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Bjørklund G, Meguid NA, Hemimi M, Sahakyan E, Fereshetyan K, Yenkoyan K. The Role of Dietary Peptides Gluten and Casein in the Development of Autism Spectrum Disorder: Biochemical Perspectives. Mol Neurobiol 2024; 61:8144-8155. [PMID: 38472652 DOI: 10.1007/s12035-024-04099-3] [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: 10/05/2023] [Accepted: 03/04/2024] [Indexed: 03/14/2024]
Abstract
This paper examines the role of dietary peptides gluten and casein in modulating brain function in individuals with autism spectrum disorder (ASD) from a biochemical perspective. Neurotransmitter systems and neural networks are crucial for brain function, and alterations at the biochemical level can contribute to the characteristic symptoms and behaviors of ASD. The paper explores how dietary peptides influence neurotransmitter systems and neural networks, highlighting their potential as interventions to improve brain function in ASD. The evidence suggests that dietary peptides can impact neurotransmitter synthesis, release, and receptor interactions, disrupting the balance of neurotransmitter systems and affecting neural network function. The findings underscore the potential of dietary interventions in modulating brain function in ASD and call for further research to elucidate the underlying mechanisms and optimize clinical practice. Considering individual dietary sensitivities and preferences, personalized dietary approaches may be necessary for optimal outcomes. Dietary interventions' timing, duration, and integration with other evidence-based treatments are crucial considerations. Safety considerations and regular monitoring are important to ensure the implementation of dietary interventions safely and effectively.
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Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Toften 24, 8610, Mo i Rana, Norway.
| | - Nagwa A Meguid
- Research on Children with Special Needs Department, National Research Centre, Giza, Egypt
- CONEM Egypt Child Brain Research Group, National Research Centre, Giza, Egypt
| | - Maha Hemimi
- Research on Children with Special Needs Department, National Research Centre, Giza, Egypt
| | - Elen Sahakyan
- Neuroscience Laboratory, Cobrain Center, Yerevan State Medical University after M. Heratsi, 2 Koryun, 0025, Yerevan, Armenia
- Department of Pharmacy, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Katarine Fereshetyan
- Neuroscience Laboratory, Cobrain Center, Yerevan State Medical University after M. Heratsi, 2 Koryun, 0025, Yerevan, Armenia
- Department of Biochemistry, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Konstantin Yenkoyan
- Neuroscience Laboratory, Cobrain Center, Yerevan State Medical University after M. Heratsi, 2 Koryun, 0025, Yerevan, Armenia.
- Department of Biochemistry, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia.
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Pérez-Cabral ID, Bernal-Mercado AT, Islas-Rubio AR, Suárez-Jiménez GM, Robles-García MÁ, Puebla-Duarte AL, Del-Toro-Sánchez CL. Exploring Dietary Interventions in Autism Spectrum Disorder. Foods 2024; 13:3010. [PMID: 39335937 PMCID: PMC11431671 DOI: 10.3390/foods13183010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Revised: 09/19/2024] [Accepted: 09/20/2024] [Indexed: 09/30/2024] Open
Abstract
Autism spectrum disorder (ASD) involves social communication difficulties and repetitive behaviors, and it has a growing prevalence worldwide. Symptoms include cognitive impairments, gastrointestinal (GI) issues, feeding difficulties, and psychological problems. A significant concern in ASD is food selectivity, leading to nutrient deficiencies. Common GI issues in ASD, such as constipation and irritable bowel syndrome, stem from abnormal gut flora and immune system dysregulation. Sensory sensitivities and behavioral challenges exacerbate these problems, correlating with neurological symptom severity. Children with ASD also exhibit higher oxidative stress due to low antioxidant levels like glutathione. Therapeutic diets, including ketogenic, high-antioxidant, gluten-free and casein-free, and probiotic-rich diets, show potential in managing ASD symptoms like behavior, communication, GI issues, and oxidative stress, though the evidence is limited. Various studies have focused on different populations, but there is increasing concern about the impact among children. This review aims to highlight the food preferences of the ASD population, analyze the effect of the physicochemical and nutritional properties of foods on the selectivity in its consumption, GI problems, and antioxidant deficiencies in individuals with ASD, and evaluate the effectiveness of therapeutic diets, including diets rich in antioxidants, gluten-free and casein-free, ketogenic and essential fatty acids, and probiotic-rich diets in managing these challenges.
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Affiliation(s)
| | | | - Alma Rosa Islas-Rubio
- Coordinación de Tecnología de Alimentos de Origen Vegetal, Centro de Investigación en Alimentación y Desarrollo A.C. (CIAD, A.C.), Hermosillo 83304, SO, Mexico
| | | | - Miguel Ángel Robles-García
- Department of Medical and Life Sciences, Cienega University Center (CUCIÉNEGA), University of Guadalajara, Av. Universidad 1115, Lindavista, Ocotlán 47820, JA, Mexico
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Gray HL, Jimenez C, Pang T, Kim E, Shaffer-Hudkins E, Agazzi H, Rosado A, Klinger A, Young C, Kandil J, Won S, Perez A, Sayre WD, Waters KA, Miltenberger RG, Stern M. Recruitment feasibility and dietary and behavioral patterns in toddlers with ASD: Preliminary results from the Autism Eats program. Contemp Clin Trials 2024; 146:107688. [PMID: 39270747 DOI: 10.1016/j.cct.2024.107688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 09/05/2024] [Accepted: 09/09/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND Problematic mealtime behaviors and inadequate diet quality are pressing concerns for children with autism spectrum disorder (ASD). This study aimed to evaluate recruitment feasibility and baseline outcomes of the Autism Eats program for children under 3 years with ASD. METHODS Recruitment feasibility was assessed through reach and participation rates. The Healthy Eating Index (HEI-2015) scores were calculated from 3-day food records. Problematic mealtime behaviors were assessed with the Brief Autism Mealtime Behavior Inventory. Parental feeding practices were assessed using the Child Feeding Questionnaire. Anthropometric measurements of children and parents were taken. Weight-for-length percentiles were calculated based on the CDC growth charts. Descriptive statistics, one-sample t-tests, and Spearman's rho correlations were used for data analysis. RESULTS Of the contacted dyads, 74 % agreed to participate. All 51 enrolled dyads completed baseline survey (100 %), and 98 % completed 3-day food records and anthropometric measurements. Significantly higher problematic mealtime behaviors were observed, compared to the reference (e.g., Total score 55.7 vs. 32.5; p < .001). Children with ASD exhibited lower HEI-2015 scores than national data (e.g., Total score 59 vs. 62). A large proportion of the children (29 %) had a weight-for-length ≥ 95th percentile. Several significant associations were found among mealtime behaviors, diet quality, parental feeding practices, and weight status. CONCLUSION Recruitment was highly feasible, and the findings suggest that early nutrition intervention may hold promise in addressing problematic mealtime behaviors and promoting healthier dietary habits in young children with ASD. CLINICAL TRIAL REGISTRATION This trial has been registered at www. CLINICALTRIALS gov (NCT05194345).
