Systematic Reviews
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Dec 9, 2024; 13(4): 99649
Published online Dec 9, 2024. doi: 10.5409/wjcp.v13.i4.99649
Nutritional management and autism spectrum disorder: A systematic review
Mohammed Al-Beltagi
Mohammed Al-Beltagi, Department of Pediatric, Faculty of Medicine, Tanta University, Tanta ‎ 31511‎, Alghrabia, Egypt
Mohammed Al-Beltagi, Department of Pediatric, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671‎‎, Bahrain
Author contributions: Al-Beltagi M wrote this review exploring the effects of diet on children with autism; Al-Beltagi M conceptualized and designed the review, conducted the search in electronic databases, and synthesized the included studies’ findings.
Conflict-of-interest statement: The author declares that there are no conflicts of interest regarding the publication of this article. The research was conducted independently, and there has been no financial or personal relationship, grants, or other support from any organizations or entities that could be perceived as influencing the outcome of this work.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammed Al-Beltagi, MBChB, MD, PhD, Chairman, Full Professor, Research Scientist, Department of Pediatric, Faculty of Medicine, Tanta University, Al-Bahr Street, The Medical Complex, Tanta ‎31511‎, Alghrabia, Egypt. mbelrem@hotmail.com
Received: July 26, 2024
Revised: September 21, 2024
Accepted: October 15, 2024
Published online: December 9, 2024
Processing time: 95 Days and 15.3 Hours
Abstract
BACKGROUND

Autism spectrum disorder (ASD) presents unique challenges related to feeding and nutritional management. Children with ASD often experience feeding difficulties, including food selectivity, refusal, and gastrointestinal issues. Various interventions have been explored to address these challenges, including dietary modifications, vitamin supplementation, feeding therapy, and behavioral interventions.

AIM

To provide a comprehensive overview of the current evidence on nutritional management in ASD. We examine the effectiveness of dietary interventions, vitamin supplements, feeding therapy, behavioral interventions, and mealtime practices in addressing the feeding challenges and nutritional needs of children with ASD.

METHODS

We systematically searched relevant literature up to June 2024, using databases such as PubMed, PsycINFO, and Scopus. Studies were included if they investigated dietary interventions, nutritional supplements, or behavioral strategies to improve feeding behaviors in children with ASD. We assessed the quality of the studies and synthesized findings on the impact of various interventions on feeding difficulties and nutritional outcomes. Data extraction focused on intervention types, study designs, participant characteristics, outcomes measured, and intervention effectiveness.

RESULTS

The review identified 316 studies that met the inclusion criteria. The evidence indicates that while dietary interventions and nutritional supplements may offer benefits in managing specific symptoms or deficiencies, the effectiveness of these approaches varies. Feeding therapy and behavioral interventions, including gradual exposure and positive reinforcement, promise to improve food acceptance and mealtime behaviors. The findings also highlight the importance of creating supportive mealtime environments tailored to the sensory and behavioral needs of children with ASD.

CONCLUSION

Nutritional management for children with ASD requires a multifaceted approach that includes dietary modifications, supplementation, feeding therapy, and behavioral strategies. The review underscores the need for personalized interventions and further research to refine treatment protocols and improve outcomes. Collaborative efforts among healthcare providers, educators, and families are essential to optimize this population's nutritional health and feeding practices. Enhancing our understanding of intervention sustainability and long-term outcomes is essential for optimizing care and improving the quality of life for children with ASD and their families.

Keywords: Feeding therapy; Behavioral interventions; Mealtime practices; Autism spectrum disorder; Children; High-dose methyl cobalamine

Core Tip: Effective management of feeding challenges in children with autism spectrum disorder (ASD) requires a comprehensive approach integrating feeding therapy and behavioral interventions. Addressing oral motor skills and sensory sensitivities and establishing structured mealtime routines are crucial. Behavioral strategies like gradual exposure, positive reinforcement, and modeling can significantly improve food acceptance and mealtime behaviors. Creating a sensory-friendly environment and involving parents in meal planning are essential. This systematic review highlights the importance of multidisciplinary collaboration and tailored interventions to enhance nutritional intake and overall health outcomes for children with ASD.