title: Correlation between Nutrition and Symptoms: Nutritional Survey of Children with Autism Spectrum Disorder in Chongqing, China.
abstract: Restricted diets and inadequate nutrient intake of children with autism spectrum disorder (ASD) have been reported. This study examined the nutritional statuses of children with ASD and the relationships between their behaviors and nutritional intake. A total of 154 children with ASD (age = 5.21 ± 1.83 years) and 73 typically-developing (TD) children (age = 4.83 ± 0.84 years) from Chongqing, China, were enrolled. The severity of ASD was evaluated using the Childhood Autism Rating Scale (CARS). The serum ferritin, folate, vitamin B12, 25(OH) vitamin D, and vitamin A concentrations in the children with ASD were determined. All participants underwent anthropometric examinations, dietary assessments, and questionnaire assessments about their feeding behaviors, and gastrointestinal symptoms. The ZHA, ZWA, and ZBMIA were found to be significantly lower in the children with ASD compared with those without ASD. In addition, the percentages of children exhibiting severe picky eating and severe resistance to new foods, as well as those with a reported general impression of severe eating problems and constipation, were higher among the children with ASD. These children consumed significantly fewer macronutrients compared with the children without ASD. In addition, the children with ASD had the highest rate of vitamin A deficiency, followed by iron deficiency. After adjusting for sex, the vitamin A concentration was found to be negatively correlated with the CARS score (rs = -0.222, p = 0.021). No correlation between the ferritin, folate, vitamin D, or vitamin B12 concentration and the CARS score was found. These results suggest that reduced macronutrient intakes, severe feeding behavior issues, constipation, and vitamin A deficiency are quite common among children with ASD. Further, a low serum vitamin A level may be a risk factor for symptoms of ASD. However, the underlying mechanism should be further studied.
authors.affiliation: Department of Child Health Care, Children's Hospital of Chongqing Medical University, Chongqing 400014, China. caretoo@163.com.|Children's Nutrition Research Center, Hospital of Chongqing Medical University, Chongqing 400014, China. caretoo@163.com.|Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China. caretoo@163.com.
authors.forename: Xiao
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Child Health Care, Children's Hospital of Chongqing Medical University, Chongqing 400014, China. liujuanyehai@163.com.|Children's Nutrition Research Center, Hospital of Chongqing Medical University, Chongqing 400014, China. liujuanyehai@163.com.|Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China. liujuanyehai@163.com.
authors.forename: Juan
authors.initials: J
authors.lastname: Liu
authors.affiliation: Pediatric Department of Clinical Medicine of Dazhou Vocational and Technical College, Dazhou 635001, China. m1868282131@163.com.
authors.forename: Xueqin
authors.initials: X
authors.lastname: Xiong
authors.affiliation: Children's Nutrition Research Center, Hospital of Chongqing Medical University, Chongqing 400014, China. tingyang1206@126.com.|Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China. tingyang1206@126.com.
authors.forename: Ting
authors.initials: T
authors.lastname: Yang
authors.affiliation: Department of Child Health Care, Children's Hospital of Chongqing Medical University, Chongqing 400014, China. candyhnl@163.com.|Children's Nutrition Research Center, Hospital of Chongqing Medical University, Chongqing 400014, China. candyhnl@163.com.|Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China. candyhnl@163.com.
authors.forename: Nali
authors.initials: N
authors.lastname: Hou
authors.affiliation: Children's Nutrition Research Center, Hospital of Chongqing Medical University, Chongqing 400014, China. liangxiaohua666@gmail.com.|Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China. liangxiaohua666@gmail.com.
authors.forename: Xiaohua
authors.initials: X
authors.lastname: Liang
authors.affiliation: Children's Nutrition Research Center, Hospital of Chongqing Medical University, Chongqing 400014, China. jchen010@cqmu.edu.cn.|Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China. jchen010@cqmu.edu.cn.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Child Health Care, Children's Hospital of Chongqing Medical University, Chongqing 400014, China. chqq5@126.com.|Children's Nutrition Research Center, Hospital of Chongqing Medical University, Chongqing 400014, China. chqq5@126.com.|Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China. chqq5@126.com.
authors.forename: Qian
authors.initials: Q
authors.lastname: Cheng
authors.affiliation: Department of Child Health Care, Children's Hospital of Chongqing Medical University, Chongqing 400014, China. tyli@vip.sina.com.|Children's Nutrition Research Center, Hospital of Chongqing Medical University, Chongqing 400014, China. tyli@vip.sina.com.|Ministry of Education Key Laboratory of Child Development and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China. tyli@vip.sina.com.
authors.forename: Tingyu
authors.initials: T
authors.lastname: Li
mesh_terms: D000818:Animals; D000067877:Autism Spectrum Disorder; D001361:Avitaminosis / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D019959:Feeding and Eating Disorders of Childhood / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009749:Nutrition Surveys; D009752:Nutritional Status; D011795:Surveys and Questionnaires
keywords: autism spectrum disorders; biochemical assessment; mealtime behavior; nutrient intake; vitamin A