: PMC7377950 DOI: 10.1007/s10803-020-04367-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This study examined trajectories of daily living skills, behavior problems, body mass index (BMI), and health conditions spanning nearly a decade in adolescents and adults with fragile X syndrome (N = 134; age range at study end = 19-49 years), examining influences of sex and autism spectrum disorder (ASD) symptoms. Hierarchical linear modeling revealed early increases in daily living skills, with decreases at older ages. Behavior problems became less severe over time, with some increases at older ages. Individuals gained weight and had increasing health problems over time. Fewer ASD symptoms were associated with greater daily living skills and fewer behavior problems at study start. This study offers some of the first prospective quantitative analyses of behavioral and health life course trajectories in FXS.
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Affiliation(s)
- Lauren V Usher
- University of Wisconsin-Madison Waisman Center, 1500 Highland Avenue, Room 531A, Madison, WI, 53705, USA.
| | - Leann S DaWalt
- University of Wisconsin-Madison Waisman Center, 1500 Highland Avenue, Room 531A, Madison, WI, 53705, USA
| | - Jinkuk Hong
- University of Wisconsin-Madison Waisman Center, 1500 Highland Avenue, Room 531A, Madison, WI, 53705, USA
| | - Jan S Greenberg
- University of Wisconsin-Madison Waisman Center, 1500 Highland Avenue, Room 531A, Madison, WI, 53705, USA
| | - Marsha R Mailick
- University of Wisconsin-Madison Waisman Center, 1500 Highland Avenue, Room 531A, Madison, WI, 53705, USA
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45
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Tsujiguchi H, Miyagi S, Nguyen TTT, Hara A, Ono Y, Kambayashi Y, Shimizu Y, Nakamura H, Suzuki K, Suzuki F, Nakamura H. Relationship between Autistic Traits and Nutrient Intake among Japanese Children and Adolescents. Nutrients 2020; 12:nu12082258. [PMID: 32731611 PMCID: PMC7468902 DOI: 10.3390/nu12082258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/25/2020] [Accepted: 07/25/2020] [Indexed: 12/27/2022] Open
Abstract
Increased food selectivity among children with autism spectrum disorder (ASD) may lead to nutritional inadequacy. The present study examined differences in nutrient intake between children and adolescents with and without ASD. We utilized cross-sectional data from the ongoing population Shika Town rural Japanese study. The participants were 1276 Japanese pupils and students aged between 7 and 15 years. ASD traits were evaluated using the Autism Spectrum Screening Questionnaire (ASSQ). Nutrient intake was assessed using a food frequency questionnaire. A one-way analysis of covariance (one-way ANCOVA) was performed to compare the mean nutrient intakes between participants with and without ASD traits. A two-way ANCOVA was conducted to compare the mean nutrient intakes among participants with and without ASD traits in different age groups (children and adolescents). The results obtained showed that the intake of carbohydrates and slightly lower intakes of protein, fat, calcium, magnesium, phosphorus, iron, zinc, retinol, vitamin B2, vitamin B12, folic acid, and pantothenic acid were higher among children and adolescents with ASD than among those without ASD. No interactions were observed between the autistic groups and age groups, excluding energy intakes. The present results indicate the importance of screening the nutrient intakes of ASD children and adolescents.
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Affiliation(s)
- Hiromasa Tsujiguchi
- Department of Public Health, Kanazawa University Graduate School of Advanced Preventive Medical Sciences, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan; (A.H.); (K.S.); (H.N.)
- Kanazawa University Advanced Preventive Medical Sciences Research Center, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
- Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan; (T.T.T.N.); (H.N.); (F.S.)
- Correspondence: ; Tel.: +81-76-245-2288
| | - Sakae Miyagi
- Innovative Clinical Research Center, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan;
| | - Thao Thi Thu Nguyen
- Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan; (T.T.T.N.); (H.N.); (F.S.)
| | - Akinori Hara
- Department of Public Health, Kanazawa University Graduate School of Advanced Preventive Medical Sciences, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan; (A.H.); (K.S.); (H.N.)
- Kanazawa University Advanced Preventive Medical Sciences Research Center, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
- Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan; (T.T.T.N.); (H.N.); (F.S.)
| | - Yasuki Ono
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, 1 Bunkyocyo, Hirosaki, Aomori 036-8224, Japan;
| | - Yasuhiro Kambayashi
- Department of Public Health, Faculty of Veterinary Medicine, Okayama University of Science, 1-3 Ikoinooka, Imabari, Ehime 794-8555, Japan;
| | - Yukari Shimizu
- Department of Nursing, Faculty of Health Sciences, Komatsu University, 1-14 Mukaimotoorimachi, Komatsu, Ishikawa 923-0961, Japan;
| | - Haruki Nakamura
- Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan; (T.T.T.N.); (H.N.); (F.S.)
| | - Keita Suzuki
- Department of Public Health, Kanazawa University Graduate School of Advanced Preventive Medical Sciences, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan; (A.H.); (K.S.); (H.N.)
| | - Fumihiko Suzuki
- Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan; (T.T.T.N.); (H.N.); (F.S.)
