Continuous and Extreme Autistic Trait Ratings Are Associated with Avoidance of Alcoholic Beverages

Background:   Selective (i.e., ‘picky’) eating is common in autism spectrum disorder (ASD) with as many as 70% of individuals exhibiting this behavior.  Prior reports suggest that although preference for particular foods and drinks is highly idiosyncratic, broader patterns emerge across children with ASD.  For example, studies suggest that children with ASD have generally less varied diets, including eating fewer vegetables, salad, and fresh fruit, as well as less sweets and fizzy drinks (Emond et al., 2010; Pediatrics) than typically developing controls.  The vast majority of studies to date have been conducted with children.  While selective eating is persistent and extends into adulthood in ASD (Kuschner et al., 2015, Res Autism Spectr Disord) and it is more common than previously believed within the general population of adults, very little is known about specific food/drink preferences (including alcohol consumption) and their associations with ASD-like behaviors during this developmental window. 

Objectives:  Examine food/drink preferences as a function of continuous and extreme autistic trait ratings within a large sample of adults. 

Methods:   A large group of 1,992 adults (1,445 females) completed online surveys including questions about how often they avoided various food/drink classes (e.g., fruits/vegetables, juices, alcoholic beverages, salty and sweet crunchy bread products, salty and sweet soft bread products, meats, and dairy products) on a scale of 1 (never) to 5 (always) as well as self-ratings of autistic traits utilizing the original 50-item Autism-Spectrum Quotient (AQ).

Results:  Correlational analyses revealed that as self-ratings of autistic traits (using the AQ total score) increased the likelihood of trying alcoholic beverages decreased (r=.14 , p<.01).  Autistic social traits (from the Social Skills subscale) was the component of the AQ most strongly correlated with a general avoidance of alcoholic beverages (r=.18, p<.01).  When submitted to regression analyses, autistic social traits predicted significant additional variance (F=58.80, p<.001; ΔR²=.03) above and beyond the influence of food neophobia and aversions to smells, each of which contributed its own significant variance (ts>2.36, ps<.02), to the likelihood of trying alcoholic beverages. 

Conclusions:  This study provides further evidence linking ASD-like behavior with food/drink preferences, albeit among a relatively large population of adults.  The food/drink that was most strongly related to subclinical ASD behavior was alcoholic beverages.  This finding is perhaps unsurprising given prior research finding highly reduced rates of alcohol use and abuse among adolescents and adults with ASD (Fortuna et al., 2015, J Gen Intern Med; Mangerud et al., 2014, J Adolesc).  Moreover, ASD-like social traits, in particular, were most strongly linked with avoidance of alcoholic beverages, and these influences were independent of generalized food neophobia and sensory aversions to smell, consistent with the notion of limited ‘social drinking.’