OTİZM SPEKTRUM BOZUKLUKLARI TEDAVİSİNDE BESLENME YAKLAŞIMLARI

Yıl 2019, , 127 - 143, 01.08.2019

Selin Aktitiz , Ece Yalçın , Zeynep Göktaş

https://doi.org/10.25279/sak.435435

Cited By: 3

Öz

Yaygınlığı
giderek artan otizm spektrum bozuklukları; sosyal etkileşimde belirgin farklı
tutumlar, takıntılı ve tekrarlanan davranışlar, motor becerileri iyi
kullanamama gibi birçok semptom ile karakterize nörolojik bir hastalıktır.
Otizmde anormal beslenme alışkanlıkları, besin tüketiminde seçicilik ve gastrointestinal
sistem problemleri gibi beslenme problemleri de görülmektedir. Ayrıca otizmde mikrobiyota
da sağlıklı bireylere göre farklıdır. Bu nedenle görülen semptomları azaltmak
için beslenme tedavilerinin uygulanması elzemdir. Vitamin ve mineral
takviyeleri,  probiyotik takviyesi,
ketojenik diyet, glutensiz kazeinsiz diyet en çok tercih edilen ve otizmde
görülen semptomları azalttığı gösterilen beslenme tedavilerindendir. Bu derlemede,
otizmde görülen beslenme ile ilgili sorunlar ve güncel beslenme tedavilerinin
etkisini araştıran yayınlar değerlendirilerek
özetlenmiştir.

Anahtar Kelimeler

Otizm, probiyotik, glutensiz diyet

Nutritional Approach In Treatment of Autism Spectrum Disorders

Öz

With an increasing prevalence, autism spectrum disorders are neurological disorders
that characterized by a number of symptoms such as significantly different attitudes in
social interactions and communication, repetitive and obsessively behaviors, and
inability to use motor skills. In addition, nutritional problems such as abnormal eating
habits, sensitivity to food texture, selectivity in food consumption, and gastrointestinal
problems are also accompanied. Besides, microbiota of patients with autism seems to
be different when compared to healthy individuals. Therefore, nutritional treatment
applications are essential for reducing the symptoms and to replace nutritional
deficiencies. The most preferred nutritional therapies that have been shown to reduce
the symptoms in autism are vitamin, mineral, and probiotic supplements, ketogenic
diet, gluten-free and casein-free diets. Since nutritional treatments don’t show the same
effect in every autistic child, nutritional therapy should be applied specific to the
individual. This review summarizes the literature that investigate nutritional problems
and the effects of current nutritional treatments in autism. 

