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Evaluation of Nutritional Status of Children with Autism Spectrum Disorder Receiving Daytime Rehabilitation

Year 2024, Volume: 4 Issue: 2, 50 - 55, 30.05.2024

Abstract

Objective: The aim of this study was to evaluate the nutritional status, eating habits and behavior of children with Autism Spectrum Disorder. Methods: This observational study included 109 individuals from Istanbul diagnosed with Autism Spectrum Disorder aged 3-18 years; the patients were receiving daytime rehabilitation. A questionnaire including socio-demographic characteristics, nutritional behavior and eating habits of participants was applied by face-to-face interview method, anthropometric measurements (body weight and height) and food consumption records were taken, using a 24-hour dietary recall taken by the researchers. Results: One hundred and nine participants, 66.1% (n = 72) were male. It was determined that 16.2% (n = 6) of the female participants were overweight and 27.0% (n = 10) were obese, while 33.3% (n = 24) of the male participants were overweight and 29.2% (n = 21) were obese. The rate of food selectivity was found to be 59.6%; 28.4% of the participants received additional support during mealtimes, 13.8% followed various special diets, including gluten-free and casein-free diets. Most of the participants’ energy intake (60.6%), vitamin D (100.0%) and calcium (71.6%) were below reference values. The majority of the participants’ vitamin A (92.7%) and sodium (92.7%) intakes were above the recommended values. Conclusion: The findings of the study reveal that children and adolescents with Autism Spectrum Disorder have high rates of obesity and food selectivity. The need for additional support at mealtimes, and the inadequate or excessive intake of nutrients are among other nutrition-related problems faced by this population.