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Affiliation(s)
- Heewon L Gray
- College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Claudia Jimenez
- College of Public Health, University of South Florida, Tampa, FL, USA
| | | | - Eunsook Kim
- Department of Educational and Psychological Studies, College of Education, University of South Florida, Tampa, FL, USA
| | - Emily Shaffer-Hudkins
- Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Heather Agazzi
- Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Alanis Rosado
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Ankeeta Klinger
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Carissa Young
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Jana Kandil
- Biomedical Sciences, University of South Florida, Tampa, FL, USA
| | - Samuel Won
- Biomedical Sciences, University of South Florida, Tampa, FL, USA
| | - Amanda Perez
- Biomedical Sciences, University of South Florida, Tampa, FL, USA
| | - William D Sayre
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Karah A Waters
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Raymond G Miltenberger
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA
| | - Marilyn Stern
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA
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Zou M, Zhang Y, Li D, Li S, Hu J, Gao Y, Cheng Z, Liu S, Wu L, Sun C. Correlation of Co-Morbidities with Symptom Severity of Children with Autism Spectrum Disorder: A Cross-Sectional Survey. Nutrients 2024; 16:2960. [PMID: 39275276 PMCID: PMC11397295 DOI: 10.3390/nu16172960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 08/23/2024] [Accepted: 08/30/2024] [Indexed: 09/16/2024] Open
Abstract
This study aims to identify potential correlations of the severity of symptoms of children with autism spectrum disorder (ASD) with serum nutritional levels, body composition indicators, diet partiality, and sleep disturbances. The cohort of this cross-sectional study included 120 children with ASD and 110 typically developing (TD) children to assess symptoms of ASD, and to measure serum levels of vitamins and minerals and the body composition values. Diet partiality and sleep disturbances were assessed by administering questionnaires. The serum levels of folic acid, copper, and vitamin B were lower in children with ASD than in TD children, while magnesium and homocysteine were higher (p < 0.05). Children with ASD had greater chest circumference, abdominal skinfold thickness, and body mass index (BMI) than TD children (p < 0.05), and higher prevalences of diet partiality and sleep disturbances (p < 0.001). Lower vitamin A levels and higher vitamin D levels were related to social impairment in children with ASD. Moreover, there were significantly positive correlations of BMI, chest circumference, diet partiality, and sleep disturbances with severity of ASD symptoms (p < 0.05). Collectively, rational nutritional supplementation, dietary management, and behavioral interventions are essential for children with ASD.
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Affiliation(s)
- Mingyang Zou
- Department of Children's and Adolescent Health, College of Public Health, Harbin Medical University, Harbin 150081, China
| | - Yilin Zhang
- Department of Children's and Adolescent Health, College of Public Health, Harbin Medical University, Harbin 150081, China
| | - Dexin Li
- Department of Children's and Adolescent Health, College of Public Health, Harbin Medical University, Harbin 150081, China
| | - Shengqi Li
- Beijing Normal University-Hong Kong Baptist University United International College, Zhuhai 519087, China
| | - Jingyi Hu
- Department of Children's and Adolescent Health, College of Public Health, Harbin Medical University, Harbin 150081, China
| | - Ya Gao
- Department of Children's and Adolescent Health, College of Public Health, Harbin Medical University, Harbin 150081, China
| | - Zeyu Cheng
- Department of Children's and Adolescent Health, College of Public Health, Harbin Medical University, Harbin 150081, China
| | - Shidan Liu
- Department of Children's and Adolescent Health, College of Public Health, Harbin Medical University, Harbin 150081, China
| | - Lijie Wu
- Department of Children's and Adolescent Health, College of Public Health, Harbin Medical University, Harbin 150081, China
| | - Caihong Sun
- Department of Children's and Adolescent Health, College of Public Health, Harbin Medical University, Harbin 150081, China
- Department of Developmental Behavioral Pediatrics, The Sixth Affiliated Hospital of Harbin Medical University, Harbin 150023, China
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Compañ-Gabucio L, Torres-Collado L, García-de-la-Hera M. Dietary Patterns in Children with Neurodevelopmental Disorders. Nutrients 2024; 16:2460. [PMID: 39125341 PMCID: PMC11313715 DOI: 10.3390/nu16152460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Accepted: 07/10/2024] [Indexed: 08/12/2024] Open
Abstract
Neurodevelopmental disorders (NDDs), of which Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) are two of the most common, are described as a group of conditions that begin in the developmental period and lead to deficits that impair functioning [...].
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Affiliation(s)
- Laura Compañ-Gabucio
- Unidad de Epidemiología de la Nutrición (EPINUT), Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550 Alicante, Spain; (L.C.-G.); (M.G.-d.-l.-H.)
