重视孤独症谱系障碍儿童的营养问题与干预

衣明纪, 杨召川

中国儿童保健杂志 ›› 2025, Vol. 33 ›› Issue (1) : 13-17.

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中国儿童保健杂志 ›› 2025, Vol. 33 ›› Issue (1) : 13-17. DOI: 10.11852/zgetbjzz2024-1473
专家笔谈

重视孤独症谱系障碍儿童的营养问题与干预

  • 衣明纪, 杨召川
作者信息 +

Emphasizing nutritional problems and intervention in children with autism spectrum disorder

  • YI Mingji, YANG Zhaochuan
Author information +
文章历史 +

摘要

孤独症谱系障碍(ASD)是一种复杂的神经发育障碍,患病率高,对儿童身心健康危害大,对家长的心理和家庭功能也会造成严重不良影响,还会带来社会问题。近年来在其早期识别、诊断和综合干预方面不断取得进展,但其营养问题仍需进一步关注。研究发现,ASD儿童常常存在更多、更严重的营养问题,这些营养问题涉及母乳喂养、辅食添加和饮食行为等方面,影响其生长发育,还可能与ASD核心症状相关。通过行为干预、应用特殊饮食处方和营养补充剂等方法科学管理这些营养问题,对于改善ASD儿童的干预效果和预后发挥着重要作用。为更好地改善ASD儿童的营养问题,建议在ASD的诊治过程中常规进行营养状况评估,充分重视导致ASD儿童营养问题的原因和危险因素,综合干预其营养问题。

Abstract

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder with a high prevalence, causing serious harm to physical and mental health in children and parents, as well as some social problems. Notable advancements have been made in early identification, diagnosis, and comprehensive intervention of ASD, but its nutritional issues still warrant further exploration and attention. Researches have found that children with ASD often experience more severe nutritional problems in recent years, which involve breastfeeding, complementary foods and dietary behavior. These nutritional problems impact growth and development of children, and may be related to core symptoms of ASD. Scientific management of these nutritional issues, including behavior intervention, individualized dietary prescriptions and nutritional supplementation, plays an important role in improving the intervention efficacy and prognosis of children with ASD. To better improve the nutritional issues of children with ASD, routine nutritional assessment is recommended during the diagnosis and treatment of ASD, placing increased focus on the causes and risk factors of nutritional problems in children with ASD, and giving comprehensive intervention in their nutritional problems.

关键词

孤独症谱系障碍 / 营养状况 / 饮食行为 / 行为干预

Key words

autism spectrum disorder / nutritional status / eating behavior / behavioral intervention

引用本文

导出引用
衣明纪, 杨召川. 重视孤独症谱系障碍儿童的营养问题与干预[J]. 中国儿童保健杂志. 2025, 33(1): 13-17 https://doi.org/10.11852/zgetbjzz2024-1473
YI Mingji, YANG Zhaochuan. Emphasizing nutritional problems and intervention in children with autism spectrum disorder[J]. Chinese Journal of Child Health Care. 2025, 33(1): 13-17 https://doi.org/10.11852/zgetbjzz2024-1473
中图分类号: R749.94   