References

  • (1) Adams JB, Audhya T, McDonough-Means S, Rubin RA, Quig D, Geis E, et al. Nutritional and metabolic status of children with autism vs. neurotypical children and the association with autism severity. Nutrition & Metabolism (Lond). 2011;8:1-32. https://doi.org/10.1186/1743-7075-8-34.
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  • [4] Ausderau K, Juarez M. The impact of autism spectrum disorders and eating challenges on family mealtimes. ICAN: Infant, Child, & Adolescent Nutrition. 2013;5(5):315-323. https://doi.org/10.1177/1941406413502808.
  • [5] Bicer AH, Alsaffar AA. Body mass index, dietary intake and feeding problems of Turkish children with autism spectrum disorder (ASD). Research in Devepolmental Disabilities. 2013;34(11):3978-3987. https://doi.org/10.1016/j.ridd.2013.08.024.
  • [6] Bicer AH, Alsaffar AA. Dietary intake and physical activity levels of male adolescents with autism spectrum disorder (ASD) and normal to high body mass index (BMI)–A case series study. Research in Autism Spectrum Disorders. 2016;31:1-10. https://doi.org/10.1016/j.rasd.2016.07.002. [7] Buie T, Fuchs GJ, Furuta GT, Kooros K, Levy J, Lewis JD, et al. Recommendations for evaluation and treatment of common gastrointestinal problems in children with ASDs. Pediatrics. 2010;125(Supplement 1):19-29. https://doi.org/10.1542/peds.2009-1878D.
  • [8] CDC, Centers for Disease Control and Prevention. Autism Prevalence Higher, According to Data from 11 ADDM Communities. Available at: https://www.cdc.gov/media/releases/2023/p0323-autism.html, Accessed May 2, 2024.
  • [9] Cornish E. A balanced approach towards healthy eating in autism. Journal of Human Nutrition and Dietetics. 1998;11(6):501-509. https://doi.org/10.1046/j.1365-277X.1998.00132.x.
  • [10] Cornish E. Gluten and casein free diets in autism: a study of the effects on food choice and nutrition. Journal of Human Nutrition and Dietetics. 2002;15(4):261-269. https://doi.org/10.1046/j.1365-277X.2002.00372.x.
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  • [13] Esteban-Figuerola P, Canals J, Fernández-Cao JC, Arija Val V. Differences in food consumption and nutritional intake between children with autism spectrum disorders and typically developing children: A meta-analysis. Autism. 2019;23(5):1079-1095. https://doi.org/10.1177/1362361318794179.
  • [14] Geraghty ME, Depasquale GM, Lane AE. Nutritional Intake and Therapies in Autism: A Spectrum of What We Know: Part 1. ICAN: Infant, Child, & Adolescent Nutrition. 2010;2(1):62-69. https://doi.org/10.1177/194140640935843.
  • [15] Gilger MA, Redel CA. Autism and the gut. Pediatrics. 2009;124(2):796-798. https://doi.org/10.1542/peds.2009-0741.
  • [16] Gray HL, Sinha S, Buro AW, Robinson C, Berkman K, Agazzi H, et al. Early history, mealtime environment, and parental views on mealtime and eating behaviors among children with ASD in Florida. Nutrients. 2018;10(12):1867. https://doi.org/10.3390/nu10121867.
  • [17] Hyman SL, Stewart PA, Schmidt B, Cain U, Lemcke N, Foley JT, et al. Nutrient intake from food in children with autism. Pediatrics. 2012;130(Supplement_2):145-153. https://doi.org/10.1542/peds.2012-0900L.
  • [18] Kirby M, Danner E. Nutritional deficiencies in children on restricted diets. Pediatric Clinics. 2009;56(5):1085-1103. https://doi.org/10.1016/j.pcl.2009.07.003.
  • [19] Kummer A, Barbosa IG, Rodrigues DH, Rocha NP, Rafael MDS, Pfeilsticker L, et al. Frequency of overweight and obesity in children and adolescents with autism and attention defcit/hyperactivity disorder. Revista Paulista de Pediatria. 2016;34:71-77. https://doi.org/10.1016/j.rppede.2015.12.006.
  • [20] Li YJ, Xie XN, Lei X, Li YM, Lei X. Global prevalence of obesity, overweight and underweight in children, adolescents and adults with autism spectrum disorder, attention‐deficit hyperactivity disorder: A systematic review and meta‐analysis. Obesity Reviews. 2020;21(12):13123. https://doi.org/10.1111/obr.13123.