Anahtar Kelimeler

Autism, Microbiota, Gluten-free Diet, Ketogenic Diet

Kaynakça

• Adams, J. B., Audhya, T., McDonough-Means, S., Rubin, R. A., Quig, D., Geis, E., . . . Lee, W. (2011). Effect of a vitamin/mineral supplement on children and adults with autism. BMC Pediatr, 11, 111. doi:10.1186/1471-2431-11-111
• Adams, J. B., & Holloway, C. (2004). Pilot study of a moderate dose multivitamin/mineral supplement for children with autistic spectrum disorder. J Altern Complement Med, 10(6), 1033-1039. doi:10.1089/acm.2004.10.1033
• Adams, J. B., Johansen, L. J., Powell, L. D., Quig, D., & Rubin, R. A. (2011). Gastrointestinal flora and gastrointestinal status in children with autism--comparisons to typical children and correlation with autism severity. BMC Gastroenterol, 11, 22. doi:10.1186/1471-230x-11-22
• Al-Farsi, Y. M., Waly, M. I., Deth, R. C., Al-Sharbati, M. M., Al-Shafaee, M., Al-Farsi, O., . . . Ouhtit, A. (2013). Low folate and vitamin B12 nourishment is common in Omani children with newly diagnosed autism. Nutrition, 29(3), 537-541. doi:10.1016/j.nut.2012.09.014
• Atladóttir, H. Ó., Henriksen, T. B., Schendel, D. E., & Parner, E. T. (2012). Autism After Infection, Febrile Episodes, and Antibiotic Use During Pregnancy: An Exploratory Study. Pediatrics, 130(6), e1447-e1454. doi:10.1542/peds.2012-1107
• Barnhill, K., Gutierrez, A., Ghossainy, M., Marediya, Z., Marti, C. N., & Hewitson, L. (2017). Growth status of children with autism spectrum disorder: a case-control study. J Hum Nutr Diet, 30(1), 59-65. doi:10.1111/jhn.12396
• Berding, K., & Donovan, S. M. (2016). Microbiome and nutrition in autism spectrum disorder: current knowledge and research needs. Nutr Rev, 74(12), 723-736. doi:10.1093/nutrit/nuw048
• Boccuto, L., Chen, C. F., Pittman, A. R., Skinner, C. D., McCartney, H. J., Jones, K., . . . Schwartz, C. E. (2013). Decreased tryptophan metabolism in patients with autism spectrum disorders. Mol Autism, 4(1), 16. doi:10.1186/2040-2392-4-16
• Castro, K., Baronio, D., Perry, I. S., Riesgo, R. D. S., & Gottfried, C. (2017). The effect of ketogenic diet in an animal model of autism induced by prenatal exposure to valproic acid. Nutr Neurosci, 20(6), 343-350. doi:10.1080/1028415x.2015.1133029
• Castro, K., Faccioli, L. S., Baronio, D., Gottfried, C., Perry, I. S., & dos Santos Riesgo, R. (2015). Effect of a ketogenic diet on autism spectrum disorder: A systematic review. Research in Autism Spectrum Disorders, 20, 31-38. doi:https://doi.org/10.1016/j.rasd.2015.08.005
• Cekici, H., & Sanlier, N. (2017). Current nutritional approaches in managing autism spectrum disorder: A review. Nutr Neurosci, 1-11.
• Christison, G. W., & Ivany, K. (2006). Elimination diets in autism spectrum disorders: any wheat amidst the chaff? J Dev Behav Pediatr, 27(2 Suppl), S162-171.
• DeVilbiss, E. A., Gardner, R. M., Newschaffer, C. J., & Lee, B. K. (2015). Maternal folate status as a risk factor for autism spectrum disorders: a review of existing evidence. British Journal of Nutrition, 114(5), 663-672.
• Ding, H. T., Taur, Y., & Walkup, J. T. (2017). Gut Microbiota and Autism: Key Concepts and Findings. J Autism Dev Disord, 47(2), 480-489. doi:10.1007/s10803-016-2960-9
• El-Ansary, A. K., Ben Bacha, A., & Kotb, M. (2012). Etiology of autistic features: the persisting neurotoxic effects of propionic acid. J Neuroinflammation, 9, 74. doi:10.1186/1742-2094-9-74
• Evangeliou, A., Vlachonikolis, I., Mihailidou, H., Spilioti, M., Skarpalezou, A., Makaronas, N., . . . Smeitink, J. (2003). Application of a ketogenic diet in children with autistic behavior: pilot study. J Child Neurol, 18(2), 113-118. doi:10.1177/08830738030180020501
• Geier, D. A., King, P. G., Sykes, L. K., & Geier, M. R. (2008). A comprehensive review of mercury provoked autism. Indian J Med Res, 128(4), 383-411.
• Ghalichi, F., Ghaemmaghami, J., Malek, A., & Ostadrahimi, A. (2016). Effect of gluten free diet on gastrointestinal and behavioral indices for children with autism spectrum disorders: a randomized clinical trial. World J Pediatr, 12(4), 436-442. doi:10.1007/s12519-016-0040-z
• Gökçe Ünal, A. Ö. (2016). Nörogelişimsel Bozukluklarda Beslenme. Clinical and Experimental Health Sciences, 6(2), 80-85.
