Unlocking the Link: Exploring the Association Between Food Selectivity and Health Outcome in Autism Spectrum Disorder-A Systematic Review.

This review looked at how picky eating affects the health of people with autism. It found that autistic individuals who are very selective about food are more likely to be overweight or obese, have nutritional deficiencies, and experience stomach problems. The picky eating patterns common in autism can lead to not getting enough vitamins and minerals, which affects overall health. However, studies used different ways to measure picky eating, making it hard to compare results.

This systematic review analyzed 15 studies to examine the relationship between food selectivity and health outcomes in individuals with autism spectrum disorder (ASD). Food selectivity, characterized by food refusal and restricted consumption patterns, was found to be associated with multiple adverse health outcomes including overweight, obesity, increased waist circumference, elevated waist-to-height ratio, and insufficient nutritional intake. The review identified increased susceptibility to micronutrient deficiencies, gastrointestinal issues, eating disorders, and hypertriglyceridemia among individuals with ASD who exhibit food selectivity. However, the authors noted significant variability in outcomes due to differences in assessment tools and definitions of food selectivity across studies, highlighting the need for standardized, ASD-specific validated assessment methods.

Healthcare providers should routinely assess food selectivity in individuals with ASD and monitor for associated health risks including weight status, nutritional deficiencies, and cardiometabolic markers. Development of standardized, ASD-specific assessment tools for food selectivity is needed. Multidisciplinary interventions addressing both feeding behaviors and nutritional adequacy should be considered.

Significant variability in outcomes due to differences in assessment tools and definitions of food selectivity across the 15 included studies. The lack of standardized methods for evaluating food selectivity complicates the ability to draw consistent conclusions and limits the strength of evidence.

Individuals with autism spectrum disorder (ASD) often face behavioral challenges during meals, such as food refusal and restricted food consumption, which encompass the concept of food selectivity (FS). The exclusion of food groups such as fruits and vegetables and preferences toward ultraprocessed foods, therefore, can expose this population to an increased risk of developing different types of malnutrition, such as overweight, obesity, and micronutrient deficiencies. The aim of this systematic review was to assess if FS is a risk factor for poor health outcomes in individuals with ASD, based on findings in the literature published between 2012 and 2023. Four databases (PubMed, Embase, Scopus, and Cochrane) were searched for relevant articles.

The search was conducted in May 2023. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A checklist was used for data extraction, including descriptive information, study design, study aim, participant information, data collection characteristics, and significant findings. A total of 15 articles were included.

Individuals with ASD and with FS appear to have inadequate weight (particularly conditions of overweight and obesity), increased waist circumference, elevated waist-to-height ratio index, and insufficient nutritional intake, all of which increase their susceptibility to malnutrition. Food selectivity, common in this population, increases the risk of micronutrient deficiencies, gastrointestinal issues, eating disorders, hypertriglyceridemia, overweight, and obesity. However, outcomes vary due to differences in assessment tools and definitions of FS across studies. The lack of standardized methods for evaluating FS complicates the ability to draw consistent conclusions, emphasizing the need for ASD-specific validated tools.

Future research should focus on standardizing assessments and exploring long-term health effects and interventions. PROSPERO registration No. CRD42023435018.