Abstract
Children with autism spectrum disorders (ASD) have several risk factors for low bone mineral density. The gluten-free, casein-free (GFCF) diet is a complementary therapy sometimes used in ASD that raises concerns for the adequacy of calcium and vitamin D intake. This study evaluated the prescribing practices of calcium and vitamin D supplements and the practice of checking 25-hydroxy vitamin D (25(OH)D) levels by providers in 100 children with ASD, 50 of whom were on the GFCF diet. Fifty-two percent and 46% of children on the GFCF diet were on some form of vitamin D and calcium supplements, respectively, compared to 18% and 14% of those not on this diet. Twenty-four percent of children in the GFCF group had a documented 25(OH)D level compared to none in the non-GFCF group. The data highlight a gap in calcium and vitamin D supplement prescribing practices among providers caring for children with ASD as well as a gap in the practice of checking 25(OH)D levels.
Highlights
Autism spectrum disorder (ASD) is a developmental disorder with various degrees of severity that can cause significant social, communication, and behavioral challenges
Forty-six percent of subjects who were on the GFCF diet were taking or prescribed calcium supplementation in comparison with 14% in the non-GFCF group (Figure 1)
Compared to children on a non-GFCF diet, children on the GFCF diet were more likely to be taking vitamin D [OR 4.94, 95% CI (1.99–12.26), and p = 0.0006] and calcium supplements [OR 5.23, 95% CI (2.63–10.41), and p < 0.0001]
Summary
Autism spectrum disorder (ASD) is a developmental disorder with various degrees of severity that can cause significant social, communication, and behavioral challenges. Factors that affect bone accrual in childhood include genetics, nutritional status, calcium and vitamin D intake, weight bearing activity, hormonal alterations, and the use of certain medications [2]. A systematic review of studies published from 1970 to 2014 related to the GFCF diet in ASD patients showed that the evidence on this topic is currently limited and weak [3]. This diet continues to be used by children with ASD, largely based on anecdotal evidence for improvement
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