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034 Madrid, Spain
| | - Laura Torres-Collado
- Unidad de Epidemiología de la Nutrición (EPINUT), Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550 Alicante, Spain; (L.C.-G.); (M.G.-d.-l.-H.)
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034 Madrid, Spain
| | - Manuela García-de-la-Hera
- Unidad de Epidemiología de la Nutrición (EPINUT), Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernández (UMH), 03550 Alicante, Spain; (L.C.-G.); (M.G.-d.-l.-H.)
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), 03010 Alicante, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28034 Madrid, Spain
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Zafirovski K, Aleksoska MT, Thomas J, Hanna F. Impact of Gluten-Free and Casein-Free Diet on Behavioural Outcomes and Quality of Life of Autistic Children and Adolescents: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:862. [PMID: 39062311 PMCID: PMC11274980 DOI: 10.3390/children11070862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/08/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Gluten- and casein-containing foods could aggravate the symptoms of children and adolescents with autism spectrum disorder (ASD), and subsequently impact their quality of life. However, there is a mixed opinion among researchers concerning the impact of alternative diet on reducing ASD symptoms. OBJECTIVE This scoping review aimed at examining the impact of the "gluten-free, casein-free" (GFCF) diet on health outcomes and the quality of life among autistic children and adolescents. METHODS A scoping review of the literature was performed following the Joanna Briggs Institute (JBI) guidelines. Four databases, including EbscoHost, Medline, CINAHL, and ProQuest, were used to obtain subject-specific studies relevant to the research question and published between July 2013 and March 2024. A comprehensive search using keywords such as "autism spectrum disorder", "gluten-free diet", and "casein-free diet" was conducted to obtain articles related to the research focus area. Only full-text, peer-reviewed, written in English articles were selected. Data extraction and data analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-extension to Scoping Review (PRISMA-ScR) protocol. RESULTS From the initial 586 studies, a total of 27 articles were included in the final analysis of the review. The thematic analysis included "GFCF diet and improvement of the core autistic symptoms", "the gut-brain link", "dietary interventions and autism", "possible side effects due to the GCFC diet", and "inconclusive studies and mixed opinions". A majority of the studies showed a positive effect of the GFCF diet on a variety of autistic symptoms, including positive changes in cognitive skills, behaviour, and gastrointestinal symptoms, while some showed conflicting evidence. CONCLUSIONS The currently available evidence on the impact of the "GFCF" diet on the quality of life of autistic children and adolescents may warrant potentially effective interventions for alleviating symptoms of autism spectrum disorders. However, this scoping review highlights the need for more research to provide more reliable evidence on the health outcomes and quality of life of ASD sufferers to guide practice.
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Affiliation(s)
- Kristina Zafirovski
- Program of Public Health, Department of Health and Education, Torrens University Australia, Melbourne, VIC 3000, Australia; (K.Z.); (M.T.A.)
| | - Mirjana Trpevska Aleksoska
- Program of Public Health, Department of Health and Education, Torrens University Australia, Melbourne, VIC 3000, Australia; (K.Z.); (M.T.A.)
| | - Joe Thomas
- Department of Public Health, Institute of Health and Management, Level 2/187 Boundary Rd, North Melbourne, VIC 3051, Australia;
| | - Fahad Hanna
- Program of Public Health, Department of Health and Education, Torrens University Australia, Melbourne, VIC 3000, Australia; (K.Z.); (M.T.A.)
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De Domenico C, Di Cara M, Piccolo A, Settimo C, Leonardi S, Giuffrè G, De Cola MC, Cucinotta F, Tripodi E, Impallomeni C, Quartarone A, Cucinotta F. Exploring the Usefulness of a Multi-Sensory Environment on Sensory Behaviors in Children with Autism Spectrum Disorder. J Clin Med 2024; 13:4162. [PMID: 39064201 PMCID: PMC11277603 DOI: 10.3390/jcm13144162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/04/2024] [Accepted: 07/14/2024] [Indexed: 07/28/2024] Open
Abstract
Background: Autism spectrum disorder (ASD) is a complex neurological development with social and communication deficits and sensory abnormalities. Sensory problems have a significant impact on daily life. Multisensory environments (MSEs), such as Snoezelen® rooms, offer controlled sensory stimulation. This study aims to evaluate the effect of MSE intervention with self-controlled sensory interactions on adaptive developmental skills and sensory responses in preschool ASD children. Methods: This pilot study was single-blind, randomized, controlled, and adhered to the CONSORT guidelines. Twenty participants were recruited and randomized into two groups: the control group (CG) underwent treatment as usual (TAU) with individual rehabilitation sessions of psychomotor therapy. The experimental group (EG) underwent TAU integrated with the use of an MSE. Developmental abilities and severity levels were assessed, pre-post, with the Psychoeducational Profile, Third Edition (PEP-3) and the Second Edition Childhood Autism Rating Scale (CARS-2). Results: A significant difference in taste, smell, and tactile behaviors according to the CARS-2, as well as in gross motor skills according to the PEP-3, was observed in the EG. Conclusions: This pilot study suggests that MSE-integrated intervention may be a valid strategy to improve self-management of the sensory profile in autistic individuals. Further studies are needed to better identify the intervention methodology and effectiveness.
