Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2025 Aug;38(4):e70099.
doi: 10.1111/jhn.70099.

Nutritional Status of Children Diagnosed With Autism Spectrum Disorder: A Systematic Review and Meta-Analysis

Afnan Alhrbi  1 , Dimitris Vlachopoulos  1 , Ellie-Mae Healey  1 , Ahmed Taher Massoud  2 , Christopher Morris  3 , Raquel Revuelta Iniesta  1
Affiliations
Meta-Analysis

Nutritional Status of Children Diagnosed With Autism Spectrum Disorder: A Systematic Review and Meta-Analysis

Afnan Alhrbi et al. J Hum Nutr Diet. 2025 Aug.

Abstract

Autism spectrum disorder (ASD) may impact feeding behaviours, which can affect physical development. We aimed to examine published evidence comparing nutritional status, defined as anthropometry, micronutrient status, and intakes and dietary intake, of children with ASD with those of typically developing children (TDC). Eligibility criteria included any studies that compared nutritional status among children with ASD and TDC. PubMed, Web of Science, Scopus and CENTRAL were searched. We used standardized mean difference (SMD) as an effect size for continuous variables and risk ratio (RR) for dichotomous variables with a 95% confidence interval (CI). Thirty-two studies with 18,480 children (ASD: 2955, TDC: 15,525) were included in our meta-analysis. Children with ASD were statistically significantly shorter than TDC (SMD: -0.16, 95% CI [-0.28, -0.04], I2 = 7%), but no difference in weight [-0.12, 95% CI (-0.17, 0.92)] and BMI [-0.06, 95% CI (-0.32, 0.20)]. They had decreased intake of protein [-0.34, 95% CI (-0.52, -0.15)] and nearly all lipid-soluble vitamins: vitamin A (SMD: -0.20, 95% CI [-0.38, -0.02], I2 = 37%), vitamin D (SMD: -0.30, 95% CI [-0.53, -0.03], I2 = 50%), and vitamin K (SMD: -41, 95% CI [-0.71, -0.10], I2 = 0%). Also, children with ASD had a statistically significantly decreased intake of some water-soluble vitamins like folate, riboflavin, thiamine and niacin. Decreased levels of some micronutrients like vitamin D and folate was also found. Children with ASD are statistically significantly shorter than TDC, which can be explained by the lower protein intake and fat- and water-soluble vitamin status and intake. These findings warrant further longitudinal population-based studies.

Keywords: autism spectrum disorder; macronutrients; minerals; nutritional status; vitamins.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow chart.
Figure 2
Figure 2
Meta‐analysis from cross‐sectional studies comparing anthrpometry, nutrient intake and vitamin status of children with ASD against TDC. (A) Weight (B) BMI (C) Height (D) Protein (E) Folate (F) Vitamin D.
See this image and copyright information in PMC

References

    1. Lord C., Elsabbagh M., Baird G., and Veenstra‐Vanderweele J., “Autism Spectrum Disorder,” Lancet 392, no. 10146 (2018): 508–520, 10.1016/S0140-6736(18)31129-2. - DOI - PMC - PubMed
    1. Maenner M. J., Warren Z., Williams A. R., et al., “Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years—Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020,” MMWR Surveillance Summaries 72, no. 2 (2023): 1–14, 10.15585/mmwr.ss7011a1. - DOI - PMC - PubMed
    1. Talantseva O. I., Romanova R. S., Shurdova E. M., et al., “The Global Prevalence of Autism Spectrum Disorder: A Three‐Level Meta‐Analysis,” Frontiers in Psychiatry 14 (2023): 1071181, 10.3389/fpsyt.2023.1071181. - DOI - PMC - PubMed
    1. Lai M. C., Kassee C., Besney R., et al., “Prevalence of Co‐Occurring Mental Health Diagnoses in the Autism Population: A Systematic Review and Meta‐Analysis,” Lancet Psychiatry 6, no. 10 (2019): 819–829, 10.1016/S2215-0366(19)30289-5. - DOI - PubMed
    1. Landa R. J., “Efficacy of Early Interventions for Infants and Young Children With, and at Risk for, Autism Spectrum Disorders,” International Review of Psychiatry 30, no. 1 (2018): 25–39, 10.1080/09540261.2018.1432574. - DOI - PMC - PubMed