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Autism spectrum disorders (ASD) are a group of neurodevelopmental disorders whose features generally become evident within the first three years of life. ASD is defined by core symptoms, including deficits in social interaction/communication and restricted/repetitive patterns of behaviour. In addition, behavioural disturbances and co-morbidities like aggression, anxiety, impulsivity, hyperactivity, tantrums, and self-injuries are also frequently observed. The most common Gastro-intestinal symptoms seen in ASD children include chronic diarrhoea, abdominal distention, discomfort and bloating, gastroesophageal reflux disease (GERD), excessive gas, constipation, faecal impaction, food regurgitation, and a leaky gut syndrome. Early treatment and rehabilitation have been the key to successfully managing children with ASD, including dietary management, in the past decade. Dr Mohd Amir, Senior Consultant- Neonatologist and Paediatrician at Cloudnine Group of Hospitals, Gurgaon, Sector 14, explains the two common approaches for dietary management in ASD.
Children with ASD often reject bitter or sour tastes. This preference can cause obesity, diabetes, and dental caries. Additionally, they usually have inadequate vitamin D, vitamin B12, vitamin C, calcium, zinc, and other micronutrients. Supplements generally in use include vitamin B6, vitamin C, vitamin D, vitamin B12, dietary fatty acids (omega-3 fatty acid and cod liver oil), melatonin, folic acid, probiotics, L-carnitine, iron, magnesium, zinc and copper. In addition, it is imperative to include fresh fruits and vegetables and avoid sweet foods in the diet of a child with ASD. Instead, focus on a natural and varied diet, avoiding pesticides, preservatives, artificial ingredients, and fast or processed foods.
It focuses on eliminating certain foods or food items from the diet. These foods are believed to trigger allergies and food intolerance (for example, casein and gluten); and contribute to the symptoms of ASD.
Although much research has been done which helped bring a lot of insight into the aetiology and pathogenesis of ASD, it remains a mystery and challenge in various aspects, and nutrition is one of the grey areas in such children. A diet with the probable trial of omitting casein and gluten might benefit in multiple cases. Therefore, it is imperative to supplement any micronutrient or trace element in the diet of such children for a wholesome effect of nutritional management.
Further research is thus needed to explore more domains as far as nutrition is concerned. In all families with a child with ASD, close monitoring of correct eating habits by family paediatricians is thus warranted.
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