Nutrient Status, Diet Quality and Growth Parameters of Children with Autism Spectrum Disorder in Northern Cyprus

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Sabiha Gökçen Zeybek
Mine Yurttagül


Autism; Nutrient Adequacy; Diet Quality; Growth Parameters; Food Selectivity


Background: There is no literature on the nutritional status and growth parameters of autistic children in Northern Cyprus. This study is the first to provide information about them. The aim of this study is to determine the nutritional status, anthropometric measurements, and healthy eating indices of autistic children who are studying at private educational centers in Northern Cyprus.


Method: All children with Autism Spectrum Disease who were educated in Northern Cyprus were included in the study. The universe of research included 48 autistic children in all private educational centers.  Food record method and healthy eating index were used to determine nutritional status. Nutrient inadequacy was determined by dietary reference intake. The growth parameters were evaluated by means of anthropometric measurements.


Results: The study was completed with 40 children as 8 children refused to participate in the study. The 82.5% of children were male and 17.5% were female. The 45.0% of children with autism were also diagnosed with a different disease. According to the eating habits of children, 30% of autistic children were skipping meals and the most missed meal was breakfast. Consequently, 70% of the children were selective against some foods and the most omitted food group is vegetables. The most inadequate intake was calcium, iodine, vitamin D and fiber. In addition, 28.2% of the children have a poor diet quality and 47.5% were obese.


Conclusions: It was determined that appropriate medical nutrition treatment and nutrition education were needed for children. There is also a need for further research.