• Graf-Myles, J., Farmer, C., Thurm, A., Royster, C., Kahn, P., Soskey, L., . . . Swedo, S. (2013). Dietary adequacy of children with autism compared with controls and the impact of restricted diet. J Dev Behav Pediatr, 34(7), 449-459. doi:10.1097/DBP.0b013e3182a00d17
• Harris, C., & Card, B. (2012). A pilot study to evaluate nutritional influences on gastrointestinal symptoms and behavior patterns in children with Autism Spectrum Disorder. Complement Ther Med, 20(6), 437-440. doi:10.1016/j.ctim.2012.08.004
• Herbert, M. R., & Buckley, J. A. (2013). Autism and dietary therapy: case report and review of the literature. J Child Neurol, 28(8), 975-982. doi:10.1177/0883073813488668
• Hsu, C. L., Lin, C. Y., Chen, C. L., Wang, C. M., & Wong, M. K. (2009). The effects of a gluten and casein-free diet in children with autism: a case report. Chang Gung Med J, 32(4), 459-465.
• Hyman, S. L., Stewart, P. A., Schmidt, B., Cain, U., Lemcke, N., Foley, J. T., . . . Ng, P. K. (2012). Nutrient intake from food in children with autism. Pediatrics, 130 Suppl 2, S145-153. doi:10.1542/peds.2012-0900L
• James, S. J., Melnyk, S., Fuchs, G., Reid, T., Jernigan, S., Pavliv, O., . . . Gaylor, D. W. (2009). Efficacy of methylcobalamin and folinic acid treatment on glutathione redox status in children with autism. The American Journal of Clinical Nutrition, 89(1), 425-430. doi:10.3945/ajcn.2008.26615
• Jory, J. (2016). Abnormal fatty acids in Canadian children with autism. Nutrition, 32(4), 474-477. doi:10.1016/j.nut.2015.10.019
• Kaluzna-Czaplinska, J., & Blaszczyk, S. (2012). The level of arabinitol in autistic children after probiotic therapy. Nutrition, 28(2), 124-126. doi:10.1016/j.nut.2011.08.002
• Lange, K. W., Hauser, J., & Reissmann, A. (2015). Gluten-free and casein-free diets in the therapy of autism. Curr Opin Clin Nutr Metab Care, 18(6), 572-575. doi:10.1097/mco.0000000000000228
• Lobar, S. L. (2016). DSM-V Changes for Autism Spectrum Disorder (ASD): Implications for Diagnosis, Management, and Care Coordination for Children With ASDs. Journal of Pediatric Health Care, 30(4), 359-365. doi:https://doi.org/10.1016/j.pedhc.2015.09.005
• Lyall, K., Schmidt, R. J., & Hertz-Picciotto, I. (2014). Maternal lifestyle and environmental risk factors for autism spectrum disorders. International Journal of Epidemiology, 43(2), 443-464. doi:10.1093/ije/dyt282
• Madore, C., Leyrolle, Q., Lacabanne, C., Benmamar-Badel, A., Joffre, C., Nadjar, A., & Laye, S. (2016). Neuroinflammation in Autism: Plausible Role of Maternal Inflammation, Dietary Omega 3, and Microbiota. Neural Plast, 2016, 3597209. doi:10.1155/2016/3597209
• Mangiola, F., Ianiro, G., Franceschi, F., Fagiuoli, S., Gasbarrini, G., & Gasbarrini, A. (2016). Gut microbiota in autism and mood disorders. World Journal of Gastroenterology, 22(1), 361-368. doi:10.3748/wjg.v22.i1.361
• Marí-Bauset, S., Llopis-González, A., Zazpe-García, I., Marí-Sanchis, A., & Morales-Suárez-Varela, M. (2015). Nutritional Status of Children with Autism Spectrum Disorders (ASDs): A Case–Control Study. Journal of autism and developmental disorders, 45(1), 203-212. doi:10.1007/s10803-014-2205-8
• Mezzelani, A., Landini, M., Facchiano, F., Raggi, M. E., Villa, L., Molteni, M., . . . Marabotti, A. (2015). Environment, dysbiosis, immunity and sex-specific susceptibility: A translational hypothesis for regressive autism pathogenesis. Nutr Neurosci, 18(4), 145-161. doi:10.1179/1476830513Y.0000000108
• Millward, C., Ferriter, M., Calver, S., & Connell-Jones, G. (2008). Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev(2), Cd003498. doi:10.1002/14651858.CD003498.pub3
• Muller, C. L., Anacker, A. M. J., & Veenstra-VanderWeele, J. (2016). The serotonin system in autism spectrum disorder: From biomarker to animal models. Neuroscience, 321, 24-41. doi:https://doi.org/10.1016/j.neuroscience.2015.11.010
• Napoli, E., Dueñas, N., & Giulivi, C. (2014a). Potential Therapeutic Use of the Ketogenic Diet in Autism Spectrum Disorders. Frontiers in Pediatrics, 2(69). doi:10.3389/fped.2014.00069