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Affiliation(s)
- Carmela De Domenico
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (C.D.D.); (M.D.C.); (C.S.); (S.L.); (M.C.D.C.); (F.C.); (E.T.); (C.I.); (A.Q.)
| | - Marcella Di Cara
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (C.D.D.); (M.D.C.); (C.S.); (S.L.); (M.C.D.C.); (F.C.); (E.T.); (C.I.); (A.Q.)
| | - Adriana Piccolo
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (C.D.D.); (M.D.C.); (C.S.); (S.L.); (M.C.D.C.); (F.C.); (E.T.); (C.I.); (A.Q.)
| | - Carmela Settimo
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (C.D.D.); (M.D.C.); (C.S.); (S.L.); (M.C.D.C.); (F.C.); (E.T.); (C.I.); (A.Q.)
| | - Simona Leonardi
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (C.D.D.); (M.D.C.); (C.S.); (S.L.); (M.C.D.C.); (F.C.); (E.T.); (C.I.); (A.Q.)
| | | | - Maria Cristina De Cola
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (C.D.D.); (M.D.C.); (C.S.); (S.L.); (M.C.D.C.); (F.C.); (E.T.); (C.I.); (A.Q.)
| | - Fabio Cucinotta
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (C.D.D.); (M.D.C.); (C.S.); (S.L.); (M.C.D.C.); (F.C.); (E.T.); (C.I.); (A.Q.)
| | - Emanuela Tripodi
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (C.D.D.); (M.D.C.); (C.S.); (S.L.); (M.C.D.C.); (F.C.); (E.T.); (C.I.); (A.Q.)
| | - Caterina Impallomeni
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (C.D.D.); (M.D.C.); (C.S.); (S.L.); (M.C.D.C.); (F.C.); (E.T.); (C.I.); (A.Q.)
| | - Angelo Quartarone
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (C.D.D.); (M.D.C.); (C.S.); (S.L.); (M.C.D.C.); (F.C.); (E.T.); (C.I.); (A.Q.)
| | - Francesca Cucinotta
- IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy; (C.D.D.); (M.D.C.); (C.S.); (S.L.); (M.C.D.C.); (F.C.); (E.T.); (C.I.); (A.Q.)
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Ishii H, Yamada H, Sato R, Hayashi W, Nakamura D, Sugita S, Tazaki T, Takashio O, Inamoto A, Iwanami A. Obesity-associated factors in psychiatric outpatients: A multicenter questionnaire survey. Neuropsychopharmacol Rep 2024. [PMID: 39010283 DOI: 10.1002/npr2.12465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/11/2024] [Accepted: 06/15/2024] [Indexed: 07/17/2024] Open
Abstract
The prevalence of obesity is increasing worldwide, resulting in various health issues such as hypertension, dyslipidemia, diabetes mellitus, heart disease, and a lower life expectancy. Importantly, several psychiatric disorders and the use of psychotropic medications have been linked to obesity, and the possible risk factors need further investigation. This study examined the prevalence of obesity and its associated factors using a self-administered questionnaire. Participants were recruited from three outpatient clinics and individuals who met one or more of the ICD-10 F0-F9, G4 diagnoses were included. In total, 1384 participants completed the questionnaire about their lifestyle. Statistical analysis compared the demographic and clinical characteristics of the individuals who were obese (Body Mass Index: BMI ≥25) and those who were non-obese (BMI <25). The results revealed that the factors associated with obesity in psychiatric outpatients were being male, prolonged treatment duration, eating out frequently, and use of both second- and first-generation antipsychotics. The study emphasized the importance of closely monitoring BMI in individuals with multiple obesity-related factors.
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Affiliation(s)
- Hiroki Ishii
- Department of Psychiatry, Graduate School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, East Hospital, Showa University Hospital, Shinagawa-ku, Tokyo, Japan
| | - Hiroki Yamada
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, Showa University Northern Yokohama Hospital, Tsuzuki-ku, Yokohama, Japan
- Shinrin Koen Mental Clinic, Namekawa-cho, Hiki-gun, Saitama, Japan
| | - Ryotaro Sato
- Department of Psychiatry, Graduate School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, East Hospital, Showa University Hospital, Shinagawa-ku, Tokyo, Japan
| | - Wakaho Hayashi
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Showa University Karasuyama Hospital, Setagaya-ku, Tokyo, Japan
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Dan Nakamura
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Showa University Karasuyama Hospital, Setagaya-ku, Tokyo, Japan
| | - Shutaro Sugita
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Showa University Karasuyama Hospital, Setagaya-ku, Tokyo, Japan
| | - Taro Tazaki
- Department of Psychiatry, Graduate School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Showa University Karasuyama Hospital, Setagaya-ku, Tokyo, Japan
| | - Osamu Takashio
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, East Hospital, Showa University Hospital, Shinagawa-ku, Tokyo, Japan
| | - Atsuko Inamoto
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Department of Psychiatry, Showa University Northern Yokohama Hospital, Tsuzuki-ku, Yokohama, Japan
| | - Akira Iwanami
- Department of Psychiatry, School of Medicine, Showa University, Shinagawa-ku, Tokyo, Japan
- Showa University Karasuyama Hospital, Setagaya-ku, Tokyo, Japan
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Vasconcelos C, Schweigert Perry I, Gottfried C, Riesgo R, Castro K. Folic acid and autism: updated evidences. Nutr Neurosci 2024:1-35. [PMID: 38968136 DOI: 10.1080/1028415x.2024.2367855] [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: 07/07/2024]
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that impairs communication, socialization, and behavior. The association of ASD with folic acid has been investigated due to the importance of this vitamin for neurological health. This study is an update of the publication 'Folic acid and autism: What do we know?' and aims to systematically review studies examining the relationship between folic acid and ASD. The search resulted in 2,389 studies on folic acid and ASD, which were selected by two reviewers based on their titles and abstracts. Studies meeting the inclusion criteria were fully read. The 52 included studies involved 10,429 individuals diagnosed with ASD and assessed the intake of vitamin B6, folic acid, and vitamin B12; serum levels of these vitamins, homocysteine, and methionine; therapeutic interventions using folic acid; and the association between maternal exposure to this vitamin and the risk of ASD. The evidence of insufficient folic acid intake in most individuals with ASD remains consistent in this update. No association was found between maternal exposure to folic acid and the risk of ASD in their children. Despite observed improvements in communication, socialization, and behavior in individuals with ASD following folic acid interventions, it is crucial to consider the individuality and complexity of ASD. Given the relevance of the topic, there remains a need for more high-quality research and clinical trials characterized by rigorous methodological designs.
