Dietary intakes, use of exclusion diets and supplements in children aged 2 1/2 - 8 years with Autism Spectrum Disorder in New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand

Abstract

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects 1 in 68 children. Children with ASD are thought to be a nutritionally vulnerable population due to a tendency to exhibit eating behaviours such as selective or picky eating. Gaining popularity among parents of children with ASD is the use of complementary and alternative medical (CAM) therapies such as exclusion diets and supplements. Little is known about the dietary intakes of this population and whether they are meeting nutrition guidelines. The aim of this study was to investigate the dietary intakes and use of exclusion diets/supplements in children with ASD in New Zealand. Methods: Fifty children aged 2.5-8 years old with a medical diagnosis of ASD according to the DSM-V were recruited through Waitakere District Health Board (WDHB) and autism support groups. Parents were supplied with a 4-day food diary and dietary questionnaire which was used to collect information on dietary intakes, types of exclusion diets and supplements being used, reasons for use, perceived improvements, and where parents received information from. Dietary data from the 4-day food diaries was also used to conduct a food group analysis. The number of servings from each of the food groups was compared to the Ministry of Health Food and Nutrition Guidelines for Healthy Children and Young People (aged 2-18 years) recommended daily serves. Results: Children in this study were found to have carbohydrate, protein and fat intakes within the acceptable range. Dietary fibre was found to be a nutrient of concern as 40% of children were not meeting the recommendation. There were a large proportion of children not meeting the Estimated Average Requirement (EAR) for calcium (26% of children). Children were not meeting the recommended number of daily serves of fruit, vegetables or dairy. Significant differences were found when looking at dietary intakes based on exclusion diet status, where children in the exclusion diet group have significantly lower calcium intakes than children in the non-exclusion diet group (p=0.03). This study also found that 31% of children were using exclusion diets and 55% were using supplements. Conclusion: Results of this study suggest that children with ASD are not meeting the daily recommended servings of various food groups including fruits, vegetables and dairy. Although energy intakes were not impaired, certain nutrients in the diets of children with ASD in this study were below recommended daily intakes, specifically calcium, vitamin D and dietary fibre. Children with ASD may not receive a dietetic referral unless their growth is faltering and therefore nutritional deficiencies may go unnoticed. More research is needed to determine the impact of exclusion diet and supplement use on the nutritional intakes of children with ASD.