  • [21] Marquenie K, Rodger S, Mangohig K, Cronin A. Dinnertime and bedtime routines and rituals in families with a young child with an autism spectrum disorder. Australian Occupational Therapy Journal. 2011;58(3):145-154. https://doi.org/10.1111/j.1440-1630.2010.00896.x.
  • [22] Mayes SD, Zickgraf H. Atypical eating behaviors in children and adolescents with autism, ADHD, other disorders, and typical development. Research in Autism Spectrum Disorders. 2019;64:76-83. https://doi.org/10.1016/j.rasd.2019.04.002.
  • [23] Molina‐López J, Leiva‐García B, Planells E, Planells P. Food selectivity, nutritional inadequacies, and mealtime behavioral problems in children with autism spectrum disorder compared to neurotypical children. International Journal of Eating Disorders. 2021;54(12);2155-2166. https://doi.org/10.1002/eat.23631.
  • [24] Özeren GS. Autism Spectrum Disorder (ASD) and Gazing Through the Evidence Window to ASD. Acıbadem University Health Sciences Journal. 2013;2:57-63. http://journal.acibadem.edu.tr/tr/pub/issue/61299/914194#article_cite.
  • [25] Plaza-Diaz J, Flores-Rojas K, Torre-Aguilar MJDL, Gomez-Fernández AR, Martín-Borreguero P, Perez-Navero JL, et al. Dietary patterns, eating behavior, and nutrient intakes of spanish preschool children with autism spectrum disorders. Nutrients. 2021;13(10):3551. https://doi.org/10.3390/nu13103551.
  • [26] Schreck KA, Williams K. Food preferences and factors influencing food selectivity for children with autism spectrum disorders. Research in developmental disabilities. 2006;27:353-363. https://doi.org/10.1016/j.ridd.2005.03.005.
  • [27] Seiverling L, Towle P, Hendy HM, Pantelides J. Prevalence of feeding problems in young children with and without autism spectrum disorder: a chart review study. Journal of Early Intervention. 2018;40(4):335-346. https://doi.org/10.1177/1053815118789396.
  • [28] Shmaya Y, Eilat-Adar S, Leitner Y, Reif S, Gabis LV. Meal time behavior difficulties but not nutritional deficiencies correlate with sensory processing in children with autism spectrum disorder. Research in developmental disabilities. 2017;66:27-33. https://doi.org/10.1016/j.ridd.2017.05.004.
  • [29] Stewart PA, Hyman SL, Schmidt BL, Macklin EA, Reynolds A, Johnson CR, et al. Dietary supplementation in children with autism spectrum disorders: common, insufficient, and excessive. Journal of the Academy of Nutrition and Dietetics. 2015;115(8):1237-1248. https://doi.org/10.1016/j.jand.2015.03.026.
  • [30] TBSA, T.C. Sağlık Bakanlığı. Türkiye Beslenme ve Sağlık Araştırması 2010: Beslenme Durumu ve Alışkanlıklarının Değerlendirilmesi Sonuç Raporu. 2014:117-150.
  • [31] TÜBER, Türkiye Beslenme Rehberi TÜBER 2015, T.C. Sağlık Bakanlığı Yayın No: 1031, Ankara 2019.
  • [32] West L, Waldrop J, Brunssen S. Pharmacologic treatment for the core deficits and associated symptoms of autism in children. Journal of Pediatric Health Care. 2009;23(2):75-89. https://doi.org/10.1016/j.pedhc.2008.12.001.
  • [33] Williams KE, Seiverling L. Eating problems in children with autism spectrum disorders. Topics in Clinical Nutrition. 2010;25(1):27-37.
  • [34] Williams PG, Dalrymple N, Neal J. Eating habits of children with autism. Pediatric Nursing. 2000;26:259-264.
  • [35] World Health Organization Multicentre Growth Reference Study Group. WHO Child Growth Standards: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: Methods and development. Geneva: World Health Organization. 2006. https://www.who.int/publications/i/item/924154693X.
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Gündüzlü Rehabilitasyon Gören Otizm Spektrum Bozukluğu Olan Çocukların Beslenme Durumlarının Değerlendirilmesi

