Food selectivity (i.e., consuming a narrow range of food by type, texture, and/or presentation) is often cited among children with ASD. Typically, children with ASD have strong preferences for carbohydrates, snacks, and/or processed foods and rejection of fruits and vegetables. Little is known, however, regarding the impact of selective eating patterns on the nutritional status of children with ASD. Children with ASD often have appropriate caloric intake; therefore, analysis on the macro- and micro-nutrient level is indicated. Provisional evidence suggests food selectivity in ASD may result in nutrient inadequacy and that this risk may not be unique to the diagnosis, although more research is needed to determine the relationship between dietary patterns and nutrient status among selective eaters with and without ASD.
Our goal was to examine the dietary variety, nutrition status and anthropometric parameters among a group of children with and without autism spectrum disorders (ASD) referred to a feeding program for the evaluation and treatment of food selectivity.
We conducted a retrospective chart review of children with food selectivity seen at an interdisciplinary feeding disorders program over a 2 year time period. We identified a total of 86 children and divided the sample into children with and without ASD. Data collection focused on dietary variety by food group (i.e., meats, starches, fruits, vegetables, and dairy), nutrient intake (calories, calcium, vitamins A, C, D, & E, iron, zinc, fiber, & protein), and anthropometric status (weight, height, % ideal body weight). Descriptive (mean, standard deviation, range) and inferential statistics (t tests, odd ratio) are presented.
Children with ASD consumed significantly fewer foods in the dairy group, but a similar number of meats, starches, fruits and vegetables compared to children who presented with food selectivity who do not have an ASD diagnosis. Consistent with this pattern of intake, the ASD group was significantly more likely to have deficits in calcium. Children without ASD were found to be at greater risk for inadequate fiber intake. No significant group differences were detected in the number of children identified as deficient in calories, vitamins A, C, D, E, iron, zinc, or protein. The two groups were similar in terms of weight and percent of ideal body weight, although the ASD group was significantly taller.
Findings suggest children with ASD and food selectivity may consume fewer foods from the dairy group and be at an increased risk for calcium deficiency, while children without ASD are more likely to have deficits in fiber. The source of the observed effect remains unclear, with possible contributors including unique patterns of food selectivity and/or greater likelihood of parent-mediated dietary restrictions targeting dairy. Implications for assessment and treatment of food selectivity in ASD, as well as parent consultation regarding dietary manipulation are discussed.
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