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1. Kanner, L. Autistic disturbances of affective contact. Nervous Child 1943; 2 (1943): 217-250.
2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-IV) (Fourth Edition). The Journal of The American Medical Association 1994; 272 (10): 828-829.
3. World Health Organization. (‎1993)‎. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization., Accessed 22.03.2019
4. Hoppenbrouwers, M., Vandermosten, M., Boets, B. Autism as a disconnection syndrome: A qualitative and quantitative review of diffusion tensor imaging studies. Research in Autism Spectrum Disorders 2014; 8 (4): 387-412
5. Centers for Disease Control and Prevention Center. Community report from the autism and developmental disabilities monitoring (ADDM) network, prevalence of autism spectrum disorder among children aged 8 years, United States, 2010. Morbidity and Mortality Weekly Report 2014; 63 (2): 1-21.
6. Siddiqi, S., Urooj, A., D’Souza, M. Dietary patterns and anthropometric measures of Indian children with autism spectrum disorder. Journal of Autism and Developmental Disorders 2018;
7. Banerjee, S., Riordan, M., Bhat, M. Genetic aspects of autism spectrum disorders: insights from animal models. Frontiers in Cellular Neuroscience 2014; 58 (8): 1 –18.
8. Kinney, D., Barch, D., Chayka, B., Napoleon, S., & Munir, K. Environmental risk factors for autism: Do they help cause de novo genetic mutations that contribute to the disorders?. Medical Hypotheses 2010; 74 (1): 102 – 106.
9. Kral, T., Eriksen, W., Souders, M., Martin, J. Eating behaviors, diet quality and gastrointestinal symptoms in children with autism spectrum disorders: A brief review. Journal of Pediatric Nursing 2013; 28 (6): 548-556.
10. Emond, A., Emmett, P., Steer, C., Golding, J. Feeding symptoms, dietary patterns, and growth in young children with autism spectrum disorders. Pediatrics 2010; 128(2): 338-342.
11. Moore, E., Crook, T., James, J., Gonzales, D., Hakkak, R. Nutrient intake among children with autism. Journal of Nutritional Disorders and Therapy 2012; 2(3): 1-3.
12. Herndon, A., DiGuiseppi, C., Johnson, S., Leiferman, J., Reynolds, A. Does nutritional intake differ between children with autism spectrum disorders and children with typical development. Journal of Autism and Developmental Disorders 2013; 39 (2): 212-222.
13. Aghaeinejad, M., Djafarian, K., Mahmoudi, M., Maskooni, M. Comparison of energy and macronutrients intake between children with autism and healthy children. International Research Journal of Applied and Basic Sciences 2013; 5 (6): 667-670.
14. Hyman, S., Stewart, S., Cain, U., Lemcke, N., Foley, J., Peck, R., et al. Nutrient intake from food in children with autism. Pediatrics 2012; 130 (2): 145-153.
15. Zimmer, M. H., Hart, L. C., Manning, P., Murray, D. S., Bing, N. M., Summer, S. Food variety as a predictor of nutritional status among children with autism. Journal of Autism and Developmental Disorders 2012; 42(4): 549-556.
16. Sharp, W., Berry, R., McCracken, C., Nuhu, N., Marvel, E., Saulnier, C., et al. Feeding Problems and nutrient intake in children in autism spectrum disorders: A metaanalysis and comprehensive review of the literature. Journal of Autism Developmental Disorders 2018; 43 (9): 2159 – 2173.
17. Deurenberg, P., Weststrate, J., Seidell, J. Body mass index as a measure of body fatness: age- and sex specific prediction formulas. British Journal of Nutrition 1991; 65 (2): 105 – 114.
18. Giarelli, E., Wiggings, L., Rice, C., Levy, S., Kirby, R., Martin, J., et al. Sex differences in the evaluation and diagnosis of autism spectrum disorders among children. Diability and Health Journal 2010; 3 (2): 107 – 116.
19. Gockley, J., Willsey, J., Dong, S., Dougherty, J., Constantino, J., Sanders, S. The female protective effect in autism spectrum disorder is not mediated by a single genetic locus. Molecular Autism 2015; 6 (25): 1 – 10.
20. Lai, M., Cohen, S., Buxbaum, J. Understanding autism in the light of sex/gender. Molecular Autism 2015; 6 (24): 1 – 5;
21. Lai, M., Lambardo, M., Auyeung, B., Chakrabarti, B., Cohen, S. Sex/Gender Differences and Autism: Setting the Scene for Future Research. Journal of the American Academy of Child and Adolescent Psychiatry 2015; 54 (1): 11 – 24.
22. Dermott, M., Hottinger, K., Seijo, R., Shulman, L. Age at diagnosis of autism spectrum disorders. The Journal of Pediatrics 2012; 161 (3): 554 – 556.
23. Kantzer, A., Fernell, E., Gilberg, C., Miniscalco, C. Autism in community preschoolers: developmental profiles. Research in Developmental Disabilities 2013; 34 (9): 2900 – 2908.
24. Olsson, M., Westerlund, J., Lundström, S., Giacobini, M., Fernell, E., Gillberg, C. Recovery from the diagnosis of autism – and then?. Neuropsychiatric Disease and Treatment 2015; (11): 999 – 1005.
25. Adams, J., Audhya, T., Means, S., Rubin, R., Quig, D., Geis, E., et al. Nutritional and metabolic status of children with autism vs. neurotypical children and the association with autism severity. Nutrition and Metabolism 2011; 8 (34): 1-32.
26. Santhanam, B., Kendler, B. Nutritional factors in autism: An overview of nutritional factors in the etiology and management of autism. Integrative Medicine 2012; 11(1): 46-49.
27. Srinivasan, P. A review of dietary interventions in autism. Annasl of Clinical Psychiatry 2009; 21(4), 237-247.
