Autism Spectrum Disorder (ASD) and Diet

Abstract

Autism spectrum disorder (ASD) is one of the diverse groups of neurodevelopmental disorders, and with a rising prevalence globally. ASD constitutes a significant public health concern. Challenges in ASD assessment pose barriers in terms of diagnosis, and it might be detected much later in life. It presents a significant health concern during the critical growing years of infancy for the child and the family, with direct psychological consequences. Individuals with ASD might lead an independent life or require lifelong support, accompanied by varying levels of impairment of individual functioning and quality of life. With improvement in the understanding of ASD over the last few decades, there was a revision of the diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the eleventh edition of the International Classification of Diseases (ICD-11) manuals. Many developmental screening tools are available, and in the absence of specific medical investigations, physicians who make the first contact with patients, such as primary care physicians and pediatricians, must have a relatively high index of suspicion for this disorder. Early diagnosis must be coupled with prompt referral to specialists, developmental pediatricians, child psychiatrists, or psychologists to ensure the coordination of holistic care to the affected children and their families. Pharmacologic agents and non-pharmacologic therapies such as dietary interventions are available. The pharmacological agents include selective serotonin reuptake inhibitors (SSRIs), antidepressants, and psychostimulants. The SSRIs have the most beneficial impact on challenging behaviors in children. Of the proposed dietary approaches, the elimination of diets such as the gluten- and casein-free diet (GF-CF diet) has been shown to address ASD symptoms in some studies. However, the evidence is not strong enough to support recommendations for this intervention in clinical practice. Novel evidence for nutritional interventions is emerging, and ongoing research might elucidate its exact role and the long-term effects on metabolism, metabolic dysfunction, and nutritional deficiencies to address the core symptoms of ASD.