Nutrient intake profile, growth patterns and hemoglobin levels in children with ASD-A case control study in Mysuru, India

Background: Research evidence suggests that the prevalence rate of Autism Spectrum Disorder (ASD) is increasing in India. In addition to socio-behavioral problems, diet-related issues are common and recurrent problems experienced by children with ASD. As there is only minimal research work done on these aspects, the present study is carried out as a case control snapshot to investigate the nutrient intakes of ASD children (n = 104) residing in the Mysore region, India. This data is compared with the nutrient intakes of Typically Developing (TD) controls (n = 121). Methods: We evaluated ASD severity using Indian Scale for assessment of autism (ISAA). All the children aged (2-15 years) were examined for anthropometric measurements and hemoglobin levels. Dietary intakes and mealtime behavior problems were assessed using three-day food records and food frequency questionnaires. Results: Significantly (p< = 0.05) lower ZHA, ZWA, ZBMIA values among ASD children were observed. Limited food variety and inadequacy of micronutrient intakes were observed and the ORs of ASD children were at 3.57-fold higher risk for failing to meet the recommendations for calcium. Their risk was 2.17-fold higher for iron, 3.06-fold for zinc, 2.92-fold for folate and 1.87fold higher for vitamin C compared with the TD children. Overall, mealtime behavior issues and eating problems were higher (28.66%) among ASD than TD (10.51 %).Hemoglobin levels of ASD were significantly (p< = 0.05) lower than TD children. There was a negative partial correlation between Hb levels (8.97 +/- 0.91 g/dL) and micronutrients viz., Iron (5.14 +/- 2.83 mg), Calcium (2.52 +/- 1.41 mg), Zn (2.81 +/- 1.90 mg),Folate (83.48 +/- 52.57 mg) and Vitamin B6 (0.47 +/- 0.29 mg). We found that while controlling the ISSA scores (1.94 +/- 0.62), there was no significant difference. Thus signifying ISSA score has strong influence on controlling the relationship between Hb levels and selected micronutrients. Conclusion: Observations strongly indicate that well-timed nutritional screening and personalized dietary interventions can prevent/manage the nutritional deficiencies prevalent among ASD children of this region.