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Observational Study
. 2024 Nov 4;50(1):228.
doi: 10.1186/s13052-024-01794-8.

Adverse food reactions and alterations in nutritional status in children with autism spectrum disorders: results of the NAFRA project

Serena Coppola #  1   2 , Rita Nocerino #  3   4   5 , Franca Oglio  1   2 , Paola Golia  1 , Maria Candida Falco  1 , Maria Pia Riccio  6 , Laura Carucci  1   2 , Teresa Rea  7 , Silvio Simeone  8 , Raffaele Garotti  1 , Nadia Marani  1 , Carmela Bravaccio  1 , Roberto Berni Canani  1   2   9   10
Affiliations
Observational Study

Adverse food reactions and alterations in nutritional status in children with autism spectrum disorders: results of the NAFRA project

Serena Coppola et al. Ital J Pediatr. .

Abstract

Background: To assess the adverse food reactions (AFR) prevalence in children with autism spectrum disorder (ASD) and in non-ASD healthy controls (NASD). Nutritional status alterations, food selectivity and adherence to Mediterranean Diet (MD) were also evaluated.

Methods: The NAFRA (Nutritional status and Adverse Food Reactions in children with Autism Spectrum Disorder) project was an observational, case-control, comparative study conducted at a tertriary center for pediatrics involving Caucasian patients of both sexes, aged 18 months-7 years, with a diagnosis of ASD, and matched NASD controls.

Results: From October 2017 to December 2023, 100 ASD patients [79 male, mean (± SD) age 49.9 months (± 15.4)] and 100 NASD controls [75 male, mean (± SD) age 49.8 months (± 17.7)] were enrolled at the Pediatric Section of the Department of Translational Medical Science of the University of Naples Federico II. A significantly higher prevalence of AFR was observed in ASD patients if compared with NASD (16% vs. 2%, p = 0.001), mainly due to a higher prevalence of food allergy (7% vs. 1%, p = 0.03). A significantly higher prevalence of food intolerance and celiac disease was also observed in ASD children. The rate of obesity was significantly higher in ASD patients compared to NASD. Food selectivity and low MD-adherence were more frequent in ASD children (26% vs. 2%, p < 0.0001 and 28% vs. 16%, p = 0.041, respectively).

Conclusions: The high rate of AFR, obesity and unhealthy dietary habits observed in ASD children strongly suggest the importance of a multidisciplinary approach, providing early diagnosis of AFR and appropriate nutritional management to improve core and associated ASD-related conditions.

Trial registration: The NAFRA Project was registered on https://clinicaltrials.gov/ with the identifier NCT04719923. Registered 18 January 2021. https://clinicaltrials.gov/study/NCT04719923 .

Keywords: Celiac disease; Food allergy; Food intolerance; Food selectivity; Malnutrition; Mediterranean diet; Obesity.

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Conflict of interest statement

The authors declare that they have no relevant conflicts of interest.

Figures

Fig. 1
Fig. 1
Graphic representation of the study design. AFR, adverse food reactions. Figure shows graphically the design of the NAFRA study
Fig. 2
Fig. 2
The flow of study subjects. Figure represents the flow diagram of participants of the NAFRA study
See this image and copyright information in PMC

References

    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th Edition Text Revised (DSM-5-TR) American Psychiatric Publishing; 2022.
    1. Scattoni ML, Fatta LM, Micai M, Sali ME, Bellomo M, Salvitti T, et al. Autism spectrum disorder prevalence in Italy: a nationwide study promoted by the Ministry of Health. Child Adolesc Psychiatry Ment Health. 2023;17:125. - PMC - PubMed
    1. Zeidan J, Fombonne E, Scorah J, Ibrahim A, Durkin MS, Saxena S, et al. Global prevalence of autism: a systematic review update. Autism Res. 2022;15:778–90. - PMC - PubMed
    1. Cottenceau H, Roux S, Blanc R, Lenoir P, Bonnet-Brilhault F, Barthélémy C. Quality of life of adolescents with autism spectrum disorders: comparison to adolescents with diabetes. Eur Child Adolesc Psychiatry. 2012;21:289–96. - PubMed
    1. Rogge N, Janssen J. The economic costs of Autism Spectrum Disorder: A literature review. J Autism Dev Disord. 2019;49:2873–900. - PubMed

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