28. Dermott, M., Mcvicar, K., Rapin, I., Wershil, B., Cohen, H., Shinnar, S. Frequency of gastrointestinal symptoms in children with autistic spectrum disorders and association with family history of autoimmune disease. Developmental and Behavioral Pediatric 2006; 27(2): 128-136.
29. Wang, L., Tancredi, D., Thomas, D. The prevalence of gastrointestinal problems in children across the United States with autism spectrum disorders from families with multiple affected members. Journal of Developmental and Behavioral Pediatrics 2011; 32 (5): 351 – 360.
30. Chaidez, V., Hansen, R., Picciotto, I. Gastrointestinal problems in children with autism developmental delays or typical development. Journal of Developmental Disorders 2014; 44 (5): 1117 – 1127.
31. Mazefsky, C., Schreiber, D., Olino, T., Minshew, N. The association between emotional and behavioral problems and gastrointestinal symptoms among children with high- functioning autism. Autism 2015; 18 (5): 493 – 501.
32. Ibrahim, S., Voigt, R., Katusic, S., Waver, A., Barbaresi, W. Incidence of gastrointestinal symptoms in children: A population- based study. Pediatrics 2009; 124 (2): 680 – 686.
33. Molloy, CA., Mannig, Courtney P. Prevalence of chronic gastrointestinal symptoms in children with autism and autistic spectrum disorders. Autism 2003; 7(2): 165 –171.
34. Nikolov, R. N., Bearss, K. E., Letting, J., Erickson, C., Rodowski, M., Aman, M. G., et al. Gastrointestinal symptoms in a sample of children with pervasive developmental disorders. Journal of Autism and Developmental Disorders 2009; 39 (3): 405 – 413.
35. Brown, R., Lozupune, C., Kang, D., Adams, J. (2015). Gut bacteria in children with autism spectrum disorders: challenges and promise of studying how a complex community influences a complex disease. Microbial Ecology in Health and Disease,
36. Erickson, C., Stigler, K., Corkins, M., Posey, D., Fitzgerald, J., McDougle, C. Gastrointestinal factors in autistic disorders: A Critical Review. Journal of Autism and Developmental Disorders 2005; 35(6): 713 – 727.
37. Bicer, A., Alsaffar, A. Body mass index, dietary intake feeding problems of Turkish children with autism spectrum disorder (ASD). Research In Developmental Disabilitie 2013; 34 (11): 3978 – 3987.
38. Postorino, V., Sanges, V., Giovagnoli, G., Fatta, L., Peppo, L., Armando, M., Vicari, S., Mazzone, L. Clinical differences in children with autism spectrum disorder with and without food selectivity. Appetite 2015; 92:126 – 132.
39. Bandini, L., Anderson, S., Curtin, C., Cermak, S., Evans, W., Scampini, R., et al. Food selectivity in children with autism spectrum disorders and typically developing children. Journal of Pediatric 2010; 157(2): 259-264.
40. Evans, W., Must, A., Anderson, S., Curtin, C., Scampini, R., Maslin, M., et al. Dietary patterns and body mass index in children with autism and typically developing children. Research in Autism Spectrum Disorders 2012; 6 (1): 399 – 405.
41. Crasta, J., Benjamin, T., Surresh, A., Alwinesh, M., Kanniappan, G., Padankatti, S., et al. Feeding problems among children with autism in a clinical population in India. Indian Journal Pediatrics 2014; 81 (2): 169 – 172.
42. Schreck, K., Williams, K. Food preferences and factors influencing food selectivity for children with autism spectrum disorders. Research in Developmental Disbilities 2005; 27 (4), 353 – 363.
43. Cermark, S., Curtin, C., Bandini, L. Food selectivity and sensory sensitivity in children with autism spectrum disorders. Journal of the American dietetic Association 2010; 110 (2): 238 – 246.
44. Souza, N. C., Mendonca, J. N., Portari, G. V., Jordao, A. A., Marchini, J. S., Chiarello, P. G. Intestinal permeability and nutritional Status in developmental disorders. Alternative Therapies in Health and Medicine 2012; 18 (2): 19 – 24.
45. Xia, W., Zhou, Y., Sun, C., Wang, J., Wu, L. A preliminary study on nutritional status and intake in Chinese children with autism. European Journals of Pediatrics 2010; 169 (10): 1201 – 1206.
46. Sun, C., Xia, W., Zhao, Y., Li, N., Zhao, D., Wu, L. Nutritional status survey of children with autism and typically developing children aged 4 – 6 years in Heilong Jiand Province, Chine. Journal of Nutritional Science 2013; doi:10.1017/jns.2013.9.
47. Schimitt, L., Heiss, C. Campbell, E. A comparison of nutrient intake and eating behaviors of boys with and witout autism. Topics in Clinical Nutrition 2008; 23 (1), 23 – 31.
48. Grondhuis, S.N., Aman, M. G. Overweight and obesity in youth with developmental disabilities: A call to action. Journal of Intellectual Disability Research 2014; 58 (9): 787 – 799.
49. Bauset, S., Zazpe, I., Mari, A. Are there anthropometric differences between children with autism and healty children?. Journal of Child Neurology 2015; 28 (10): 1226 –1232
50. Johnson, C., Turner, K., Stewart, P., Schmidt, B., Shui, A., Macklin, E., et al. Relationships between feeding problems, behavioral characteristics and nutritional quality in children with ASD. Journal of Autism and Developmental Disorders 2014; 44 (9): 2175 – 2184.
51. Bhattacharjee, S. Study of antropometric parameters along with postural changes in blood pressure ın children with autistic spectral disorders. International Journal of Basic and Applied Psysiology 2012; 1(1): 88–92.