Year 2024, Volume: 4 Issue: 2, 50 - 55, 30.05.2024

Abstract

Amaç: Bu çalışmada, Otizm Spektrum Bozukluğu olan çocukların beslenme durumlarının, yeme alışkanlıklarının ve davranışlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Bu gözlemsel çalışmaya İstanbul’da gündüzlü rehabilitasyon gören 3-18 yaş arası Otizm Spektrum Bozukluğu olan 109 birey dahil edilmiştir. Katılımcılara yüz yüze görüşme metoduyla sosyo-demografik özellikleri, beslenme davranışları ve yemek yeme alışkanlıklarını içeren bir anket uygulanmış, antropometrik ölçümleri (vücut ağırlığı ve boy uzunluğu) ve 24 saatlik hatırlatma yöntemi ile besin tüketim kayıtları araştırmacılar tarafından alınmıştır. Bulgular: Yüz dokuz katılımcının %66,1 (n = 72)'inin erkek olduğu saptanmıştır. Kızların %16,2 (n = 6)’sinin hafif şişman, %27,0 (n = 10)'ının obez olduğu, erkek katılımcıların ise %33,3 (n = 24)’ünün hafif şişman ve %29,2 (n=21)'sinin obez olduğu belirlenmiştir. Katılımcılarda, besin seçicilik oranı %59,6 olarak bulunmuş ve katılımcıların %28,4'ü öğün zamanlarında ek destek aldığı, %13,8'i glütensiz ve kazeinsiz diyet de dahil olmak üzere çeşitli özel diyetler uyguladığı belirlenmiştir. Katılımcıların çoğunun enerji (%60,6), D vitamini (%100,0) ve kalsiyum (%71,6) alımları referans değerlerin altında; A vitamini (%92,7) ve sodyum (%92,7) alımları önerilen değerlerin üzerinde bulunmuştur. Sonuç: Çalışmanın bulguları, Otizm Spektrum Bozukluğu olan çocuk ve adölesanlarda yüksek oranda obezite ve besin seçiciliği olduğunu ortaya koymaktadır. Öğün zamanlarında ek desteğe ihtiyaç duyulması, yetersiz veya fazla besin ögesi alımı, bu popülasyonun karşılaştığı diğer beslenme ile ilintili sorunlar arasındadır.

