Abstract
Background
Food selectivity is common in children with autism spectrum disorder (ASD). The clinical
characteristics, however, of severe food selectivity in children with ASD is not well
documented.
Objective
This study examined the demographic characteristics, anthropometric parameters, risk
of nutritional inadequacy, dietary variety, and problematic mealtime behaviors in
a sample of children with ASD with severe food selectivity.
Design
The study involved a cross-sectional electronic medical record review. Data extraction
followed a systematic protocol for data extraction.
Participants/setting
Children (age 2 to 17 years) with ASD, severe food selectivity, and complete nutritional
data who received a multidisciplinary evaluation at a specialty feeding clinic in
the southeastern United States between January 2014 and January 2016. Criteria for
severe food selectivity used in this clinical practice required complete omission
of one or more food groups (eg, fruit, vegetable, protein, grain, dairy) or consuming
a narrow range of items on a weekly basis (eg, five or fewer total food items).
Main outcome measures
Analyses examined demographic characteristics, dietary preferences, risk for nutritional
inadequacies, anthropometric parameters, and problematic mealtime behaviors.
Results
Of the 279 patients evaluated during the 24-month period, 70 children with ASD and
severe food selectivity met inclusion criteria. Caregivers reported 67% of the sample
(n=47) omitted vegetables and 27% omitted fruits (n=19). Seventy-eight percent consumed
a diet at risk for five or more inadequacies. Risk for specific inadequacies included
vitamin D (97% of the sample), fiber (91%) vitamin E (83%), and calcium (71%). Children
with five or more nutritional inadequacies (n=55) were more likely to make negative
statements during meals (P<0.05). Severe food selectivity was not associated with compromised growth or obesity.
Conclusion
Children with ASD and severe food selectivity may be at increased risk for nutritional
inadequacies. Future research should examine causes, consequences, and remediation
of severe food selectivity in this population.
Keywords
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Biography
W. G. Sharp is director, Pediatric Feeding Disorders Program, Marcus Autism Center, Atlanta, GA, and associate professor, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
Biography
V. Postorino is postdoctoral fellow, Emory University School of Medicine, Atlanta, GA, and Marcus Autism Center, Atlanta, GA.
Biography
C. E. McCracken is director, Pediatric Biostatistics Core, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
Biography
R. C. Berry is lead nutritionist, Pediatric Feeding Disorders Program, Marcus Autism Center, Atlanta, GA.
Biography
K. K. Criado is a psychologist, Pediatric Feeding Disorders Program, Marcus Autism Center, Atlanta, GA, and assistant professor, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
Biography
T. L. Burrell is a psychologist, Pediatric Feeding Disorders Program, Marcus Autism Center, Atlanta, GA, and assistant professor, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
Biography
L. Scahill is director, Clinical Trials, Marcus Autism Center and professor, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
Article info
Publication history
Published online: July 10, 2018
Accepted:
May 2,
2018
Received:
August 15,
2017
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT There is no funding to disclose.
Identification
Copyright
© 2018 by the Academy of Nutrition and Dietetics.