- Division of Dental Anesthesiology, Department of Oral Surgery, Ohu University School of Dentistry, 1-31, Misumidou, Tomitamachi, Kohriyama, Fukushima 963-8611, Japan
| | - Hiroyuki Nakamura
- Department of Public Health, Kanazawa University Graduate School of Advanced Preventive Medical Sciences, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan; (A.H.); (K.S.); (H.N.)
- Kanazawa University Advanced Preventive Medical Sciences Research Center, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan
- Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, 1-13 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan; (T.T.T.N.); (H.N.); (F.S.)
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Neurobiology of sensory processing in autism spectrum disorder. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2020; 173:161-181. [PMID: 32711809 DOI: 10.1016/bs.pmbts.2020.04.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Altered sensory processing and perception has been one of the characteristics of autism spectrum disorder (ASD). In this chapter, we review the neural underpinnings of sensory abnormalities of ASD by examining the literature on clinical, behavioral and neurobiological evidence that underlies the main patterns of sensory integration function and dysfunction. Furthermore, neural differences in anatomy, function and connectivity of different regions underlying sensory processing are also discussed. We conclude that sensory integration intervention is built on the premise of neuroplasticity to improve function and behavior for individuals with ASD.
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47
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Johnson CR, Brown K, Hyman SL, Brooks MM, Aponte C, Levato L, Schmidt B, Evans V, Huo Z, Bendixen R, Eng H, Sax T, Smith T. Parent Training for Feeding Problems in Children With Autism Spectrum Disorder: Initial Randomized Trial. J Pediatr Psychol 2020; 44:164-175. [PMID: 30101320 DOI: 10.1093/jpepsy/jsy063] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 07/20/2018] [Indexed: 11/13/2022] Open
Abstract
Objective Many children with autism spectrum disorder (ASD) have feeding and mealtime problems. To address these, we conducted a pilot randomized trial of a new 11-session, individually delivered parent training program that integrated behavioral strategies and nutritional guidance (PT-F). Methods Forty-two young children (age: 2 to 7-11 years) with ASD and feeding problems were assigned to 11 sessions of PT-F intervention over 20 weeks or a waitlist control. Outcomes included attendance, parent satisfaction, therapist fidelity, and preliminary assessments of child and parent outcomes. Results Of the 21 PT-F families, attendance was high (85%) as was parent satisfaction (94% would recommend to others). Treatment fidelity was also high (97%-therapist integrity; 94%-parent adherence). Compared with waitlist, children whose parents participated in PT-F showed significantly greater reductions on the two parent-completed primary outcomes (Brief Autism Mealtime Behavior Inventory-Revised; Twald = -2.79; p = .003; About Your Child's Eating; Twald = -3.58; p = .001). On the independent evaluator-completed secondary eating outcome, the Clinical Global Impression-Improvement, 48.8% of the participants in PT-F were rated as "responders" compared with 0% in waitlist (p = .006). General child disruptive behavior outcomes decreased more in PT-F but not significantly. Parent outcomes of caregiver stress showed nonsignificant trends favoring PT-F with moderate to small effect sizes. Conclusions This trial provides evidence for feasibility, satisfaction, and fidelity of implementation of PT-F for feeding problems in young children with ASD. Feeding outcomes also appeared favorable and lends support for conducting a larger efficacy trial.
