Features of eating behavior in children with autism spectrum disorder

Objective. To study the effect of nutrition and psychopathological traits on the development of eating behavior in children with autism spectrum disorder (ASD). Patients and methods. A comparative analysis of the features of nutrition and eating behavior in 40 children with ASD and 40 neurotypical controls was performed. Two patient groups were comparable in age (3–8 years). The methods used to assess nutrition included retrospective dietary recall, analysis of the frequency of consumption of specific foods or meals, and a 24-hour dietary recall survey. For retrospective analysis of children’s nutrition, we developed a questionnaire for parents, considering the characteristics of eating behavior in both children with ASD and neurotypical controls. Results. The introduction of first complementary foods in children with ASD did not differ significantly from neurotypical controls. The first peculiarities of eating behavior in children with ASD began to manifest themselves when trying to expand the variety of complementary foods. In 57.5% of children with ASD, clear disorders of eating behavior coincided with the onset of regression in neuropsychological development. There appeared food selectivity (in 72.5% of children with ASD), picky eating (in 22.5%), gagging at the sight, consistency, and color of food (in 42.5%) and a limited range of foods (in 70%), which was practically impossible to expand. The nutrition of children in the control group was diverse. They were interested in new tastes and consistency of foods, and food selectivity was noticed only in 16.7% of cases and was not so categorical. An attempt to influence the health status of children with ASD, primarily to reduce psychomotor agitation, was manifested in the use of elimination diets (gluten-free and/or casein-free) in 37.5% of children with ASD, which demonstrated a positive effect in most children. However, the indications for their use and duration were commonly not coordinated with a physician, which created a risk of deterioration in children’s health. Conclusion. Eating disorders are not always noticed by specialists in time and require special attention, as they can be both symptoms of ASD and contribute to disease aggravation. Refusal of children with ASD from previously consumed foods, selectivity, and picky eating commonly coincide with regression in neuropsychological development. The use of gluten-free and/or casein-free elimination diets in children with ASD should be justified. Restricted and unbalanced diets prescribed by parents without medical supervision may exacerbate the nutritional and health problems in children with ASD. Key words: autism spectrum disorder, children, eating behavior, nutrition, gluten-free diet, casein-free diet