参考文献

[1] Botelho RM, Silva ALM, et al. The autism spectrum disorder and its possible origins in pregnancy[J]. Int J Environ Res Public Health,2024,21(3):244-265.
[2] Maenner MJ, Warren Z, Williams AR, et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years-autism and developmental disabilities Monitoring Network, 11 Sites, United States, 2020[J]. MMWR Surveill Summ,2023,72(2):1-14.
[3] Zhou H, Xu X, Yan W,et al. Prevalence of autism spectrum disorder in China:A nationwide multi-center population-based study among children aged 6 to 12 years[J]. Neurosci Bull, 2020,36(9):961-971.
[4] Mandecka A, Regulska-Ilow B. The importance of nutritional management and education in the treatment of autism[J]. Rocz Panstw Zakl Hig,2022,73(3):247-258.
[5] Tanoue Y, Oda S. Weaning time of children with infantile autism[J]. J Autism Dev Disord, 1989,19(3):425-434.
[6] Schultz ST, Klonoff-Cohen HS, Wingard DL, et al. Breastfeeding, infant formula supplementation, and autistic disorder: The results of a parent survey[J]. Int Breastfeed J, 2006,1:16.
[7] Xiang X, Yang T, Chen J, et al. Association of feeding patterns in infancy with later autism symptoms and neurodevelopment: A national multicentre survey[J]. BMC Psychiatry, 2023, 23(1): 174.
[8] Huang S, Wang X, Sun T,et al. Association of breastfeeding for the first six months of life and autism spectrum disorders: A national multi-center study in China[J]. Nutrients, 2021,14(1):45.
[9] Jenabi E, Bashirian S, Salehi AM,et al. Not breastfeeding and risk of autism spectrum disorders among children:A meta-analysis[J]. Clin Exp Pediatr,2023,66(1):28-31.
[10] Ghozy S, Tran L, Naveed S, et al. Association of breastfeeding status with risk of autism spectrum disorder: A systematic review, dose-response analysis and meta-analysis[J]. Asian J Psychiatr,2020,48:101916.
[11] Manohar H, Pravallika M, Kandasamy P,et al. Role of exclusive breastfeeding in conferring protection in children at-risk for autism spectrum disorder: Results from a sibling case-control study[J]. J Neurosci Rural Pract,2018,9(1):132-136.
[12] Wang T, Feng J, Xue Y,et al. Feeding problems, age of introduction of complementary food and autism symptom in children with autism spectrum disorder[J]. Front Pediatr,2022,10:860947.
[13] Şahan AK, Öztürk N, Demir N,et al. A Comparative analysis of chewing function and feeding behaviors in children with autism[J]. Dysphagia,2021,36(6):993-998.
[14] Esposito M, Mirizzi P, Fadda R, et al. Food selectivity in children with autism: Guidelines for assessment and clinical interventions[J]. Int J Environ Res Public Health,2023,20(6):5092.
[15] Baraskewich J, von Ranson KM, McCrimmon A, et al. Feeding and eating problems in children and adolescents with autism: A scoping review[J]. Autism,2021,25(6):1505-1519.
[16] 王宇,姜秀洁,尹晶,等. 孤独症儿童饮食行为管理最佳证据总结[J]. 中国实用护理杂志,2024,40(18):1382-1390.
Wang Y,Jiang XJ,Yin J,et al.Summary of the best evidence for diet behavioral management for autism children[J].Chin J Practical Nursing, 2024,40(18):1382-1390.(in Chinese)
[17] Hsiao EY. Gastrointestinal issues in autism spectrum disorder[J]. Harv Rev Psychiatry, 2014,22(2):104-111.
[18] Madra M, Ringel R, Margolis KG. Gastrointestinal issues and autism spectrum disorder[J]. Child Adolesc Psychiatr Clin N Am, 2020,29(3):501-513.
[19] Ristori MV, Quagliariello A, Reddel S,et al. Autism, gastrointestinal symptoms and modulation of gut microbiota by nutritional interventions[J]. Nutrients,2019,11(11):2812.
[20] Couturier JL, Speechley KN, Steele M, et al. Parental perception of sleep problems in children of normal intelligence with pervasive developmental disorders: Prevalence, severity, and pattern[J]. J Am Acad Child Adolesc Psychiatry, 2005,44(8):815-822.
[21] Moore M, Evans V, Hanvey G, et al. Assessment of sleep in children with autism spectrum disorder[J]. Children (Basel), 2017,4(8):72.
[22] Sikora DM, Johnson K, Clemons T, et al. The relationship between sleep problems and daytime behavior in children of different ages with autism spectrum disorders[J]. Pediatrics, 2012,130 (Suppl 2):83-90.
[23] Tan Y, Thomas S, Lee BK. Parent-reported prevalence of food allergies in children with autism spectrum disorder: National health interview survey, 2011-2015[J]. Autism Res,2019,12(5):802-805.
[24] Li H, Liu H, Chen X, et al. Association of food hypersensitivity in children with the risk of autism spectrum disorder: A meta-analysis[J]. Eur J Pediatr,2021,180(4):999-1008.
[25] Croteau C, Ben Amor L, Ilies D,et al. Impact of psychoactive drug use on developing obesity among children and adolescents with autism spectrum diagnosis: A nested case-control study[J]. Child Obes,2019,15(2):131-141.
[26] Meguid NA, Anwar M, Bjørklund G, et al. Dietary adequacy of Egyptian children with autism spectrum disorder compared to healthy developing children[J]. Metab Brain Dis,2017,32(2):607-615.