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Affiliation(s)
| | | | | | - Maria M Brooks
- Graduate School of Public Health, University of Pittsburgh
| | | | | | | | | | | | - Roxanna Bendixen
- School of Health and Rehabilitation Sciences, University of Pittsburgh
| | - Heather Eng
- Graduate School of Public Health, University of Pittsburgh
| | - Theresa Sax
- Graduate School of Public Health, University of Pittsburgh
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48
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Association between Dietary Intake and Autistic Traits in Japanese Working Adults: Findings from the Eating Habit and Well-Being Study. Nutrients 2019; 11:nu11123010. [PMID: 31835384 PMCID: PMC6950727 DOI: 10.3390/nu11123010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/02/2019] [Accepted: 12/06/2019] [Indexed: 12/14/2022] Open
Abstract
“Autistic traits” include a wide range of severity levels. They are often subclinical, and widely distributed in the general population. It is possible that food selectivity due to hyper- or hypo-reactivity to smell or texture, an autistic feature, may result in inadequate nutrient intakes even among non-clinical adults with autistic traits. However, dietary intake of adults with autistic traits has not been elucidated. This study aimed to investigate an association between dietary intake and autistic traits. We cross-sectionally analyzed data of 1440 men and 613 women extracted from the Eating Habit and Well-Being study. Autistic traits were assessed using the Japanese version of the Subthreshold Autism Trait Questionnaire (SATQ), and dietary intake was assessed using a validated food frequency questionnaire. Iron and vitamin B12 intakes were marginally and inversely associated with the SATQ score in men. The SATQ score in women was positively associated with carbohydrate intake, but had an inverse association with protein, mineral, vitamin, and dietary fiber intakes. Low intakes of seaweed, fish and shellfish, and vegetables were observed in participants with severe autistic traits. Associations of autistic traits with food selectivity and low nutrient intakes should be further investigated to promote a new dietary strategy in the general population.
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49
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Peverill S, Smith IM, Duku E, Szatmari P, Mirenda P, Vaillancourt T, Volden J, Zwaigenbaum L, Bennett T, Elsabbagh M, Georgiades S, Ungar WJ. Developmental Trajectories of Feeding Problems in Children with Autism Spectrum Disorder. J Pediatr Psychol 2019; 44:988-998. [PMID: 31089730 PMCID: PMC6705712 DOI: 10.1093/jpepsy/jsz033] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 03/17/2019] [Accepted: 04/18/2019] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Although feeding problems are a common concern in children with autism spectrum disorder (ASD), few longitudinal studies have examined their persistence over time. The purpose of this study was to examine the developmental progression of feeding problems across four time points in preschoolers with ASD. METHODS Group-based trajectory analyses revealed four distinct trajectories of feeding problems in our sample (N = 396). RESULTS The majority of children showed levels of feeding problems that were low from the outset and stable (Group 1; 26.3%) or moderate and declining over time (Group 2; 38.9%). A third group (26.5%) showed high levels of feeding problems as preschoolers that declined to the average range by school age. Few participants (8.3%) showed evidence of severe chronic feeding problems. Feeding problems were more highly correlated with general behavior problems than with autism symptom severity. CONCLUSIONS Overall, our findings demonstrated that in our sample of children with ASD, most feeding problems remitted over time, but a small subgroup showed chronic feeding problems into school age. It is important to consider and assess feeding problems in ASD against the backdrop of typical development, as many children with ASD may show improvement with age.
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Affiliation(s)
- Sarah Peverill
- Department of Psychology and Neuroscience, Dalhousie University
| | | | | | | | - Pat Mirenda
- Department of Educational & Counselling Psychology and Special Education, University of British Columbia
| | | | - Joanne Volden
- Faculty of Rehabilitation Medicine, University of Alberta
| | | | | | | | | | - Wendy J Ungar
- Child Evaluative Health Sciences, Hospital for Sick Children
- Institute for Health Policy, Management and Evaluation, University of Toronto
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Eating as an autistic adult: An exploratory qualitative study. PLoS One 2019; 14:e0221937. [PMID: 31465510 PMCID: PMC6715205 DOI: 10.1371/journal.pone.0221937] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 08/19/2019] [Indexed: 12/28/2022] Open
Abstract
Background Although eating difficulties are known to be common in children on the autism spectrum, there is a lack of research on whether these behaviours persist or change into adulthood. Emerging evidence suggests that autistic adults may experience higher levels of disordered eating than the general population, indicating the impact of autism on eating in this adult population warrants further exploration. Method This study interviewed 12 autistic adults about their eating habits, with a focus on the continuing or changing presence of behaviours often seen in autistic children such as sensory sensitivity or a preference for routines. Interviews were transcribed and analysed using thematic analysis. Results Overall, participants suggested that autism did continue to impact their eating into adulthood, particularly in the areas of sensory sensitivity, medical difficulties, executive functioning difficulties, and rigidity, but that they had learned to adapt so that these issues no longer represented a problem. However, a minority of participants did feel that their autism had a negative effect on their eating, particularly those diagnosed with eating disorders. Additionally, eating behaviours associated with autism were identified as potentially contributing to having an unhealthy body weight. Conclusions Certain traits associated with autism, such as cognitive rigidity and sensory sensitivity, could potentially continue to influence the eating behaviours of autistic adults. These traits are typically experienced as differences which can be adapted around and managed, rather than specific problems. However, these traits can potentially contribute to difficulties such as disordered eating and weight gain, and the implications of these should be explored by future research.
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