Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder triggered by several factors, including those of genetic and environmental nature. ASD can alter communication, behavior, and children's nutritional status, placing them at high risk for nutritional imbalances. Therefore, this study aims to assess preschool autistic children's nutritional status as compared to that of Typically Developing (TD) children of the same age. The study also revealed some of the ASD risk factors among the Jordanian population. It included 52 ASD and 51 TD children (3–6 years), and considered sociodemographic, obstetric, and nutritional factors of the two groups, stratified by gender. Nutritional status was evaluated through a comprehensive questionnaire, 3-day food record, and anthropometric and biochemical measurements. Differences between groups were identified using the chi-square and independent-sample t-test. The logistic regression model was used after the adjustment of confounders to detect an autistic child's determinants. The study showed little difference between ASD and TD children with respect to nutrients' intake inadequacy and biochemical-nutritional deficiencies, but did reveal gender-based differences. Autistic girls were at higher risk of inadequate carbohydrate intake, while autistic boys were at higher risk of inadequate vitamin E, vitamin K, and fluoride compared to TD children. More autistic children had been treated in neonatal care units after birth than had TD children. The regression analysis revealed that lower maternal education level (OR, 12.25; 95% CI, 1.18–126.91), vaginal delivery (OR, 0.273; 95% CI, 0.105–0.712), family history of autism (OR, 0.189; 95% CI, 0.059–0.612), and taking dietary supplements during pregnancy (OR, 4.665; 95% CI, 1.158–18.79) were all determinants of ASD in children. In conclusion, maternal nutrition, postnatal conditions, and nutritional status might be contributors to ASD in children. Pre-school children are at high risk for developing nutritional deficiencies. It is therefore important to maintain optimal nutritional status in pregnant patients, and in children after delivery and during early childhood. Future studies that investigate the role of nutrient deficiencies and nutritional interventions in ASD are necessary. Also required are studies that focus on gender differences in the prevalence of ASD, types and severity of symptoms, and ASD nutrition-related problems.
Highlights
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by lack of social and emotional interactions [1], repetitive behaviors, and restricted verbal and non-verbal linguistic skills [2]
Some pregnancy-related factors are presented in Table 3; the results indicated that more ASD children were born through cesarean section compared to Typically Developing (TD) children (55.8 vs. 27.5%, P = 0.004)
The results showed higher rates of inadequacy of vitamin B2 and vitamin B6 intake among ASD boys compared to TD boys, while more ASD girls failed to meet the daily needs of pantothenic acid, and biotin compared to TD girls
Summary
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by lack of social and emotional interactions [1], repetitive behaviors, and restricted verbal and non-verbal linguistic skills [2]. During the past several years, the number of ASD cases has increased, with a prevalence of 62 per 10,000 and a higher occurrence in boys compared to girls (ratio of 5:1) [3, 4]. Many ASD children suffer from multiple nutrition-related issues such as maldigestion, malabsorption [8], abnormal fatty acid and amino acid metabolism, or multiple food intolerances [9]. ASD children display eating problems, food selectivity and increased refusal of new food items, which could place them at greater risk for nutritional excess or/and deficiencies [10, 11]. Inadequacies of several nutrients were reported in ASD children were reported [12]. A comprehensive array of symptoms in the digestive tract in ASD children suggest the need for introducing nutritional interventions that could decreasing some ASD symptoms that may be associated with imbalanced nutrient intake and/or utilization [13,14,15]
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