BACKGROUND Food selectivity is common in children with autism spectrum disorder (ASD). The clinical characteristics, however, of severe food selectivity in children with ASD is not well documented. OBJECTIVE This study examined the demographic characteristics, anthropometric parameters, risk of nutritional inadequacy, dietary variety, and problematic mealtime behaviors in a sample of children with ASD with severe food selectivity. DESIGN The study involved a cross-sectional electronic medical record review. Data extraction followed a systematic protocol for data extraction. PARTICIPANTS/SETTING Children (age 2 to 17 years) with ASD, severe food selectivity, and complete nutritional data who received a multidisciplinary evaluation at a specialty feeding clinic in the southeastern United States between January 2014 and January 2016. Criteria for severe food selectivity used in this clinical practice required complete omission of one or more food groups (eg, fruit, vegetable, protein, grain, dairy) or consuming a narrow range of items on a weekly basis (eg, five or fewer total food items). MAIN OUTCOME MEASURES Analyses examined demographic characteristics, dietary preferences, risk for nutritional inadequacies, anthropometric parameters, and problematic mealtime behaviors. RESULTS Of the 279 patients evaluated during the 24-month period, 70 children with ASD and severe food selectivity met inclusion criteria. Caregivers reported 67% of the sample (n=47) omitted vegetables and 27% omitted fruits (n=19). Seventy-eight percent consumed a diet at risk for five or more inadequacies. Risk for specific inadequacies included vitamin D (97% of the sample), fiber (91%) vitamin E (83%), and calcium (71%). Children with five or more nutritional inadequacies (n=55) were more likely to make negative statements during meals (P<0.05). Severe food selectivity was not associated with compromised growth or obesity. CONCLUSION Children with ASD and severe food selectivity may be at increased risk for nutritional inadequacies. Future research should examine causes, consequences, and remediation of severe food selectivity in this population.

中文翻译：

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自闭症谱系障碍和严重食物选择性儿童的膳食摄入量、营养状况和生长参数：电子病历审查

背景食物选择性在患有自闭症谱系障碍（ASD）的儿童中很常见。然而，ASD 儿童严重食物选择性的临床特征没有得到很好的记录。目的 本研究检查了具有严重食物选择性的 ASD 儿童样本的人口学特征、人体测量参数、营养不足的风险、饮食多样性和有问题的进餐行为。设计 该研究涉及横断面电子病历审查。数据提取遵循数据提取的系统协议。参与者/地点 2014 年 1 月至 2016 年 1 月期间在美国东南部的一家专业喂养诊所接受多学科评估的患有 ASD、严重食物选择性和完整营养数据的儿童（2 至 17 岁）。该临床实践中使用的严重食物选择性标准要求完全省略一个或多个食物组（例如，水果、蔬菜、蛋白质、谷物、乳制品）或每周食用范围狭窄的食物（例如，总共五个或更少）食品）。主要结果测量分析检查了人口特征、饮食偏好、营养不足的风险、人体测量参数和有问题的进餐行为。结果 在 24 个月期间评估的 279 名患者中，70 名患有 ASD 和严重食物选择性的儿童符合纳入标准。照料者报告样本中有 67% (n=47) 遗漏了蔬菜，27% 遗漏了水果 (n=19)。78% 的人饮食有五个或更多不足的风险。特定不足的风险包括维生素 D（样本的 97%）、纤维（91%）、维生素 E（83%）、和钙 (71%)。有五个或更多营养不足的儿童（n=55）更有可能在进餐时做出负面陈述（P<0.05）。严重的食物选择性与生长迟缓或肥胖无关。结论 患有 ASD 和严重食物选择性的儿童营养不足的风险可能增加。未来的研究应该检查该人群严重食物选择性的原因、后果和补救措施。