References

  • (1) Adams JB, Audhya T, McDonough-Means S, Rubin RA, Quig D, Geis E, et al. Nutritional and metabolic status of children with autism vs. neurotypical children and the association with autism severity. Nutrition & Metabolism (Lond). 2011;8:1-32. https://doi.org/10.1186/1743-7075-8-34.
  • [2] APA, American Psychiatric Association D. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5 (Vol. 5, No. 5). Washington, DC. 2013.
  • [3] Attlee A, Kassem H, Hashim M, Obaid RS. Physical status and feeding behavior of children with autism. The Indian Journal of Pediatrics. 2015;82:682-687. https://doi.org/10.1007/s12098-015-1696-4.
  • [4] Ausderau K, Juarez M. The impact of autism spectrum disorders and eating challenges on family mealtimes. ICAN: Infant, Child, & Adolescent Nutrition. 2013;5(5):315-323. https://doi.org/10.1177/1941406413502808.
  • [5] Bicer AH, Alsaffar AA. Body mass index, dietary intake and feeding problems of Turkish children with autism spectrum disorder (ASD). Research in Devepolmental Disabilities. 2013;34(11):3978-3987. https://doi.org/10.1016/j.ridd.2013.08.024.
  • [6] Bicer AH, Alsaffar AA. Dietary intake and physical activity levels of male adolescents with autism spectrum disorder (ASD) and normal to high body mass index (BMI)–A case series study. Research in Autism Spectrum Disorders. 2016;31:1-10. https://doi.org/10.1016/j.rasd.2016.07.002. [7] Buie T, Fuchs GJ, Furuta GT, Kooros K, Levy J, Lewis JD, et al. Recommendations for evaluation and treatment of common gastrointestinal problems in children with ASDs. Pediatrics. 2010;125(Supplement 1):19-29. https://doi.org/10.1542/peds.2009-1878D.
  • [8] CDC, Centers for Disease Control and Prevention. Autism Prevalence Higher, According to Data from 11 ADDM Communities. Available at: https://www.cdc.gov/media/releases/2023/p0323-autism.html, Accessed May 2, 2024.
  • [9] Cornish E. A balanced approach towards healthy eating in autism. Journal of Human Nutrition and Dietetics. 1998;11(6):501-509. https://doi.org/10.1046/j.1365-277X.1998.00132.x.
  • [10] Cornish E. Gluten and casein free diets in autism: a study of the effects on food choice and nutrition. Journal of Human Nutrition and Dietetics. 2002;15(4):261-269. https://doi.org/10.1046/j.1365-277X.2002.00372.x.
  • [11] Ebispro for Windows. Stuttgart, Germany; Turkish Version (BeBiS 7.0), Pasifik Elektirik Elektronik Ltd. Şti. (www.bebis.com.tr); Istanbul. 2019.
  • [12] Egan AM, Dreyer ML, Odar CC, Beckwith M, Garrison CB. Obesity in Young Children with Autism Spectrum Disorders: Prevalence and Associated Factors. Childhood Obesity. 2013;9(2):125-131. https://doi.org/10.1089/chi.2012.0028.
  • [13] Esteban-Figuerola P, Canals J, Fernández-Cao JC, Arija Val V. Differences in food consumption and nutritional intake between children with autism spectrum disorders and typically developing children: A meta-analysis. Autism. 2019;23(5):1079-1095. https://doi.org/10.1177/1362361318794179.
  • [14] Geraghty ME, Depasquale GM, Lane AE. Nutritional Intake and Therapies in Autism: A Spectrum of What We Know: Part 1. ICAN: Infant, Child, & Adolescent Nutrition. 2010;2(1):62-69. https://doi.org/10.1177/194140640935843.
  • [15] Gilger MA, Redel CA. Autism and the gut. Pediatrics. 2009;124(2):796-798. https://doi.org/10.1542/peds.2009-0741.
  • [16] Gray HL, Sinha S, Buro AW, Robinson C, Berkman K, Agazzi H, et al. Early history, mealtime environment, and parental views on mealtime and eating behaviors among children with ASD in Florida. Nutrients. 2018;10(12):1867. https://doi.org/10.3390/nu10121867.
  • [17] Hyman SL, Stewart PA, Schmidt B, Cain U, Lemcke N, Foley JT, et al. Nutrient intake from food in children with autism. Pediatrics. 2012;130(Supplement_2):145-153. https://doi.org/10.1542/peds.2012-0900L.
  • [18] Kirby M, Danner E. Nutritional deficiencies in children on restricted diets. Pediatric Clinics. 2009;56(5):1085-1103. https://doi.org/10.1016/j.pcl.2009.07.003.
  • [19] Kummer A, Barbosa IG, Rodrigues DH, Rocha NP, Rafael MDS, Pfeilsticker L, et al. Frequency of overweight and obesity in children and adolescents with autism and attention defcit/hyperactivity disorder. Revista Paulista de Pediatria. 2016;34:71-77. https://doi.org/10.1016/j.rppede.2015.12.006.
  • [20] Li YJ, Xie XN, Lei X, Li YM, Lei X. Global prevalence of obesity, overweight and underweight in children, adolescents and adults with autism spectrum disorder, attention‐deficit hyperactivity disorder: A systematic review and meta‐analysis. Obesity Reviews. 2020;21(12):13123. https://doi.org/10.1111/obr.13123.
  • [21] Marquenie K, Rodger S, Mangohig K, Cronin A. Dinnertime and bedtime routines and rituals in families with a young child with an autism spectrum disorder. Australian Occupational Therapy Journal. 2011;58(3):145-154. https://doi.org/10.1111/j.1440-1630.2010.00896.x.