• Patrick, R. P., & Ames, B. N. (2014). Vitamin D hormone regulates serotonin synthesis. Part 1: relevance for autism. Faseb j, 28(6), 2398-2413. doi:10.1096/fj.13-246546
• Pennesi, C. M., & Klein, L. C. (2012). Effectiveness of the gluten-free, casein-free diet for children diagnosed with autism spectrum disorder: based on parental report. Nutr Neurosci, 15(2), 85-91. doi:10.1179/1476830512y.0000000003
• Reynolds, A., Krebs, N. F., Stewart, P. A., Austin, H., Johnson, S. L., Withrow, N., . . . Hyman, S. L. (2012). Iron status in children with autism spectrum disorder. Pediatrics, 130 Suppl 2, S154-159. doi:10.1542/peds.2012-0900M
• Rodakis, J. (2015). An n=1 case report of a child with autism improving on antibiotics and a father's quest to understand what it may mean. Microbial Ecology in Health and Disease, 26, 10.3402/mehd.v3426.26382. doi:10.3402/mehd.v26.26382
• Ruskin, D. N., Svedova, J., Cote, J. L., Sandau, U., Rho, J. M., Kawamura, M., Jr., . . . Masino, S. A. (2013). Ketogenic diet improves core symptoms of autism in BTBR mice. PLoS One, 8(6), e65021. doi:10.1371/journal.pone.0065021
• Saad, K., Abdel-rahman, A. A., Elserogy, Y. M., Al-Atram, A. A., Cannell, J. J., Bjørklund, G., . . . Ali, A. M. (2016). Vitamin D status in autism spectrum disorders and the efficacy of vitamin D supplementation in autistic children. Nutr Neurosci, 19(8), 346-351. doi:10.1179/1476830515Y.0000000019
• Saad, K., Abdel-Rahman, A. A., Elserogy, Y. M., Al-Atram, A. A., El-Houfey, A. A., Othman, H. A., . . . Abdel-Salam, A. M. (2018). Randomized controlled trial of vitamin D supplementation in children with autism spectrum disorder. J Child Psychol Psychiatry, 59(1), 20-29. doi:10.1111/jcpp.12652
• Santocchi, E., Guiducci, L., Fulceri, F., Billeci, L., Buzzigoli, E., Apicella, F., . . . 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. doi:10.1186/s12888-016-0887-5
• Schengrund, C.-L., Ali-Rahmani, F., & Ramer, J. C. (2012). Cholesterol, GM1, and Autism. Neurochemical Research, 37(6), 1201-1207. doi:10.1007/s11064-011-0697-6
• Spilioti, M., Evangeliou, A. E., Tramma, D., Theodoridou, Z., Metaxas, S., Michailidi, E., . . . Gibson, K. M. (2013). Evidence for treatable inborn errors of metabolism in a cohort of 187 Greek patients with autism spectrum disorder (ASD). Front Hum Neurosci, 7, 858. doi:10.3389/fnhum.2013.00858
• Spratt, E. G., Nicholas, J. S., Brady, K. T., Carpenter, L. A., Hatcher, C. R., Meekins, K. A., . . . Charles, J. M. (2012). Enhanced Cortisol Response to Stress in Children in Autism. Journal of autism and developmental disorders, 42(1), 75-81. doi:10.1007/s10803-011-1214-0
• Tomova, A., Husarova, V., Lakatosova, S., Bakos, J., Vlkova, B., Babinska, K., & Ostatnikova, D. (2015). Gastrointestinal microbiota in children with autism in Slovakia. Physiol Behav, 138, 179-187. doi:10.1016/j.physbeh.2014.10.033
• Tuohy, K., Venuti, P., Cuva, S., Furlanello, S., Gasperotti, M., Mancini, A.,, Ceppa, F., Cavalieri, D., de Filippo, C., Vrhovsek, U., Mena, P., Del Rio,, & D. and Fava, F. (2015). Chapter 15 - Diet and the Gut Microbiota – How the Gut: Brain Axis Impacts on Autism. 225 - 245. doi:https://doi.org/10.1016/B978-0-12-407825-3.00015-0
• Tuohy, K. M., Venuti, P., Cuva, S., Furlanello, C., Gasperotti, M., Mancini, A., . . . Vrhovsek, U. (2014). Diet and the Gut Microbiota–How the Gut: Brain Axis Impacts on Autism Diet-Microbe Interactions in the Gut (pp. 225-245): Elsevier.
• West Md, R., & Roberts, E. (2013). Improvements in Gastrointestinal Symptoms among Children with Autism Spectrum Disorder Receiving the Delpro� Probiotic and Immunomodulator Formulation (Vol. 1).
• Whiteley, P., Haracopos, D., Knivsberg, A. M., Reichelt, K. L., Parlar, S., Jacobsen, J., . . . Shattock, P. (2010). The ScanBrit randomised, controlled, single-blind study of a gluten- and casein-free dietary intervention for children with autism spectrum disorders. Nutr Neurosci, 13(2), 87-100. doi:10.1179/147683010x12611460763922
• Whiteley, P., Shattock, P., Knivsberg, A.-M., Seim, A., Reichelt, K. L., Todd, L., . . . Hooper, M. (2012). Gluten- and casein-free dietary intervention for autism spectrum conditions. Front Hum Neurosci, 6, 344. doi:10.3389/fnhum.2012.00344