Child Autistic Traits, Food Selectivity, and Diet Quality: A Population-Based Study.

This large study of over 4,000 children found that children with more autistic traits tend to have poorer diet quality as they grow up. The researchers tracked children from 1.5 to 8 years old and discovered that picky eating (food selectivity) at age 4 helps explain why children with more autistic traits have less nutritious diets later on. Even children without an autism diagnosis but with some autistic traits showed this pattern. The study suggests that addressing picky eating early might help improve nutrition for children with autistic traits.

This population-based study examined 4,092 children from the Generation R Study to investigate relationships between autistic traits in early childhood and diet quality in mid-childhood. Parents reported autistic traits at 1.5, 3, and 6 years, food selectivity at 4 years, and dietary intake at 8 years. The study found that higher autistic traits were associated with poorer diet quality, with food selectivity mediating this relationship. Two trajectory groups were identified: 95% with 'low and stable' autistic traits and 5% with 'high and increasing' traits.

Children in the high and increasing group demonstrated significantly poorer diet quality. The findings suggest that even subclinical autistic traits may impact nutritional outcomes through food selectivity behaviors.

Results suggest that children with elevated autistic traits may benefit from early nutrition interventions targeting food selectivity. Behavioral strategies to support parents in managing food selectivity could help optimize nutrition. Screening for autistic traits and food selectivity behaviors may identify children at risk for poor diet quality who could benefit from targeted support.

Study relied on parent-reported measures which may introduce bias. Diet quality was assessed only at age 8, limiting understanding of longer-term nutritional outcomes. The study design prevents establishing causation. Information about intervention strategies or specific nutritional deficiencies was not provided.

Children with Autism Spectrum Disorders (ASDs) tend to be selective in their food intake, which may compromise their diet quality. While ASD diagnoses capture severe levels of impairment, autistic traits vary on a continuum throughout the population. Yet, little is known about how autistic traits relate to diet quality at the population level. This study examines the association between autistic traits in early childhood and diet quality in mid-childhood and explores the mediating role of food selectivity.

Participants were children (n = 4092) from the population-based Generation R Study. Parents reported their child's autistic traits at 1.5, 3, and 6 years; food selectivity at 4 years; and food intake at 8 years, from which a diet quality score was derived. Associations of autistic traits and the autistic trait trajectory (identified using Latent Class Growth Modelling) with diet quality were examined using multiple linear regression models. The indirect effect of food selectivity in the association between autistic traits at 1.5 years and diet quality was examined using mediation analysis.

Autistic traits were associated with diet quality (e.g., 1.5 years: β = -0.09; 95% CI: -0.13 to -0.06). Two classes captured the autistic trait trajectories from 1.5 to 6 years: children with "low and stable" (95%) and "high and increasing" (5%) mean scores. Children in the high and increasing group had poorer diet quality than those in the low and stable group (β = -0.28; 95% CI: -0.44 to -0.11). Food selectivity mediated the association between autistic traits at 1.5 years and diet quality at 8 years (βindirect = -0.03; 95% CI: -0.03 to -0.02).

Autistic traits in early childhood are associated with poorer diet quality in mid-childhood, and food selectivity appears to mediate this association. Interventions intended to optimize nutrition in children with elevated autistic traits may integrate behavioral strategies to support parents' responding to their child's food selectivity.