Problematic behaviors at mealtimes and the nutritional status of Brazilian children with Autism Spectrum Disorder

Objective: The aim of this study was to explore problematic behaviors and their association with the food consumption and nutritional status of children with Autism Spectrum Disorder (ASD).

Methods: This is a cross-sectional study which enrolled 90 Brazilian children (aged 2-10 years) with ASD. A sociodemographic questionnaire, the ASD Eating Behavior Assessment Scale, and the 24-h recall were used. Age, height, total body weight, and Body Mass Index (BMI) were accessed to estimate nutritional status (BMI/Age). Consumption of fruits, vegetables, total calories, macro and micronutrients (calcium, iron, zinc, omega 3 and omega 6), and Body Mass Index (BMI) were assessed. The regression models were adjusted for covariates (prevalence ratio - PR, α = 0.05).

Results: All studied children presented problematic behaviors at mealtimes, with a predominance of food selectivity (57.8%), followed by changes in mealtime skills (34.4%), changes in masticatory motor skills (25.6%), oppositional eating behaviors (20.4%), and rigid eating behaviors (20.0%). Food selectivity was associated with excess body weight (PR: 1.94; 95% CI: 1.08-3.51) and absence of vegetable consumption (PR: 0.61; 95% CI: 0.46-0.81). Rigid eating behaviors was associated with low consumption of fiber (PR: 1.42; 95% CI: 1.15-1.75) and zinc (PR: 2.15; 95% CI: 1.33-3.45), and with excessive caloric (PR: 1.14; 95% CI: 1.02-1.29) and lower calcium intake (PR: 0.52; 95% CI: 0.29-0.91).

Conclusion: Selectivity and rigidity behaviors have different relationships with food consumption and are associated with a higher prevalence of inadequacies, which may lead to nutritional risks for children. Further studies may investigate the influence of problematic behaviors and excess body weight in ASD.