Multicomponent Nutritional Support for Children with Autism Spectrum Disorder: An Exploratory Pilot Study in Vietnam.

Abstract

Background: Children with Autism Spectrum Disorder (ASD) frequently exhibit severe food selectivity and micronutrient deficiencies, impacting growth and nutritional status. Evidence on integrated nutritional interventions in resource-constrained settings remains limited.

Objective: To assess the feasibility and preliminary pre-post changes associated with a 12-week multicomponent nutritional intervention among Vietnamese children with ASD.

Methods: In this exploratory single-arm pilot study, 56 children with ASD (mean age 59.0 ± 22.3 months; 80.4% male) were recruited from five community centers in Nghe An Province, Vietnam. The intervention comprised caregiver nutrition education, individualized dietary counseling, and daily multi-micronutrient supplementation. Anthropometric indicators, biochemical markers, feeding behaviors, and dietary intake were assessed at baseline and after 12 weeks. Pre-post changes were evaluated using paired statistical tests, and multivariable linear regression examined factors associated with growth response.

Results: The study achieved a 100% completion rate, with all 56 recruited participants finishing the 12-week intervention and all scheduled follow-up assessments. Among children < 60 months, mean Weight-for-Age Z-score (WAZ) increased from -0.66 to -0.28 and mean Height-for-Age Z-score (HAZ) from -1.18 to -0.97 (p < 0.001). For children older than 60 months, mean HAZ increased from -0.87 to -0.58 (p < 0.001) and Body Mass Index-for-Age Z-score (BAZ) from -0.20 to 0.06 (p = 0.006). Significant increases occurred in serum zinc (10.29 to 11.72 µmol/L; p = 0.001), ferritin (31.74 to 34.79 ng/mL; p = 0.001), and hemoglobin (122.73 to 124.77 g/L; p = 0.002), while albumin remained unchanged. Concurrent improvements were observed in feeding behaviors and nutrient-dense food intake. Regression analysis indicated that lower baseline anthropometric status was significantly associated with greater gains in WAZ and HAZ.

Conclusions: This community-based multicomponent intervention was feasible and associated with short-term improvements in feeding behaviors, dietary intake, selected biomarkers, and growth measures in children with ASD, supporting further evaluation in randomized controlled trials.