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Affiliation(s)
- Cristiane Vasconcelos
- Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Ingrid Schweigert Perry
- Food and Nutrition Research Center (CESAN), Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Carmem Gottfried
- Translational Research Group in Autism Spectrum Disorders-GETTEA, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Department of Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- National Institute of Science and Technology on Neuroimmunomodulation (INCT-NIM), Rio de Janeiro, Brazil
- Autism Wellbeing And Research Development (AWARD) Initiative, BR-UK- CA, Porto Alegre, Brazil
| | - Rudimar Riesgo
- Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Translational Research Group in Autism Spectrum Disorders-GETTEA, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Child Neurology Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Kamila Castro
- Postgraduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Food and Nutrition Research Center (CESAN), Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Translational Research Group in Autism Spectrum Disorders-GETTEA, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Child Neurology Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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10
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Cui T, Zhang J, Han Y, Su Y, Li Z, Zhang X. Sensory sensitivity and intelligence are correlated with nutrient deficiency in children with autism spectrum disorder and intellectual disability. Eur J Clin Nutr 2024; 78:286-294. [PMID: 37978257 DOI: 10.1038/s41430-023-01365-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND/OBJECTIVES Relationship between dietary intake and sensory sensitivity and intelligence in autism spectrum disorder (ASD) is not well described. This study aims to investigate nutrition status in children with ASD and ID and its association with sensory sensitivity and intelligence. SUBJECTS/METHODS 84 students (34 ASD and 48 ID) in a special education school were recruited. Dietary intakes were evaluated with 3-day food dairy. Sensory sensitivity was measured using short sensory profile (SSP). Wechsler IQ test were performed. RESULTS Two out of twenty-four investigated nutrients had an adequate intake rate of over 50%. Four out of ten investigated vitamins had an inadequate intake rate of over 90% and another two over 80%. 75.6% of participants had inadequate energy intake. After adjusting for age, ASD participants had a higher intake of all surveyed nutrients but only the intake of vitamin E and folate were statistically different (p < 0.05) along with a smaller number of inadequate nutrients (p < 0.001). Taste/smell sensitivity, movement sensitivity, underresponsive/seeks sensation, and total sensory sensitivity symptoms severity were slightly higher in ASD group than in ID group (all p < 0.05). After adjusting for IQ and sensory sensitivity score, difference of number of inadequate nutrients between ASD and ID group were not statistically significant (p = 0.193). CONCLUSIONS Individuals with ASD had better dietary intake but worse sensory sensitivity compared to those with ID. Sensory sensitivity and intelligence are correlated with nutritional status in individuals with neurodevelopmental disorder.
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Affiliation(s)
- Tingkai Cui
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jingchao Zhang
- Tianjin Medical University Stomatological Hospital, No.12 Qixiangtai Road, 300070, Tianjin, China
| | - Yu Han
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuanyuan Su
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
- Experimental Teaching Center of Preventive Medicine, Tianjin Medical University, Tianjin, China
| | - Zhi Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xin Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, 300070, Tianjin, China.
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China.
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11
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Congiu S, Doneddu G, Fadda R. Attention toward Social and Non-Social Stimuli in Preschool Children with Autism Spectrum Disorder: A Paired Preference Eye-Tracking Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:421. [PMID: 38673332 PMCID: PMC11050167 DOI: 10.3390/ijerph21040421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/24/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024]
Abstract
Different dimensions of visual attention to social (human faces) and non-social stimuli (objects) were assessed in 19 preschool children with Autism Spectrum Disorder (ASD) and 19 typically developing (TD) age, gender, and IQ-matched controls through an original paired preference eye-tracking paradigm. The present study found a significantly reduced attentional bias toward human faces in children with ASD compared to TD controls. The analysis of the total fixation time showed a significantly reduced preference for faces in children with ASD compared to TD children. Moreover, while TD children showed a significant preference for the face over the object, children in the ASD group observed the two paired pictures for a similar amount of time, thus showing no preference. Besides, children with ASD paid significantly more sustained attention to the objects than TD children. Children in the TD group paid greater sustained attention to the faces over the objects, while children in the ASD group did not differentiate between objects and faces. Finally, an age effect was found in ASD, as younger children in the group tended to prefer objects and to show more sustained attention towards them. Overall, these findings add to the literature on anomalies in attention toward social and non-social stimuli in young children with ASD compared to their TD counterparts. These results are discussed in the light of previous studies and suggest possible directions for future research.
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Affiliation(s)
- Sara Congiu
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, 09126 Cagliari, Italy;
| | - Giuseppe Doneddu
- Center for Autism and Related Disorder, Nuovo Centro Fisioterapico Sardo, 09131 Cagliari, Italy;
| | - Roberta Fadda
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, 09126 Cagliari, Italy;
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12
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Smolko NA, Valiev RI, Kabdesh IM, Fayzullina RA, Mukhamedshina YO. Eating disorder in children: Impact on quality of life, with a spotlight on autism spectrum disorder. Nutr Res 2024; 123:38-52. [PMID: 38241984 DOI: 10.1016/j.nutres.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 12/18/2023] [Accepted: 12/18/2023] [Indexed: 01/21/2024]
Abstract
Eating behavior, which includes eating habits and preferences, frequency of eating, and other features related to diet, is a major characteristic not only of a person's nutritional status, but also of health in general. In recent years, the prevalence of eating disorders in children has tended to increase; they also require cross-system approaches in diagnosis by a variety of specialists and correction requires appropriate selection of optimal methods. Maladaptive eating attitudes formed at an early age can contribute to the formation of eating disorders, which can lead to or worsen various neuropsychiatric diseases, digestive diseases, and other related conditions. In children with autism spectrum disorder (ASD), eating disorders often appear earlier than other major symptoms of the condition. However, the clinical manifestations of eating disorders in children with ASD are varied and differ in severity and duration, whereas these disorders in neurotypical children might present as short-lived and may not lead to serious consequences. Nevertheless, cases of progressive eating disorders accompanied by a child presenting as under- or overweight and/or with macronutrient and micronutrient deficiencies cannot be excluded. Given the high prevalence of eating disorders in children, many researchers have highlighted the lack of a valid and universally accepted instruments to assess atypical eating behaviors in this population. Therefore, in this review, we wanted to highlight the problems and causes of eating disorders in children, and also to analyze the existing approaches to the validation of these problems, taking into account the existing behavioral features in children with ASD.
