Food selectivity, nutritional inadequacies, and mealtime behavioral problems in children with autism spectrum disorder compared to neurotypical children

Abstract

Objective: To evaluate body composition, nutritional status through food selectivity and degree of inadequate intake, and mealtime behavior in children with autism spectrum disorder (ASD) compared to neurotypical children. Method: A cross-sectional case–control study was carried out in 144 children (N = 55 with ASD; N = 91 with neurotypical children) between 6 and 18 years of age. Body composition, nutritional intake, food consumption frequency (FFQ), and mealtime behavior were evaluated. Results: Results showed a greater presence of children with a low weight (18.4% ASD vs. 3.20% comparison group) and obesity (16.3% ASD vs. 8.6% comparison group) in the ASD group for body mass index (BMI) categories (p = .003; number needed to take [NNT] = 8.07). The presence of obesity in ASD children compared to the comparison group was even higher when considering the fat component (47.5% ASD vs. 19.4% comparison group, p = .002; NNT = 10.3). ASD children had greater intake inadequacy (50% ASD vs. 22% comparison group, p = .014; NNT = 3.58), high food selectivity by FFQ (60.6% ASD vs. 37.9% comparison group, p < .037; NNT = 4.41), and more eating problems (food rejection, limited variety, disruptive behavior), compared to neurotypical children (p = .001). Conclusion: Children with ASD showed an unbalanced body composition toward both underweight and obesity, a greater degree of inadequate intake, high food selectivity as indicated by their consumption frequency, and more disturbed eating behavior than children with neurotypical development. We suggest monitoring nutritional inadequacies and implementing nutritional strategies to expand the variety of foods children with ASD consume.