Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with increasing incidence. An expanding body of literature is examining connections between ASD and dietary interventions. Existing reports suggest a beneficial effect of ketogenic dietary therapies (KDTs) in improving behavioral symptoms in ASD. In this context, the purpose of this scoping review was to identify and map available evidence in the literature about the feasibility and potential efficacy of KDTs in pediatric patients with ASD and to inform clinical practice in the field. Moreover, based on the resulting data from the literature review, we aimed to provide a shared protocol to develop a personalized KDT intervention in patients with ASD. A comprehensive and structured web-based literature search was performed using PubMed and Scopus and it yielded 203 records. Seven papers were finally selected and included in the review. Data were abstracted by independent coders. High variability was identified in study designs and dietary aspects emerged among selected studies. Results supported the effectiveness of KDTs in promoting behavioral improvements. Clinical recommendations on which patients may benefit most from KDTs implementation and difficulties in dietary adherence were discussed.
Highlights
Autism spectrum disorder (ASD) represents a heterogeneous neurodevelopmental disorder encompassing a complex range of lifelong abnormal social interactions, communication deficits, and repetitive and restricted behaviors [1]
Our scoping review aimed to provide a snapshot of the current state of application of
One study was designed as a randomized controlled trial, which compared the effect of two different interventions (MAD and GF/CF) versus normal diet [29]
Summary
Autism spectrum disorder (ASD) represents a heterogeneous neurodevelopmental disorder encompassing a complex range of lifelong abnormal social interactions, communication deficits, and repetitive and restricted behaviors [1]. International epidemiological studies report a generalized increase in the prevalence of ASD. 1% to be a conservative median worldwide figure for ASD prevalence [2]. Diagnosis and monitoring are based on clinical criteria and may incorporate standardized scales [1]. Behavioral interventions, directed both at the patient and the “significant others” (i.e., parents, teachers, caregivers), are considered the basic treatment option [3]. Several studies have tried to show a possible relationship between dietary habits and autism, starting from the fact that gastrointestinal problems are the most frequent medical comorbidity of ASD [7]. Dietary interventions have been mainly based on an “elimination diet,”
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