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Affiliation(s)
- Natalia A Smolko
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia; Department of Propaedeutics of Pediatric Diseases and Faculty Pediatrics, Kazan State Medical University, Kazan, Russia
| | - Rushan I Valiev
- Department of General Hygiene, Kazan State Medical University, Kazan, Russia
| | - Ilyas M Kabdesh
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia.
| | - Rezeda A Fayzullina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia; Department of Propaedeutics of Pediatric Diseases and Faculty Pediatrics, Kazan State Medical University, Kazan, Russia
| | - Yana O Mukhamedshina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia; Department of Histology, Cytology and Embryology, Kazan State Medical University, Kazan, Russia
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13
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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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14
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Dixon CJ, Ethridge BA, Tillman AP, Sugg JH. Self-Restricted Diet in Pediatric Autism Leading to Vitamin A Deficiency and Severe Photophobia. Cureus 2024; 16:e54618. [PMID: 38523918 PMCID: PMC10959461 DOI: 10.7759/cureus.54618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 02/21/2024] [Indexed: 03/26/2024] Open
Abstract
In developed countries, vitamin A deficiency (VAD) remains rare but is a leading cause of global blindness. We describe the case of a 10-year-old girl with autism spectrum disorder (ASD) initially presenting mild VAD symptoms, escalating to severe photophobia and reluctance to leave a darkened room due to a self-restricted diet of fast-food french fries. A timely examination revealed severe VAD and vitamin A supplementation resolved her symptoms in three weeks. This case highlights the challenge of obtaining accurate patient history in ASD, emphasizing the need for routine dietary discussions and micronutrient testing, especially at ages nine and 13 when the United States Department of Agriculture (USDA) recommends increased vitamin A intake. Early intervention can prevent micronutrient deficiencies in pediatric patients, particularly those with ASD.
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Affiliation(s)
- Cory J Dixon
- Department of Research, Alabama College of Osteopathic Medicine, Dothan, USA
| | - Britton A Ethridge
- Department of Research, Alabama College of Osteopathic Medicine, Dothan, USA
| | - Aaron P Tillman
- Department of Research, Alabama College of Osteopathic Medicine, Dothan, USA
| | - Joseph H Sugg
- Department of Ophthalmology, Eye Surgical Associates, Dothan, USA
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15
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Aspragkathou DD, Spilioti MG, Gkampeta A, Dalpa E, Holeva V, Papadopoulou MT, Serdari A, Dafoulis V, Zafeiriou DI, Evangeliou AE. Branched-chain amino acids as adjunctive-alternative treatment in patients with autism: a pilot study. Br J Nutr 2024; 131:73-81. [PMID: 37424284 DOI: 10.1017/s0007114523001496] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
The branched-chain amino acid (BCAA) is a group of essential amino acids that are involved in maintaining the energy balance of a human being as well as the homoeostasis of GABAergic, glutamatergic, serotonergic and dopaminergic systems. Disruption of these systems has been associated with the pathophysiology of autism while low levels of these amino acids have been discovered in patients with autism. A pilot open-label, prospective, follow-up study of the use of BCAA in children with autistic behaviour was carried out. Fifty-five children between the ages of 6 and 18 participated in the study from May 2015 to May 2018. We used a carbohydrate-free BCAA-powdered mixture containing 45·5 g of leucine, 30 g of isoleucine and 24·5 g of valine in a daily dose of 0·4 g/kg of body weight which was administered every morning. Following the initiation of BCAA administration, children were submitted to a monthly psychological examination. Beyond the 4-week mark, BCAA were given to thirty-two people (58·18 %). Six of them (10·9 %) discontinued after 4-10 weeks owing to lack of improvement. The remaining twenty-six children (47·27 %) who took BCAA for longer than 10 weeks displayed improved social behaviour and interactions, as well as improvements in their speech, cooperation, stereotypy and, principally, their hyperactivity. There were no adverse reactions reported during the course of the treatment. Although these data are preliminary, there is some evidence that BCAA could be used as adjunctive treatment to conventional therapeutic methods for the management of autism.
