Dietary adequacy of Egyptian children with autism spectrum disorder compared to healthy developing children
- 653 Downloads
Although the etiology and pathology of autism spectrum disorder (ASD) is still poorly understood, a number of environmental, anthropological, neurobiological and genetic factors have been related to the pathophysiology of ASD, even the impact of oxidative stress response related to the environment and nutrition intake. Usual recommended dietary habits are based on the combination of behavioral and dietary or nutraceutical interventions together with pharmacotherapy. Investigations about a reliable relationship between diet and ASD are still lacking. The present study aimed at comparing dietary regimens and habits of normally developing apparently healthy children, without diagnosed ASD, with a pediatric population of individuals affected by autistic disorder. Assessments of nutritional and anthropometric data, in addition to biochemical evaluation for nutrient deficiencies, were performed. A total of 80 children with autistic disorder and 80 healthy, normally developing pediatric individuals were enrolled in the study. Parents were asked to complete the standardized questionnaire regarding the different types of food and the proportion of a serving for their children. Biochemical analysis of micro- and macronutrients were also done. Plotting on the Egyptian sex-specific anthropometric growth (auximetric) chart, absolute weights as well as weight-related for age classes, were significantly higher in cases than healthy controls. No differences between groups were observed in regard to total kilocalories (kcal), carbohydrates, and fat intake. A total of 23.8% of children with autistic disorder vs. 11.3% in the healthy control group had a nutrient intake with features below the Recommended Dietary Allowance (RDA) of protein. Children with autistic disorder showed low dietary intake of some micronutrients; calcium (Ca), magnesium (Mg), iron (Fe), selenium (Se) and sodium (Na), also they had significantly high intake of potassium (K) and vitamin C compared to healthy controls. Serum Mg, Fe, Ca, folate and vitamin B12 in children with autistic disorder were significantly low compared with healthy children. Significant positive correlations between serum Mg, Fe, Ca, vitamin B12 and folate and their levels in food were present. These results confirmed that different nutritional inadequacy was observed in Egyptian children with autistic disorder. The evidence reported in the present study should recommend screening of the nutritional status of ASD children for nutrient adequacy to reduce these deficiencies by dietary means or by administering appropriate vitamin and mineral supplements. Nutritional intervention plan should be tailored to address specific needs.
KeywordsChildren Autism Eating behavior Nutrient intake Anthropometry Egyptian
This research project was supported by the Science and Technology Development Fund in Egypt (STDF) for Dr. Nagwa Abdel Meguid, project number 5541.
Compliance with ethical standards
Conflict of interest
The authors declare no potential conflicts of interest with respect to the authorship, and/or publication of this article.
All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- Al-Farsi YM, Waly MI, Al-Sharbati MM, Al-Shafaee MA, Al-Farsi OA, Al-Khaduri MM, Gupta I, Ouhtit A, Al-Adawi S, Al-Said MF, Deth RC (2013a) Levels of heavy metals and essential minerals in hair samples of children with autism in Oman: a case-control study. Biol Trace Elem Res 151:181–186CrossRefPubMedGoogle Scholar
- APA - American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders: DSM-IV-TR. American Psychiatric Association, Washington, DCGoogle Scholar
- APA - American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders: DSM-5. American Psychiatric Association Publishing, ArlingtonGoogle Scholar
- Bjørklund G (2013) The role of zinc and copper in autism spectrum disorders. Acta Neurobiol Exp 73:225–236Google Scholar
