Abstract
Abnormalities in folate-dependent one-carbon metabolism have been reported in many children with autism. Because inadequate choline and betaine can negatively affect folate metabolism and in turn downstream methylation and antioxidant capacity, we sought to determine whether dietary intake of choline and betaine in children with autism was adequate to meet nutritional needs based on national recommendations. Three-day food records were analyzed for 288 children with autism (ASDs) who participated in the national Autism Intervention Research Network for Physical Health (AIR-P) Study on Diet and Nutrition in children with autism. Plasma concentrations of choline and betaine were measured in a subgroup of 35 children with ASDs and 32 age-matched control children. The results indicated that 60–93% of children with ASDs were consuming less than the recommended Adequate Intake (AI) for choline. Strong positive correlations were found between dietary intake and plasma concentrations of choline and betaine in autistic children as well as lower plasma concentrations compared to the control group. We conclude that choline and betaine intake is inadequate in a significant subgroup of children with ASDs and is reflected in lower plasma levels. Inadequate intake of choline and betaine may contribute to the metabolic abnormalities observed in many children with autism and warrants attention in nutritional counseling.
Highlights
Autism is a complex, behaviorally-defined neurodevelopmental disorder characterized by significant impairments in social interaction, verbal and nonverbal communication, and by restrictive, repetitive, and stereotypic patterns of behavior
Nutritional data on choline and betaine intake from food was obtained from 288 children with Autism spectrum disorders (ASDs) who participated in the Autism Intervention Research Network for Physical Health (AIR-P) Study on Diet and Nutrition in Children with Autism and they were recruited from four national sites including Pittsburg, Pennsylvania, Little Rock, Arkansas, Rochester, New York, and Denver, Colorado
Dietary deficits in both pathways for methionine synthesis may be compromised in children with ASDs and additively contribute to the low methionine and SAM levels previously reported in these children [8,9,10]
Summary
Behaviorally-defined neurodevelopmental disorder characterized by significant impairments in social interaction, verbal and nonverbal communication, and by restrictive, repetitive, and stereotypic patterns of behavior. The Centers for Disease Control estimates that the current prevalence of autism spectrum disorders (ASD) in the United States is 1 in 110 children [1]. Nutritional screening and assessment of children with ASDs is an important clinical consideration for several reasons. These children often exhibit nutrition-related medical issues including gastrointestinal discomfort, bowel inflammation, diarrhea, constipation, and acid reflux [1]. Abnormal sensory processing can affect taste and texture perception leading to food avoidance and restricted food intake in many children with ASD. Children with ASDs have multiple risk factors that may increase the prevalence of nutrient deficiencies in this population
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