Gastrointestinal Symptoms and Feeding Problems and Their Associations with Dietary Interventions, Food Supplement Use, and Behavioral Characteristics in a Sample of Children and Adolescents with Autism Spectrum Disorders.

Katarina Babinska,Dagmar Nemcsicsova,Iveta Waczulikova,Ivan Belica,Hana Celusakova,Daniela Ostatnikova,Zofia Szapuova,Aleksandra Tomova

doi:10.3390/ijerph17176372

Katarina Babinska, Dagmar Nemcsicsova + Show 6 more

Open Access

https://doi.org/10.3390/ijerph17176372

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Abstract

Autism spectrum disorders (ASD) are characterized by impairments in social interaction, communication, and restricted, stereotyped behavior. Gastrointestinal (GI), nutritional, and feeding problems are often reported in ASD. We investigated the prevalence of GI symptoms, food selectivity, and mealtime difficulties, and their associations with dietary interventions, food supplement use, and behavioral characteristics in a sample involving 247 participants with ASD and 267 controls aged 2–18 years. Data were collected by a questionnaire. GI symptoms were observed in 88.9% of children and adolescents with ASD, more often in girls than in boys. High rates of food selectivity (69.1%) and mealtime problems (64.3%) were found. Food supplements were used by 66.7% of individuals, mainly vitamins/minerals, probiotics, and omega-3 fatty acids. In the ASD sample, 21.2% of subjects followed a diet, mostly based on gluten and milk restriction, including individuals exhibiting food selectivity. Frequency of GI symptoms, food selectivity, and mealtime problems correlated weakly, but significantly with behavioral characteristics in the ASD group, but not with food supplement use. The study demonstrated that higher frequency of GI symptoms, food selectivity, and mealtime problems are a common problem in pre-schoolers, schoolchildren, and adolescents with ASD, and together with dietary modification, they are significantly associated with ASD.

Highlights

Autism spectrum disorders (ASD) are lifelong neurodevelopmental disorders characterized by the core symptoms that include impairments of social communication, social interaction, and restricted or repetitive patterns of behavior, interests, and activities [1]
We found that 88.7% of subjects with ASD and 79.0% of controls experienced gastrointestinal symptoms in last 3 months (χ2 = 8.7, p = 0.003)
We further explored pairwise linear correlations (Table 8) focused on the strength of association between GI symptoms, food selectivity, mealtime problems, dietary intervention, food supplement use, and behavioral characteristics of the children with ASD

Summary

Introduction

Autism spectrum disorders (ASD) are lifelong neurodevelopmental disorders characterized by the core symptoms that include impairments of social communication, social interaction, and restricted or repetitive patterns of behavior, interests, and activities [1]. The term “spectrum” refers to heterogeneity in the clinical manifestation and severity of ASD symptoms, as well as intellectual capacity, daily adaptive functioning, or other phenotypic characteristics [2]. The phenotypic heterogeneity seems to reflect etiological heterogeneity; according to current concepts, ASD are a multifactorial disease with. Res. Public Health 2020, 17, 6372; doi:10.3390/ijerph17176372 www.mdpi.com/journal/ijerph

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