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Affiliation(s)
- Despoina D Aspragkathou
- Department of Pediatrics, Aristotle University of Thessaloniki, Medical School, Papageorgiou Hospital, Efkarpia, 56403Thessaloniki, Greece
| | - Martha G Spilioti
- Department of Neurology, Aristotle University of Thessaloniki, Medical School, AHEPA Hospital, Thessaloniki, Greece
| | - Anastasia Gkampeta
- Department of Pediatrics, Aristotle University of Thessaloniki, Medical School, Papageorgiou Hospital, Efkarpia, 56403Thessaloniki, Greece
| | - Efterpi Dalpa
- Department of Pediatrics, Aristotle University of Thessaloniki, Medical School, Papageorgiou Hospital, Efkarpia, 56403Thessaloniki, Greece
| | - Vasiliki Holeva
- Psychiatric Clinic, Papageorgiou Hospital, Aristotle University of Thessaloniki, Medical School, Thessaloniki, Greece
| | - Maria T Papadopoulou
- Department of Pediatrics, Aristotle University of Thessaloniki, Medical School, Papageorgiou Hospital, Efkarpia, 56403Thessaloniki, Greece
| | - Aspasia Serdari
- Psychiatric Clinic, University Hospital of Alexandroupolis, Thrace University, Medical School, Alexandroupolis, Greece
| | - Vaios Dafoulis
- Psychiatric Clinic of the Hippokration Hospital, Thessaloniki, Greece
| | - Dimitrios I Zafeiriou
- Department of Pediatrics, Aristotle University of Thessaloniki, Medical School, Hippokration Hospital, Thessaloniki, Greece
| | - Athanasios E Evangeliou
- Department of Pediatrics, Aristotle University of Thessaloniki, Medical School, Papageorgiou Hospital, Efkarpia, 56403Thessaloniki, Greece
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16
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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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17
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Hielscher L, Irvine K, Ludlow AK, Rogers S, Mengoni SE. A Scoping Review of the Complementary Feeding Practices and Early Eating Experiences of Children With Down Syndrome. J Pediatr Psychol 2023; 48:914-930. [PMID: 37738668 PMCID: PMC10653358 DOI: 10.1093/jpepsy/jsad060] [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: 04/14/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVE Children with Down syndrome may experience more challenges in their early feeding and may be introduced to complementary foods comparatively later than typically developing (TD) children. This scoping review aimed to identify and synthesize the existing literature that describes feeding problems and early eating experiences relating to the period of complementary feeding for children with Down syndrome. METHODS Scopus, PubMed, Medline, Web of Science, and PsycInfo were searched. Journal articles published between January 1991 and June 2022 that reported on the complementary feeding period with children with Down syndrome were included. RESULTS Eighteen journal articles met the inclusion criteria. Children with Down syndrome were introduced to complementary foods later than TD children and progressed to more challenging food textures at a slower rate. Gross and fine motor skill delays and sensory difficulties contributed to secondary feeding problems such as difficulties chewing, biting, and reduced awareness of food on lips and tongue. Parents of children with Down syndrome reported exercising more caution and employing more controlling feeding practices compared to TD and had higher levels of concern regarding their child's weight. CONCLUSIONS Guidelines and early feeding support specific to children with Down syndrome should be available before the first complementary foods are introduced and throughout this period. Feeding support should aim to address parental concerns and provide assistance when feeding problems occur, to minimize delays and encourage the optimum development of eating abilities. Future research should address the development of feeding problems during this period and explore possible interventions.
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Affiliation(s)
- Laura Hielscher
- Department of Psychology, Sport and Geography, University of Hertfordshire, UK
| | - Karen Irvine
- Department of Psychology, Sport and Geography, University of Hertfordshire, UK
| | - Amanda K Ludlow
- Department of Psychology, Sport and Geography, University of Hertfordshire, UK
| | - Samantha Rogers
- Department of Psychology, Sport and Geography, University of Hertfordshire, UK
| | - Silvana E Mengoni
- Department of Psychology, Sport and Geography, University of Hertfordshire, UK
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18
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Byrska A, Błażejczyk I, Faruga A, Potaczek M, Wilczyński KM, Janas-Kozik M. Patterns of Food Selectivity among Children with Autism Spectrum Disorder. J Clin Med 2023; 12:5469. [PMID: 37685537 PMCID: PMC10488249 DOI: 10.3390/jcm12175469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/06/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Autism spectrum disorder (ASD) is a heterogeneous group of neurodevelopmental disorders characterized by food selectivity in a significant portion of the population. The nature of this selectivity remains unclear, with hypotheses suggesting associations with sensory disorders or stereotypical and repetitive patterns of activity and interests. This study aimed to determine the prevalence and nature of food selectivity traits in individuals with ASD compared with the neurotypical population. This study involved 219 participants, with 115 diagnosed with autism and 92 without. Twelve children undergoing diagnosis were excluded from the analyses. The findings revealed that food selectivity traits are more common in individuals with ASD, with differences in preferences mainly involving structure, color, taste, and serving method. Children with ASD had more food selectivity traits than those without, and the intake of certain food characteristics could be altered as they grow. Selectivity occurred for both sensory and stereotypical reasons, but stereotypical features significantly differentiated neurotypical individuals from those with ASD.
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Affiliation(s)
- Anna Byrska
- Student’s Scientific Association, Department of Psychiatry and Psychotherapy of Developmental Age, Medical University of Silesia, 40-055 Katowice, Poland
| | - Idalia Błażejczyk
- Student’s Scientific Association, Department of Psychiatry and Psychotherapy of Developmental Age, Medical University of Silesia, 40-055 Katowice, Poland
| | - Anna Faruga
- Student’s Scientific Association, Department of Psychiatry and Psychotherapy of Developmental Age, Medical University of Silesia, 40-055 Katowice, Poland
| | - Maria Potaczek
- Student’s Scientific Association, Department of Psychiatry and Psychotherapy of Developmental Age, Medical University of Silesia, 40-055 Katowice, Poland
| | - Krzysztof M. Wilczyński
- John Paul 2nd Child and Family Health Center in Sosnowiec Sp. z o.o., 41-218 Sosnowiec, Poland
- Department of Psychiatry and Psychotherapy of Developmental Age, Medical University of Silesia, 40-055 Katowice, Poland
| | - Małgorzata Janas-Kozik
- John Paul 2nd Child and Family Health Center in Sosnowiec Sp. z o.o., 41-218 Sosnowiec, Poland
- Department of Psychiatry and Psychotherapy of Developmental Age, Medical University of Silesia, 40-055 Katowice, Poland
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19
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Cerchiari A, Giordani C, Franceschetti S, Mazzafoglia S, Carosi F, Pizza F, Bella GD, Raponi M, Tofani M. The Efficacy of the Global Intensive Feeding Therapy on Feeding and Swallowing Abilities in Children with Autism Spectrum Disorder: A Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1241. [PMID: 37508738 PMCID: PMC10377905 DOI: 10.3390/children10071241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023]
Abstract
The present investigation aims to explore the efficacy of Global Intensive Feeding Therapy (GIFT) on feeding and swallowing abilities in children with autism spectrum disorder (ASD). GIFT was developed as an intensive rehabilitation approach, divided into 30 sessions for 2 weeks, three times a day. GIFT focused on (a) encouraging desensitization; (b) widening the food repertoire (in terms of both variety and quantity); (c) reducing inappropriate mealtime behaviors; and (d) encouraging the development of appropriate chewing and swallowing abilities. GIFT was preliminarily implemented among 11 children with a diagnosis of ASD. To measure the efficacy of GIFT, the Karaduman Chewing Performance Scale (KCPS), the Brief Autism Mealtime Behavior Inventory (BAMBI), and food repertoire were investigated using Wilcoxon signed-rank test in three different times: baseline (T1), after treatment (T2), and one month after treatment (T3). Using Bonferroni correction, statistically significant differences were found between T1 and T2 for behavioral issues, as measured with BAMBI (p = 0.007), as well as for chewing abilities as measured with KCPS (p = 0.005) and for food acceptance (p = 0.005). These improvements were maintained after a month of follow-up, thanks to the collaboration of families and/or primary caregivers. In conclusion, GIFT seems to be an effective approach to improving behavioral issues, food acceptance, and chewing abilities in children with ASD.
