Abstract
ABSTRACTObjective: To identify and analyze the scientific evidence of nutritional interventions performed in children and adolescents with Autism Spectrum Disorder.Data sources: A systematic review was conducted in the MEDLINE, Cochrane Library, Embase, LILACS, Google Scholar, PubMed, PsycINFO and Periódicos CAPES databases, using a search strategy to identify studies published between January 2003 and March 2018, in Portuguese, English and Spanish. Were included studies that described nutritional interventions in children and adolescents with autism spectrum disorders and assessed autistic behavior and/or gastrointestinal symptoms. We excluded other review articles and studies that did not include a control group in the research design. The studies were reviewed for descriptive information, and the quality of evidence was assessed through the GRADE system.Data synthesis: 18 studies were included in the review, being 16 randomized clinical trials, 1 case-control study and 1 open-label trial. As a result, the implementation of a gluten-free and casein-free diet was the most used intervention among the studies. Of the total, 10 studies showed a positive association of intervention with the evaluated results, while 8 did not find of a significant association.Conclusions: Although some authors report progress in the symptoms associated with autism in individuals with Autistic Spectrum Disorder undergoing nutritional interventions, there is little scientific evidence to support the use of nutritional supplements or dietary therapies in children and adolescents with autism.
Highlights
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that encompasses Autism, Rett Syndrome, Asperger’s Syndrome, childhood disintegrative disorder, and global developmental disorder without further specification
In an attempt to explain the pathophysiology involved in autism and help with making diagnoses, several studies have investigated changes in physiology and different biomarkers in subjects with ASD
The articles were evaluated according to the GRADE System: six articles were classified in category A,16,18,19,28-30 showing low risk of bias and highly reliable evidence; ten articles were in category B, 9,17,20,22-27,31 with moderate risk of bias and reliable evidence; and two articles were in category C,16,21 indicating a high risk of bias and poor quality of evidence
Summary
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that encompasses Autism, Rett Syndrome, Asperger’s Syndrome, childhood disintegrative disorder, and global developmental disorder without further specification. Evidence suggests the involvement of diverse genetic defects in conjunction with environmental and biological factors.[4,5] In an attempt to explain the pathophysiology involved in autism and help with making diagnoses, several studies have investigated changes in physiology and different biomarkers in subjects with ASD. Through these studies, it was observed that individuals with ASD had several biological changes, such as a greater circulation of inflammatory cytokines, modifications and nonspecific intestinal inflammation, in addition to high concentrations of amino acids and peptides from food in the blood, cerebrospinal fluid and urine, leading to a theory about the connection between autism and problems in metabolizing substances from food.[3]
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