- Cornish J, Callon KE, King AR, Cooper GJ, Reid IR (1998) Systemic administration of amylin increases bone mass, linear growth, and adiposity in adult male mice. Am J Physiol 275:E694–E699Google Scholar
- FAO/WHO (2002) Human vitamin and mineral requirements: report of a joint FAO/WHO expert consultation Bangkok, Thailand. Food and Agriculture Organization of the United Nations, RomeGoogle Scholar
- FAO/WHO/UNU (2004) Human energy requirements. Report of a joint FAO/WHO/UNU expert consultation. FAO food and nutrition technical report series, no. 1. Food and Agriculture Organization of the United Nations, RomeGoogle Scholar
- IOM - Institute of Medicine (US) Panel on Dietary Antioxidants and Related Compounds (2000) Dietary reference intakes for vitamin C, vitamin E, selenium, and carotenoids. National Academies Press, WashingtonGoogle Scholar
- IOM - Institute of Medicine (US) Panel on Micronutrients (2001) Dietary reference intakes for vitamin a, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. National Academies Press, WashingtonGoogle Scholar
- IOM - Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes (1997) Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. National Academies Press, WashingtonGoogle Scholar
- IOM - Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Other B Vitamins, and Choline (1998) Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. National Academies Press, WashingtonGoogle Scholar
- Lindsay RL, Eugene Arnold L, Aman MG, Vitiello B, Posey DJ, McDougle CJ, Scahill L, Pachler M, McCracken JT, Tierney E, Bozzolo D (2006) Dietary status and impact of risperidone on nutritional balance in children with autism: a pilot study. J Intellect Develop Disabil 31:204–209CrossRefGoogle Scholar
- Macedoni-Lukšič M, Gosar D, Bjørklund G, Oražem J, Kodrič J, Lešnik-Musek P, Zupančič M, France-Štiglic A, Sešek-Briški A, Neubauer D, Osredkar J (2015) Levels of metals in the blood and specific porphyrins in the urine in children with autism spectrum disorders. Biol Trace Elem Res 163:2–10CrossRefPubMedGoogle Scholar
- Palmieri L, Papaleo V, Porcelli V, Scarcia P, Gaita L, Sacco R, Hager J, Rousseau F, Curatolo P, Manzi B, Militerni R, Bravaccio C, Trillo S, Schneider C, Melmed R, Elia M, Lenti C, Saccani M, Pascucci T, Puglisi-Allegra S, Reichelt KL, Persico AM (2010) Altered calcium homeostasis in autism-spectrum disorders: evidence from biochemical and genetic studies of the mitochondrial aspartate/glutamate carrier AGC1. Mol Psychiatry 15:38–52CrossRefPubMedGoogle Scholar
- Rutter M, Le CA, Lord C (2003) Autism diagnostic interview-revised (ADI-R). Western Psychological Services, Los AngelesGoogle Scholar
- Santocchi E, Guiducci L, Fulceri F, Billeci L, Buzzigoli E, Apicella F, Calderoni S, Grossi E, Morales MA, Muratori F (2016) Gut to brain interaction in autism spectrum disorders: a randomized controlled trial on the role of probiotics on clinical, biochemical and neurophysiological parameters. BMC Psychiatry 16:183–185CrossRefPubMedPubMedCentralGoogle Scholar
- Schopler E, Reichler RJ, Rochen-Renner B (1998) The childhood autism rating scale (CARS). Western Psychological Services, Los AngelesGoogle Scholar
- Siu AL, Bibbins-Domingo K, Grossman DC, Baumann LC, Davidson KW, Ebell M, García FA, Gillman M, Herzstein J, Kemper AR, Krist AH, Kurth AE, Owens DK, Phillips WR, Phipps MG, Pignone MP (2016) Screening for autism Spectrum disorder in young children: US preventive services task force recommendation statement. JAMA 315:691–696CrossRefPubMedGoogle Scholar
- WHO - World Health Organization (2008) Training course on child growth assessment, WHO child growth standards. B: measuring a child’s growth. World Health Organization, GenevaGoogle Scholar
- WHO - World Health Organization (2009) WHO Anthro for personal computers, version 3.01: software for assessing growth and development of the world’s children. World Health Organization, GenevaGoogle Scholar
- Zablotsky B, Black LI, Maenner MJ, Schieve LA, Blumberg SJ (2015) Estimated prevalence of autism and other developmental disabilities following questionnaire changes in the 2014 National Health Interview Survey. Natl Health Stat Rep 87:1–20Google Scholar