  • [22] Mayes SD, Zickgraf H. Atypical eating behaviors in children and adolescents with autism, ADHD, other disorders, and typical development. Research in Autism Spectrum Disorders. 2019;64:76-83. https://doi.org/10.1016/j.rasd.2019.04.002.
  • [23] Molina‐López J, Leiva‐García B, Planells E, Planells P. Food selectivity, nutritional inadequacies, and mealtime behavioral problems in children with autism spectrum disorder compared to neurotypical children. International Journal of Eating Disorders. 2021;54(12);2155-2166. https://doi.org/10.1002/eat.23631.
  • [24] Özeren GS. Autism Spectrum Disorder (ASD) and Gazing Through the Evidence Window to ASD. Acıbadem University Health Sciences Journal. 2013;2:57-63. http://journal.acibadem.edu.tr/tr/pub/issue/61299/914194#article_cite.
  • [25] Plaza-Diaz J, Flores-Rojas K, Torre-Aguilar MJDL, Gomez-Fernández AR, Martín-Borreguero P, Perez-Navero JL, et al. Dietary patterns, eating behavior, and nutrient intakes of spanish preschool children with autism spectrum disorders. Nutrients. 2021;13(10):3551. https://doi.org/10.3390/nu13103551.
  • [26] Schreck KA, Williams K. Food preferences and factors influencing food selectivity for children with autism spectrum disorders. Research in developmental disabilities. 2006;27:353-363. https://doi.org/10.1016/j.ridd.2005.03.005.
  • [27] Seiverling L, Towle P, Hendy HM, Pantelides J. Prevalence of feeding problems in young children with and without autism spectrum disorder: a chart review study. Journal of Early Intervention. 2018;40(4):335-346. https://doi.org/10.1177/1053815118789396.
  • [28] Shmaya Y, Eilat-Adar S, Leitner Y, Reif S, Gabis LV. Meal time behavior difficulties but not nutritional deficiencies correlate with sensory processing in children with autism spectrum disorder. Research in developmental disabilities. 2017;66:27-33. https://doi.org/10.1016/j.ridd.2017.05.004.
  • [29] Stewart PA, Hyman SL, Schmidt BL, Macklin EA, Reynolds A, Johnson CR, et al. Dietary supplementation in children with autism spectrum disorders: common, insufficient, and excessive. Journal of the Academy of Nutrition and Dietetics. 2015;115(8):1237-1248. https://doi.org/10.1016/j.jand.2015.03.026.
  • [30] TBSA, T.C. Sağlık Bakanlığı. Türkiye Beslenme ve Sağlık Araştırması 2010: Beslenme Durumu ve Alışkanlıklarının Değerlendirilmesi Sonuç Raporu. 2014:117-150.
  • [31] TÜBER, Türkiye Beslenme Rehberi TÜBER 2015, T.C. Sağlık Bakanlığı Yayın No: 1031, Ankara 2019.
  • [32] West L, Waldrop J, Brunssen S. Pharmacologic treatment for the core deficits and associated symptoms of autism in children. Journal of Pediatric Health Care. 2009;23(2):75-89. https://doi.org/10.1016/j.pedhc.2008.12.001.
  • [33] Williams KE, Seiverling L. Eating problems in children with autism spectrum disorders. Topics in Clinical Nutrition. 2010;25(1):27-37.
  • [34] Williams PG, Dalrymple N, Neal J. Eating habits of children with autism. Pediatric Nursing. 2000;26:259-264.
  • [35] World Health Organization Multicentre Growth Reference Study Group. WHO Child Growth Standards: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: Methods and development. Geneva: World Health Organization. 2006. https://www.who.int/publications/i/item/924154693X.
  • [36] World Health Organization Multicentre Growth Reference Study Group. WHO Child Growth Standards: Head circumference-forage, arm circumference-for-age, triceps skinfold-for-age and subscapular skinfold-for-age: Methods and development. Geneva: World Health Organization. 2007. https://www.who.int/publications/i/item/9789241547185.
  • [37] World Health Organization (WHO). Application tools: WHO AnthroPlus software. World Health Organization, Geneva, Switzerland. Accessed May 2, 2023. https://www.who.int/tools/growth-reference-data-for-5to19-years/application-tools.
  • [38] Zheng Z, Zhang L, Li S, Zhao F, Wang Y, Huang L, et al. Association among obesity, overweight and autism spectrum disorder: a systematic review and meta-analysis. Scientific Reports. 2017;7(1):11697. https://doi.org/10.1038/s41598-017-12003-4.
There are 37 citations in total.

Details

Primary Language English
Subjects Public Health (Other)
Journal Section Research Articles
Authors

Ayşe Hümeyra İslamoğlu 0000-0002-2138-5996

Güleren Sabuncular 0000-0001-5922-295X

Zehra Margot Çelik 0000-0002-4622-9252

Şule Aktaç 0000-0002-2158-5015

Fatma Esra Güneş 0000-0003-0334-7598

Publication Date May 30, 2024
Submission Date May 14, 2024
Acceptance Date May 22, 2024
Published in Issue Year 2024 Volume: 4 Issue: 2

Cite

APA İslamoğlu, A. H., Sabuncular, G., Çelik, Z. M., Aktaç, Ş., et al. (2024). Evaluation of Nutritional Status of Children with Autism Spectrum Disorder Receiving Daytime Rehabilitation. Journal of Health Sciences and Management, 4(2), 50-55.