[27] Esteban-Figuerola P, Canals J, Fernández-Cao JC,et al. Differences in food consumption and nutritional intake between children with autism spectrum disorders and typically developing children: A meta-analysis.[J] Autism,2019,23(5):1079-1095.
[28] 杨睿博,刘佳雪,韩钰,等.天津市3-7岁孤独症谱系障碍儿童体格发育和营养状况研究[J].中国儿童保健杂志,2021,29(10):1058-1062,1081.
Yang RB, Liu JX, Han Y, et al.Study on physical development and nutritional status of children with autism spectrum disorder aged 3-7 in Tianjin[J]. Chin J Child Health Care, 2021,29(10): 1058-1062,1081.(in Chinese)
[29] Criado KK, Sharp WG, McCracken CE,et al. Overweight and obese status in children with autism spectrum disorder and disruptive behavior[J]. Autism,2018,22(4):450-459.
[30] Dhaliwal KK, Orsso CE, Richard C,et al. Risk factors for unhealthy weight gain and obesity among children with autism spectrum disorder[J]. Int J Mol Sci,2019,20(13):3285.
[31] 李慧萍,徐琼,胡梅新,等.孤独症谱系障碍儿童体格生长状况的横断面调查[J].中国循证儿科杂志,2020,15(3):220-223.
Li HP,Xu Q,Hu MX,et al. A cross-sectional study on the physical growth status of children with autism spectrum disorder[J].Chin J Evid Based Pediatr, 2020,15(3):220-223.(in Chinese)
[32] Yang T, Chen L, Dai Y,et al. Vitamin A status is more commonly associated with symptoms and neurodevelopment in boys with autism spectrum disorders-a multicenter study in China[J]. Front Nutr,2022,9:851980.
[33] Xu X, Li C, Gao X,et al. Excessive UBE3A dosage impairs retinoic acid signaling and synaptic plasticity in autism spectrum disorders[J]. Cell Res,2018,28(1):48-68.
[34] Siracusano M, Riccioni A, Abate R,et al. Vitamin D deficiency and autism spectrum disorder[J]. Curr Pharm Des,2020,26(21):2460-2474.
[35] Fang S, Wang Y, Wang Q,et al. Vitamin D status is primarily associated with core symptoms in children with autism spectrum disorder: A multicenter study in China[J]. Psychiatry Res, 2022;317:114807.
[36] Chen L, Guo X, Hou C, et al. The causal association between iron status and the risk of autism: A Mendelian randomizationstudy[J]. Front Nutr,2022;9:957600.
[37] Li Q, Yang T, Chen L,et al. Serum folate status is primarily associated with neurodevelopment in children with autism spectrum disorders aged three and under-a multi-center study in China[J]. Front Nutr,2021,8:661223.
[38] Mandecka A, Regulska-Ilow B. The importance of nutritional management and education in the treatment of autism[J]. Rocz Panstw Zakl Hig,2022,73(3):247-258.
[39] Karhu E, Zukerman R, Eshraghi RS, et al. Nutritional interventions for autism spectrum disorder[J]. Nutr Rev,2020,78(7):515-531.
[40] 刘杰,董萍,王怡,等.孤独症儿童饮食行为问题及相关干预[J].中国儿童保健杂志2020,28(1):6-9,14.
Liu J, Dong P,Wang Y, et al.Dietary behavior problems and related interventions in children with autism[J]. Chin J Child Health Care, 2020,28(1): 6-9,14.(in Chinese)
[41] Kuschner ES, Morton HE, Maddox BB,et al. The BUFFET Program: Development of a cognitive behavioral treatment for selective eating in youth with autism spectrum disorder[J]. Clin Child Fam Psychol Rev,2017,20(4):403-421.
[42] Winburn E, Charlton J, McConachie H, et al. Parents′ and child health professionals′ attitudes towards dietary interventions for children with autism spectrum disorders[J]. J Autism Dev Disord, 2014,44(4):747-757.
[43] Quan L, Xu X, Cui Y, et al. A systematic review and meta-analysis of the benefits of a gluten-free diet and/or casein-free diet for children with autism spectrum disorder[J]. Nutr Rev,2022,80(5):1237-1246.
[44] 罗玉梅,曹俊,任杰,等.生酮饮食在儿童孤独症谱系障碍中的应用[J]. 中国妇幼健康研究,2018,29(12):1570-1572.
Luo YM, Cao J,Ren J, et al. Application of ketogenic diet in autism spectrum disorder in children[J]. Chin J Woman Child Health Research, 2018,29(12): 1570-1572.(in Chinese)
[45] Lee RWY, Corley MJ, Pang A, et al. A modified ketogenic gluten-free diet with MCT improves behavior in children with autism spectrum disorder[J]. Physiol Behav,2018,188:205-211.
[46] Matthews JS, Adams JB. Ratings of the effectiveness of 13 therapeutic diets for autism spectrum disorder: results of a national survey[J]. J Pers Med,2023,13(10):1448.
[47] Adams JB, Audhya T, Geis E, et al. Comprehensive nutritional and dietary intervention for autism spectrum disorder-A randomized, controlled 12-month trial[J]. Nutrients,2018,10(3):369-411.
[48] Saeid Doaei, Bourbour F, Teymoori Z, et al. The effect of omega-3 fatty acids supplementation on social and behavioral disorders of children with autism: A randomized clinical trial[J]. Pediatr Endocrinol Diabetes Metab,2021,27(1):12-18.
[49] 李廷玉,谭梅.孤独症谱系障碍儿童微量营养素缺乏的监测与干预原则[J].中国儿童保健杂志,2021,29(1):1-4.
Li TY, Tan M. Monitoring and intervention principles for micronutrient deficiencies in children with autism spectrum disorder[J]. Chin J Child Health Care, 2021,29(1): 1-4.(in Chinese)

基金

国家自然科学基金(81700029);山东省自然科学基金(ZR2022MH030)

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