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Affiliation(s)
- Antonella Cerchiari
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Carolina Giordani
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Silvia Franceschetti
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Serena Mazzafoglia
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Flavia Carosi
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Francesca Pizza
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Gessica Della Bella
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Massimiliano Raponi
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Medical Directorate, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Marco Tofani
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Professional Development, Continuous Education and Research Service, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
- Department of Human Neurosciences, Sapienza University of Rome, 00183 Rome, Italy
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20
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Derbyshire E, Maes M. The Role of Choline in Neurodevelopmental Disorders-A Narrative Review Focusing on ASC, ADHD and Dyslexia. Nutrients 2023; 15:2876. [PMID: 37447203 DOI: 10.3390/nu15132876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Neurodevelopmental disorders appear to be rising in prevalence, according to the recent Global Burden of Disease Study. This rise is likely to be multi-factorial, but the role of certain nutrients known to facilitate neurodevelopment should be considered. One possible contributing factor could be attributed to deficits in choline intake, particularly during key stages of neurodevelopment, which includes the first 1000 days of life and childhood. Choline, a key micronutrient, is crucial for optimal neurodevelopment and brain functioning of offspring. The present narrative review discusses the main research, describing the effect of choline in neurodevelopmental disorders, to better understand its role in the etiology and management of these disorders. In terms of findings, low choline intakes and reduced or altered choline status have been reported in relevant population subgroups: pregnancy (in utero), children with autism spectrum disorders, people with attention deficit hyperactivity disorder and those with dyslexia. In conclusion, an optimal choline provision may offer some neuronal protection in early life and help to mitigate some cognitive effects in later life attributed to neurodevelopmental conditions. Research indicates that choline may act as a modifiable risk factor for certain neurodevelopmental conditions. Ongoing research is needed to unravel the mechanisms and explanations.
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Affiliation(s)
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok 4002, Thailand
- Research Institute, Medical University of Plovdiv, 10330 Plovdiv, Bulgaria
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Opoku MP, Anwahi N, Belbase S, Shah H, Alkateri T, Moustafa A. Accessibility of nutritional services for children with autism spectrum disorder in the United Arab Emirates: Insights from special education teachers and parents. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 138:104521. [PMID: 37148575 DOI: 10.1016/j.ridd.2023.104521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 04/08/2023] [Accepted: 04/30/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Goal 2 of United Nation's Sustainable Development Goals exhorts countries to provide guidelines on better nutrition for all children. In response, the United Arab Emirates (UAE) government designed a national nutrition framework to encourage better eating habits. However, large body of literature has reported that children with ASD are at high risks of malnutrition and poor eating habits. Yet, in the UAE and other contexts, there is limited research on accessibility of nutritional services to adults in the lives of children with ASD. AIMS As parents and teachers spend the most time with children with ASD, this study sought to understand their perceptions of the availability of nutritional services for such children in the UAE. METHOD AND PROCEDURES Penchansky and Thomas' (1981) health access theory served as the theoretical framework; its five tenets (geography, finance, accommodation, resources and acceptability) informed the design of a semi-structured interview guide. Data were collected from 21 participants, comprising 6 parents and 15 teachers of children with ASD. OUTCOMES AND RESULTS Thematic analysis revealed that participants perceived accommodation, acceptability, and human resource availability as barriers to accessibility. However, geographical and financial accessibility were not identified as challenges. CONCLUSIONS AND IMPLICATIONS The study calls for health policymakers to formalise nutritional services as an integrated part of the UAE health system, while also extending services to children with ASD. CONTRIBUTION This study makes a substantial contribution to the literature. First, it addresses the needs for nutritional services for children with ASD. There is a limited body of knowledge on whether children with ASD have access to the requisite nutrition for development This study sheds light on an area that has received limited scholarly insight. Second, it adds to the usage of health access theory in studies on nutritional services for children with ASD.
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Affiliation(s)
- Maxwell Peprah Opoku
- Special Education Department, United Arab Emirates University, Al-Ain, United Arab Emirates.
| | - Noora Anwahi
- Special Education Department, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Shashidhar Belbase
- Curriculum and Method of Instruction, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Haseena Shah
- Special Education Department, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Thara Alkateri
- Special Education Department, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Ashraf Moustafa
- Special Education Department, United Arab Emirates University, Al-Ain, United Arab Emirates
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