Children with autism spectrum disorder (ASD) are often picky eaters, which can lead parents to worry that they aren’t getting the right amounts of vitamins and minerals. This sometimes leads parents to try nutritional supplements and dietary regimens, such as gluten-free and casein-free (GFCF) diets without professional supervision.
But a new study published in the Journal of the Academy of Nutrition and Dietetics found that this often results in both insufficient nutrients and excessive nutrients.
For example, researchers found that despite supplementation, children with ASD were deficient in calcium, while some were consuming excessive amounts of vitamin A and other nutrients.
“Many families try a GFCF diet in an attempt to improve symptoms of ASD,” said lead investigator Patricia A. Stewart, Ph.D., R.D., an assistant professor of pediatrics at the University of Rochester Medical Center in New York. “While 19 percent of all Autism Speaks Autism Treatment Network (AS ATN) participants were reported to be on a GFCF diet, 12 percent of the children in the subgroup participating in this study were given a GFCF diet and were significantly more likely to use nutritional supplements — 78 percent vs 53 percent — however, the micronutrient intake of children on or off the diet was remarkably similar.”
The researchers recruited 368 children between the ages of 2 and 11 from five AS ATN sites at Cincinnati Children’s Hospital, University of Arkansas, University of Colorado, University of Pittsburgh and University of Rochester. All had been diagnosed with autistic disorder, Asperger disorder, or pervasive developmental disorder.
Three-day food records were completed for the children by their caregivers. A registered dietitian nutritionist trained the caregivers to record the amount of all foods, beverages and nutritional supplements consumed, including brand names and recipes used for food preparation.
In the case of nutritional supplements, photographs of the labels were taken to ensure that ingredients were accurately recorded, the researchers reported. Registered dietitian nutritionists verified the records and called the parents if clarification was needed.
Examining these detailed eating records, investigators found that the children were consuming similar amounts of micronutrients as children without ASD. They also had the same deficits in vitamins D, E, calcium, potassium, and choline as the general population.
Although autistic children are given supplements more often — 56 percent vs. 31-37 percent of the general population — even after supplementation, 40 percent to 55 percent were lacking in calcium and 30 percent to 40 percent were lacking in vitamin D, according to the study’s findings.
Children on the GFCF diet consumed more magnesium and vitamin E, the researchers reported, noting this may be due to the substitution of soy and nut-based products. Children on this diet were more adequately supplemented with vitamin D. Calcium supplementation was equally inadequate in those on and off the diet, the researchers added.
Despite different eating behaviors, autistic children received much of their needed micronutrients from their food. This might be due to the high levels of fortification in the modern food supply, where vitamins and minerals are often added, the researchers theorized.
This fortification may also be responsible for the overconsumption of certain nutrients by children with ASD, researchers noted. For the supplement users in this study, many exceeded the Tolerable Upper Limit for safe intake levels of vitamin A, folic acid, and zinc, according to the study’s findings.
“In clinical practice, each patient needs to be individually assessed for potential nutritional deficiencies or excess,” Stewart said. “Few children with ASD need most of the micronutrients they are commonly given as multivitamins, which often leads to excess intake that may place children at risk for adverse effects. When supplements are used, careful attention should be given to adequacy of vitamin D and calcium intake.”
Source: Elsevier Health Sciences