Nutrition in children with autism: Parental influences, physical activity, food intake, and medication

This investigation explored the nutritional status of children with autism in terms of anthropometric measurements, nutrient sufficiency, food diversity, physical activity patterns, medication treatment, and aberrant behaviors at mealtimes and compared these parameters to data from typical children. Parental perceptions of nutritional health and food consumption of their children, use of complementary nutrition practices, and use of nutrition support sources was also assessed. For data collection, parents completed multiple four-day food diaries, and health and nutrition related questionnaires. Additionally, children were observed at a mealtime for subjective analysis of behavior expression. Twenty-three children with autism and fourteen typical children were enrolled in the study; thirteen children with autism and ten typical children completed all study phases. Data analysis compared children with autism on an unrestricted diet, children with autism on a gluten/casein free (GFCF) diet, and typical children on an unrestricted diet. Although children with autism on a GFCF diet had a significantly increased intake of niacin and copper, and lower intake of calcium, overall dietary mean adequacy ratios were comparable to typical children, and anthropometric measurements were comparable indicating similar dietary adequacy amongst the groups. Children with autism had significantly less dietary variety and higher appearance of problematic behavior at meal times as perceived by parents. Physical activity patterns were not significantly different than typical children; however, typical children tended to participate in team sports and activities involving fine motor skills, while children with autism participated in therapeutic exercises. Even though children with autism had a higher usage of prescription medications with implications on weight patterns and nutrient sufficiency, and were more likely to consume nutrient supplements neither of these differences were significant compared to typical children. Parents of children with autism conveyed apprehension regarding their child's mealtime behavior. Both parents of typical children and children with autism utilize the Internet as their primary source of nutrition data. Implications for clinical applications and future research directions are discussed.