Nutrition and Bone Density in Boys with Autism Spectrum Disorder

Published:March 02, 2018DOI:https://doi.org/10.1016/j.jand.2017.11.006

      Abstract

      Background

      Boys with autism spectrum disorder (ASD) have lower bone mineral density (BMD) than typically developing controls. Differences in diet and exercise may contribute to low BMD.

      Objective

      Our aim was to examine macro- and micronutrient intakes and self-reported physical activity in boys with ASD compared to TDC and the relationship of these variables with BMD.

      Design/methods

      We conducted a cross-sectional study of 49 boys (25 ASD, 24 typically developing controls) assessed for 3-day food records and physical activity records, and BMD of the whole body less head, hip, and spine using dual-energy x-ray absorptiometry. Fasting levels of 25(OH) vitamin D and calcium were obtained.

      Participants

      Participants were adolescent boys, aged 8 to 17 years, recruited from a clinic population (ASD) or community advertisements (ASD and typically developing controls) matched for age.

      Results

      ASD participants were approximately 9 months younger than typically developing control participants on average. Body mass index and serum vitamin D and calcium levels were similar. Boys with ASD consumed 16% fewer calories, with a larger percentage obtained from carbohydrates, and 37% less animal protein and 20% less fat than typically developing controls. A lower proportion of ASD participants were categorized as “very physically active” (27% vs 79%; P<0.001). BMD z scores were 0.7 to 1.2 standard deviations lower in ASD than typically developing controls at all locations. Higher animal protein, calcium, and phosphorus intakes were associated positively with bone density measures in boys with ASD.

      Conclusions

      Compared to typically developing controls, boys with ASD had lower protein, calcium, and phosphorus intakes, activity levels, and BMD z scores at the lumbar spine, femoral neck, total hip, and whole body less head. Protein, calcium, and phosphorus intakes were associated positively with BMD.

      Keywords

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      Biography

      A. M. Neumeyer is medical director and a child neurologist, Lurie Center for Autism, Massachusetts General Hospital, Lexington, and an assistant professor, Harvard Medical School, Boston, MA.

      Biography

      N. Cano Sokoloff is a clinical research fellow, Lurie Center for Autism, Massachusetts General Hospital, Lexington.

      Biography

      E. I. McDonnell is staff biostatistician, Biostatistics Center, Massachusetts General Hospital, Boston.

      Biography

      E. A. Macklin is an assistant in statistics, Biostatistics Center, Massachusetts General Hospital, Boston, and instructor in medicine, Harvard Medical School, Boston, MA.

      Biography

      C. J. McDougle is director and a child psychiatrist, Lurie Center for Autism, Massachusetts General Hospital, Lexington, and a professor, Harvard Medical School, Boston, MA.

      Biography

      T. M. Holmes is a clinical research dietitian, Translational & Clinical Research Center, Massachusetts General Hospital, Boston.

      Biography

      J. L. Hubbard is a senior research dietitian, Translational & Clinical Research Center, Massachusetts General Hospital, Boston.

      Biography

      M. Misra is chief of pediatric endocrine and neuroendocrine units, Massachusetts General Hospital, Boston, and a professor, Harvard Medical School, Boston, MA.