Study on Aberrant Eating Behaviors, Food Intolerance, and Stereotyped Behaviors in Autism Spectrum Disorder.

Chunyan Li,Yang Liu,Ting Xiao,Mengyao Zhai,Jiao Weng,Xiaoyan Ke,Hui Fang,Yu Chen

doi:10.3389/fpsyt.2020.493695

Abstract

Objective: To investigate the aberrant eating behaviors (EBs), gastrointestinal (GI) symptoms, and food intolerance in children with autism spectrum disorder (ASD) and their association with clinical core symptoms of ASD.Method: A total of 94 preschool children with ASD treated at the Child Mental Health Research Center of Nanjing Brain Hospital between October 2016 and April 2018 were enrolled. In addition, 90 children with typical development (TD) in the community during the same period were recruited. The conditions of aberrant EBs and GI symptoms in children were investigated using questionnaire surveys. Serum specific IgG antibodies against 14 kinds of food were detected using enzyme-linked immunosorbent assays (ELISAs).Results: The detection rate of aberrant EBs in the ASD group was significantly higher than that in the TD group (67.39 vs. 34.94%), and the rate of GI symptoms was also higher in the ASD group than that in the TD group (80.22 vs. 42.11%). Detection of food intolerance in children with ASD showed that the positive rate was 89.89% and that the majority of children had multiple food intolerances. The correlation analysis results showed that the severity of aberrant EBs positively correlated with stereotyped behavior of children with ASD (r = 0.21, P = 0.04) and that food-specific IgG antibodies concentrations positively correlated with high-level stereotyped behavior in children with ASD (r = 0.23, P = 0.03).Conclusion: ASD with aberrant EBs or high food-specific IgG antibodies concentrations had more severe stereotyped behavior, which may have implications for exploring the immune mechanism of ASD.Clinical Trial Registration: ChiCTR-RPC-16008139.

Highlights

It has been more than 70 years since the American child psychiatrist Leo Kanner first formally reported and described infantile autism in 1943 [1]
Child refuses food based on type, refuses food based on texture, and feeding difficulties were the top 3 eating behaviors (EBs) in the autism spectrum disorder (ASD) group
The results showed that 89.89% (80 children) of children with ASD had at least one food intolerance item, of which children with 6 food intolerance items accounted for 4.49% (4 children), children with 5 food intolerance items accounted for 2.25% (2 children), children with 4 food intolerance items accounted for 16.85% (15 children), children with 3 food intolerance items accounted for 22.71% (22 children), children with 2 food intolerance items accounted for 22.71% (22 children), and children with only one food intolerance item accounted for 18.00% (16 children)

Summary

Introduction

It has been more than 70 years since the American child psychiatrist Leo Kanner first formally reported and described infantile autism in 1943 [1]. In addition to 2 major core symptoms, social communication disorders and stereotyped and repetitive interests and behaviors, there are many accompanied symptoms such as aberrant eating behaviors (EBs), gastrointestinal (GI) symptoms, food intolerance, sleep disorder, epilepsy, and attention deficit hyperactivity disorder. These accompanied symptoms increase difficulties in the clinical diagnosis of ASD and increase the complexity of ASD treatment. In 2013, Chandler surveyed GI symptoms in 132 children with ASD aged between 10 and 14 years and showed that the incidence rate of GI symptoms in children with ASD was 46.5% and significantly increased compared to that in the normal adolescent population, GI symptoms did not correlate with the severity of ASD clinical symptoms [6]

Methods

Results

Conclusion