An expert panel has published new guidelines in the Journal of Academy Nutrition and Dietetics specifying new nutritional guidelines for the management of gastrointestinal symptoms in children diagnosed with autism spectrum disorders (ASD).
“Children with autism are at increased risk for feeding and gastrointestinal (GI) concerns compared with peers and both of these issues involve nutrition management. We viewed the lack of an evidence-based guideline regarding nutrition management of GI symptoms in children with ASD as unacceptable,” said co-author William Sharp, PhD, director of the Pediatric Feeding Disorders program at Marcus Autism Center and assistant professor of pediatrics at Emory University School of Medicine. “Our goal was to establish a standard manual of care for nutrition management which clinicians around the world could refer to.”
“The committee developed the guideline with consideration of the unique dietary, medical, and behavioral challenges observed in children with ASD. This includes high rates of food selectivity observed in children with ASD, frequent use of caregiver-initiated complementary/alternative diet therapies, and growing concern regarding possible nutritional deficits and excesses often observed in this population,” said co-author Rashelle Berry, lead dietician at Pediatric Feeding Disorders program at Marcus Autism Center.
Food sensitivity is associated with gastrointestinal symptoms in children with ASD. Some parents have obtained significant health improvement by providing the appropriate diet. Alternative diets such as gluten-free, casein-free diets or other diets that restrict or eliminate certain food groups are often initiated by caregivers. ASD children may be at higher risk for nutrition-related conditions such as obesity or poor bone growth.
“Children with autism, like their typically developing peers, present with medical conditions that require nutrition intervention,” said Berry. “Awareness of the unique challenges seen in this population is needed so that clinicians are well-equipped to plan effective interventions. The ultimate goal of nutrition management in autism is resolution of symptoms, promotion of adequate growth, and assurance of a nutritionally complete diet.”
The scientists highlight that in cases of severe food selectivity, nutrition therapy should occur concurrently with feeding therapy consisting of nutritional supplements or liquid formulas.
“A key take home message from this guideline is that nutrition management in ASD should play a central role in a child’s overall plan of care, ideally from the time of diagnosis,” said Sharp.
Rashelle C. Berry, Patricia Novak, Nicole Withrow, Brianne Schmidt, Sheah Rarback, Sharon Feucht, Kristen K. Criado, William G. Sharp. Nutrition Management of Gastrointestinal Symptoms in Children with Autism Spectrum Disorder: Guideline from an Expert Panel. Journal of the Academy of Nutrition and Dietetics, 2015; DOI: 10.1016/j.jand.2015.05.016