Adverse food reactions and alterations in nutritional status in children with autism spectrum disorders: results of the NAFRA project.

IF 3.2 3区医学 Q1 PEDIATRICS Italian Journal of Pediatrics Pub Date : 2024-11-04 DOI:10.1186/s13052-024-01794-8

Serena Coppola, Rita Nocerino, Franca Oglio, Paola Golia, Maria Candida Falco, Maria Pia Riccio, Laura Carucci, Teresa Rea, Silvio Simeone, Raffaele Garotti, Nadia Marani, Carmela Bravaccio, Roberto Berni Canani

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Abstract

Background: To assess the adverse food reactions (AFR) prevalence in children with autism spectrum disorder (ASD) and in non-ASD healthy controls (NASD). Nutritional status alterations, food selectivity and adherence to Mediterranean Diet (MD) were also evaluated.

Methods: The NAFRA (Nutritional status and Adverse Food Reactions in children with Autism Spectrum Disorder) project was an observational, case-control, comparative study conducted at a tertriary center for pediatrics involving Caucasian patients of both sexes, aged 18 months-7 years, with a diagnosis of ASD, and matched NASD controls.

Results: From October 2017 to December 2023, 100 ASD patients [79 male, mean (± SD) age 49.9 months (± 15.4)] and 100 NASD controls [75 male, mean (± SD) age 49.8 months (± 17.7)] were enrolled at the Pediatric Section of the Department of Translational Medical Science of the University of Naples Federico II. A significantly higher prevalence of AFR was observed in ASD patients if compared with NASD (16% vs. 2%, p = 0.001), mainly due to a higher prevalence of food allergy (7% vs. 1%, p = 0.03). A significantly higher prevalence of food intolerance and celiac disease was also observed in ASD children. The rate of obesity was significantly higher in ASD patients compared to NASD. Food selectivity and low MD-adherence were more frequent in ASD children (26% vs. 2%, p < 0.0001 and 28% vs. 16%, p = 0.041, respectively).

Conclusions: The high rate of AFR, obesity and unhealthy dietary habits observed in ASD children strongly suggest the importance of a multidisciplinary approach, providing early diagnosis of AFR and appropriate nutritional management to improve core and associated ASD-related conditions.

Trial registration: The NAFRA Project was registered on https://clinicaltrials.gov/ with the identifier NCT04719923. Registered 18 January 2021. https://clinicaltrials.gov/study/NCT04719923 .

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自闭症谱系障碍儿童的不良食物反应和营养状况改变：NAFRA 项目的结果。

背景：目的：评估自闭症谱系障碍（ASD）儿童和非自闭症谱系障碍健康对照组（NASD）的食物不良反应（AFR）发生率。此外，还评估了营养状况改变、食物选择性和地中海饮食（Mediterranean Diet）的坚持情况：NAFRA（自闭症谱系障碍儿童的营养状况和不良食物反应）项目是一项观察性、病例对照、比较研究，在一家儿科三级中心进行，涉及年龄为18个月至7岁、诊断为自闭症谱系障碍的高加索男女患者以及匹配的NASD对照组：从2017年10月至2023年12月，那不勒斯费德里科二世大学转化医学科学系儿科中心共招募了100名ASD患者（79名男性，平均（±SD）年龄为49.9个月（±15.4）岁）和100名NASD对照组患者（75名男性，平均（±SD）年龄为49.8个月（±17.7）岁）。与NASD相比，ASD患者的AFR患病率明显更高（16% vs. 2%，p = 0.001），这主要是由于食物过敏的患病率更高（7% vs. 1%，p = 0.03）。在ASD儿童中，食物不耐受和乳糜泻的发病率也明显较高。与NASD相比，ASD患者的肥胖率明显更高。食物选择性和低MD-依从性在ASD儿童中更为常见（26% vs. 2%，P 结论：ASD儿童的食物选择性和肥胖率较高，而NASD儿童的食物选择性和低MD-依从性较低：在 ASD 儿童中观察到的高 AFR 率、肥胖症和不健康的饮食习惯强烈提示了多学科方法的重要性，即提供 AFR 的早期诊断和适当的营养管理，以改善核心和相关的 ASD 症状：NAFRA项目注册于https://clinicaltrials.gov/，标识符为NCT04719923。注册日期为 2021 年 1 月 18 日。https://clinicaltrials.gov/study/NCT04719923 。

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来源期刊

Italian Journal of Pediatrics PEDIATRICS-

CiteScore

6.10

自引率

13.90%

发文量

192

审稿时长

6-12 weeks

期刊介绍： Italian Journal of Pediatrics is an open access peer-reviewed journal that includes all aspects of pediatric medicine. The journal also covers health service and public health research that addresses primary care issues. The journal provides a high-quality forum for pediatricians and other healthcare professionals to report and discuss up-to-the-minute research and expert reviews in the field of pediatric medicine. The journal will continue to develop the range of articles published to enable this invaluable resource to stay at the forefront of the field. Italian Journal of Pediatrics, which commenced in 1975 as Rivista Italiana di Pediatria, provides a high-quality forum for pediatricians and other healthcare professionals to report and discuss up-to-the-minute research and expert reviews in the field of pediatric medicine. The journal will continue to develop the range of articles published to enable this invaluable resource to stay at the forefront of the field.