The Correlation Between Diet And Behavioral Symptoms Among Children With Autism Spectrum Disorders

ObjectiveIn the past decades,the incidence of autism spectrum disorder(ASD)showed a rapid upward trend.ASD is characterized by deficits in social communication and social interactions,as well as restricted,repetitive patterns of behavior,interests,or activities.In recent years,the role of microbiota–gut–brain axis in ASD is emerging as a prominent factor in the generation of autistic behaviors.Some studies have shown that diets and gastrointestinal symptoms are closely related to abnormal behavior in ASD.This study focuses on the diet and functional gastrointestinal symptoms in ASD,from the perspective of microbiota–gut–brain axis,investigating and analyzing diet,gastrointestinal symptoms and nutrition of ASD children.To provide clues of the diet intervention for caregivers or intervention workers of ASD children,in order to improve the life quality of children with ASD.Methods1.The food frequency questionnaire(FFQ)was used to investigate the dietary frequency of 237 preschoolers ASD children and 231 normal children.The GI symptoms of 237 ASD children and 231 normal children were investigated by The Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III(QPGS-R III).2.107 ASD of preschool ASD children in Community-based rehabilitation project and special education school were used social communication questionnaire(SCQ),strengths and difficulties questionnaire(SDQ)and repetitive behavior questionnaire(RBQ-2)to evaluate the abnormal behavior.3.The nutrient intake of 47 ASD children was investigated by the 3-day 24-hour dietary survey.Results1.The survey included 237 ASD and 231 healthy children.Compared with the normal children,the frequency of eating staple food,fish or meat,egg and snack of children with ASD was higher than that of control group(t=-5.09,-2.11,-4.95,-4.95,P<0.05).2.In the ASD group,46(19.4%)children were diagnosed with GI symptoms using the QPGS questionnaire.The positive rate was 9.5%in the normal group,which lower than the ASD children group with statistically significant differences(?~2=9.21,P<0.05).3.Five dietary modes of 107 ASD children is healthy,processed,high calorie,protein and coarse grain.The scores of five dietary factors were divided into low,middle and high groups.The relationship between dietary pattern score and SCQ,SDQ and RBQ-2 in children with ASD was compared.In SCQ social interaction field,communication field,SDQ peer interaction field,RBQ-2 abnormal sensory pattern field,these scores in the high factor score group of processed dietary was higher than low score group,the difference was statistically significant(F=3.97,3.44,5.10,1.30,P<0.05).In the SDQ,the score of prosocial behavior in the high score group were lower than those in the low scores(F=4.42,P<0.05).In the high calorie diet pattern,compared with low factor score group,the score in the high factor score group were higher in SDQ hyperactivity field with statistically significant differences(F=3.39,P<0.05);In the protein and grain pattern,compared with low factor score group,the score in the high factor score group were higher in SDQ peer interaction field,the difference was statistically significant(F=3.52,5.63,P<0.05).Among 107 children with ASD,31 had GI symptoms.The score of repetitive and stereotypical behavioral patterns in SCQ,and RBQ-2 total score,in ASD children with GI symptoms were significantly higher than that in ASQ children without GI symptoms(t=-2.48,-2.10,P<0.05)4.According to the dietary survey,the results showed that children with ASD not only had multiple nutrient deficiencies,for example,VD,VB1,VB6,folic acid,calcium and iodine did not reach the standard of DRIs.Among them,VB6,Folic acid,calcium,iodine and VD is particularly serious.There are still excess nutrients,such as protein,carbohydrate,VE,nicotinic acid,zinc,magnesium,iron,phosphorus,manganese.5.The relationship between the nutrient intake of ASD children and SCQ,SDQ,RBQ-2 shows that the repeated stereotyped behavior and social communication and interaction are related to some nutrients in dietary intake,such as protein,VA,while The association between SDQ and dietary nutrition intake is not robust.Conclusion(1)Children with ASD had more limited diet than normal children,preferring rice,meat and snacks.And their GI symptoms were more than those of normal children.In addition,comparisons of ASD children with GI symptoms and ASD children without GI symptoms found that the former had more behavioral problems than the latter.There may be a role of the brain-gut axis in this.This article suggests that except for comprehensive intervention to improve ASD behavior,we should should not overlook dietary interventions in relieving their GI symptoms.(2)Through the investigation of dietary intake of children with ASD,we found that ASD children not only have the problem of undernutrition,but also have the situation of overnutrition.Both of them should not be neglected.The nutritional status can affects their cognition.These further illustrate the importance of diet interventions for ASD children.