Re: Diets and ASD/previous topics

[Guest guest]

No worries Ruth. We revisit the same topics regularly on this list. Any mention

of earlier discussions is just to help if you want to read even more.

Diets and ASD

To:

Date: Wednesday, August 4, 2010, 7:02 PM

 

For those of you still worried about your kids eating habits and whether or

not they are getting enough, I posted this last week. Like many of us who

have been on this site for yrs, our kids survived their limited (2-4

foods) and, eventually, started to eat more varieties of food.

Relax.........pick more important battles to fight.

From_Medscape Medical News_ (_http://www.medscape.com/news_

(http://www.medscape.com/news) )

Children With Autism Routinely Exhibit Feeding Difficulties in Infancy

Deborah Brauser

July 28, 2010  Although children with autism spectrum disorders (ASDs)

exhibit feeding symptoms as early as 6 months of age and have a less varied

diet than healthy children after 15 months of age, these eating patterns do

not impair their energy intake and/or growth, according to a new comparison

study of almost 13,000 children from the United Kingdom.

" A clinical implication of these findings is that the possibility of an ASD

should be considered for young children who present with feeding problems,

pervasive food refusal, and limited food preferences, " write lead study

author Alan Emond, MD, from the Center for Child and Adolescent Health in

the

Department of Community Based Medicine at the University of Bristol in

England, and colleagues.

" Appropriate questions should be asked about the child's social

communication, shared attention, and stereotypic and self-stimulatory

behaviors, " add

the study authors.

" Many parents of children with [ASD] are worried about the choosiness of

their children and possible lack of a balanced diet, " study investigator

Jean

Golding, PhD, emeritus professor of pediatrics and perinatal epidemiology

at the University of Bristol, told Medscape Medical News.

" By comparing the diets of these children with diets of children without an

[ASD], we have shown that, although there are differences in the variety

of foods these children eat, there is little indication that they are

coming

to any harm in consequence, " she noted. " I [would] suggest that clinicians

reassure parents...that fussiness over food is a normal part of these

disorders. "

The study was published online July 19 in Pediatrics.

Almost 13,000 Children Evaluated

" People with ASDs are often resistant to change and have a narrow range of

interests, which can extend to the foods they like, " write the study

authors.

They note that most past studies looking at the eating patterns of children

with this disorder have " been based on small clinical samples with no

control group " or been retrospective in design.

For this study, the investigators used " a population-based cohort to

investigate feeding patterns, diet, and growth of children with ASDs and

used

prospectively reported data collected before the diagnosis of an autism

disorder had been made. "

They evaluated and compared data on 79 children with ASD (median age at

referral, 28 months; median age at diagnosis, 45 months) with 12,901

healthy

controls from the Avon Longitudinal Study of Parents and Children (ALSPAC),

a trial that followed up kids from southwest England born between April

1991 and December 1992.

Questionnaires on feeding patterns and frequency of foods eaten were

completed by the mothers of all participating children when the child was

6, 15,

24, 38, and 54 months of age.

Height and weight measurements were examined from the Avon Child Health

Computer database, which tracks health records for preschool-aged children,

and at a special ALSPAC research clinic when each child reached 7 years of

age. Venous blood samples were also taken during the research clinic.

Significant Differences in Eating Patterns

Results showed that at the age of 6 months, the children subsequently

diagnosed as having ASD were more likely to be described by their mothers

as

" slow feeders " compared with the healthy group (P = .04) and were more

likely

to have a late introduction of solid food after 6 months (P = .004).

These findings " could be seen as early symptoms of an autistic child's

difficulty in accepting change, " explain the study authors.

During the 15- to 54-month time points, the mothers consistently reported

that their children with ASD were " very difficult to feed " (P < .001) and

" very choosy " (P < .001) compared to the other study group.

Starting at 15 months, the ASD group also had a significantly less varied

diet than did the healthy controls, with this difference growing with

increasing age (interaction P = .002). They were also more likely to have

different meals from their families starting at 24 months.

By the age of 54 months, 8% of the ASD group were taking a special diet for

" allergy " vs just 2% of the other group (odds ratio, 3.41; 95% confidence

interval, 1.35 – 8.63; P = .01).

In addition, " ASD children consumed less vegetables, salad, and fresh

fruit, but also less sweets and fizzy drinks, " the study authors report.

Although the intake of energy, total fat, carbohydrates, and protein was

similar between the groups at the age of 38 months, those with ASD consumed

less of the vitamins C (P = .02) and D (P = .003).

" [Parents] should be aware that their child's diet may be deficient in

certain vitamins, possibly warranting appropriate supplementation, " said

Dr.

Golding.

At both the 18-month and 7-year time points, no differences were found in

mean weight, height, or body mass index between the 2 study groups.

Hemoglobin concentrations at the age of 7 years were also similar.

Finally, " the limitation in number of foods accepted was most apparent in

children with classical autism, but no other differences were apparent

between different types of [ASD] in feeding symptoms, diet, or growth, " the

study authors write.

Problems in Infancy Surprising

" This study did confirm things that we'd already found in older children, "

, PhD, director of the Feeding Program at the Penn State

Hershey Medical Center and associate professor of Pediatrics at the Penn

State

College of Medicine, told Medscape Medical News.

" Several studies have found that kids with [ASD] have problems with food

selectivity and feeding problems more generally and this confirmed that.

They

just found it in a younger population than anybody [ever] looked at

before, " said Dr. , who was not involved with this study.

He noted that the finding of these symptoms in such a young age surprised

him. " The fact that [the investigators] were seeing these feeding problems

in infants was interesting and has not been found before. "

Dr. added that the findings will need to be replicated on a larger

scale because of the study's relatively small sample size of children with

ASD. " Also, they found some nutrient deficiencies which make me wonder: if

you were to look over a longer period of time, would those deficiencies

become significant? Perhaps we need to pay a little more attention to their

diet to make sure it's nutritionally appropriate.

" One of the things that pediatricians often tell parents when they have

children that are selective is that it's just a phase that they'll outgrow.

And that's probably not true for some kids and certainly not true for the

kids with [ASD], " continued Dr. . " So I think it should give pause

to

some of the primary care providers that see these children that this may be

a sign of something more than just the typical toddler picky eating. "

This study was funded by the Medical Research Council. The study authors

and Dr. has disclosed no relevant financial relationships.

Pediatrics. Published online July 19, 2010.