孤独症儿童膳食及营养状况的对比研究
- 孙彩虹,李楠楠,赵栋,夏薇
作者信息
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Study on nutritional status survey of children with autism.
- SUN Cai-hong,LI Nan-nan,ZHAO Dong,XIA Wei.
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文章历史
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摘要
目的 比较孤独症儿童与正常发育儿童的营养状况,以便临床能有效地进行监测和干预。 方法 募集孤独症儿童及正常发育儿童各53例,由家长完成受试儿童3 d的膳食记录评价膳食摄入情况,检测血清生化指标评价血清营养素水平,并进行体格检查评价其生长发育状况。 结果 两组儿童维生素A、维生素B6、锌和钙的摄入水平与我国该年龄段儿童的膳食营养素推荐摄入量相比较均<80%,表明我国儿童上述营养素普遍摄入不足;而维生素B1、B2和叶酸的摄入水平两组儿童均属于边缘不足(为该年龄段儿童膳食营养素推荐摄入量的81%~100%);孤独症儿童维生素C和钙摄入不足的人数明显高于对照组。两组儿童血清锌水平均低于正常参考范围,但差异无统计学意义;孤独症儿童血清钙和叶酸的水平明显低于正常发育儿童,且血清钙水平还低于正常参考值范围。孤独症儿童的ZWA、ZBMIA及BMI指数,及6岁以下孤独症儿童ZWH均明显高于正常发育儿童,但两组儿童生长问题的分布差异无统计学意义。 结论 孤独症儿童和正常发育儿童均存在营养缺乏情况,但孤独症儿童更为严重,特别是钙、锌、维生素C和叶酸的缺乏较正常发育儿童更为明显。
Abstract
Objective To compare the nutritional status of children with autism and typically developing children. Methods A total of 53 children with autism and 53 typically developing children were enrolled in this study.The parents of the participated children were asked to provide a three-day food diary that was used to assess the nutritional intakes.Biochemical assessment and anthropometry were also completed for all the subjects. Results The levels of vitamins A and B6,zinc,and calcium intakes were <80% of the dietary reference intakes in both groups.In addition,the proportions of vitamin C and calcium intake deficiencies in the autism group were significantly higher than those in the control group.Serum zinc levels were less than the normal reference range in both groups.Serum calcium and folate levels in children with autism were significantly lower compared with those in children without autism.According to physical assessment,ZWA,ZBMIA and BMI of children with autism,and ZWH of autistic children under 6 years old were significantly higher than those of the typically developing children. Conclusion Inadequate nutritional status was observed in children with autism and typically developing children in China,but the nutritional deficiency in children with autism is worse,especially for calcium,zinc,vitamin C and folic acid.
关键词
孤独症儿童 / 膳食摄入 / 营养水平生化指标 / 人体测量
Key words
children with autism / nutrient intake / trophic level biochemical assessment / anthropometry
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参考文献
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[11] Hyman SL,Stewart PA,Schmidt B,et al.Nutrient intake from food in children with autism[J].Pediatrics,2012,130(S2):145-153.
[12] Adams JB,Audhya T,McDonough-Means S,et al.Nutritional and metabolic status of children with autism vs.neurotypical children,and the association with autism severity[J].Nutrition & Metabolism,2011,8(1):34-66.
[13] James SJ,Melnyk S,Fuchs G,et al.Efficacy of methylcobalamin and folinic acid treatment on glutathione redox status in children with autism[J].Am J Clin Nutr,2009,89(1):425-430.
[14] Ali A,Waly MI,Al-Farsi YM,et al.Hyperhomocysteinemia among Omani autistic children:a case-control study[J].Acta Biochim Pol,2011,58(4):547-551.
[15] Buie T,Campbell DB,Fuchs GJ,et al.Evaluation,diagnosis,and treatment of gastrointestinal disorders in individuals with ASDs:a consensus report[J].Pediatrics,2010,125(S):1-18.
[2] Dominick KC,Davis NO,Lainhart J,et al.Atypical behavior in children with autism and children with a history of language empairment[J].Research in Development Disabilities,2007,28(2):145-162.
[3] Lockner DW,Crowe TK,Skipper BJ.Dietary intake and parents' perception of mealtime behaviors in preschool-age children with autism spectrum disorder and in typically developing children[J].J Am Diet Assoc,2008,108(8):1360-1363.
[4] Mazurek MO,Vasa RA,Kalb LG,et al.Anxiety,sensory over-responsivity,and gastrointestinal problems in children with autism spectrum disorders[J].Journal of Abnormal Child Psychology,2013,41(1):165-176.
[5] Harris C,Card B.A pilot study to evaluate nutritional influences on gastrointestinal symptoms and behavior patterns in children with autism spectrum disorder[J].Complement Ther Med,2012,20(6):437-440.
[6] de Onis M,Onyango AW,Van den BJ,et al.Measurement and standardization protocols for anthropometry used in the construction of a new international growth reference[J].Food and Nutrition Bulletin,2004,25(S):27-36.
[7] WHO.WHO Anthro for personal computers,version 3.01:Software for assessing growth and development of the world's children[R].2009.
[8] World Health Organization.Training course on child growth assessment WHO child growth standards[R].Geneva,WHO.2008:14-20.
[9] Herndon AC,DiGuiseppi C,Johnson SL,et al.Does nutritional intake differ between children with autism spectrum disorders and children with typical development?[J].J Autism Dev Disord,2009,39(2):212-222. [10] Xia W,Zhou Y,Sun C,et al.A preliminary study on nutritional status and intake in Chinese children with autism[J].Eur J Pediatr,2010,169(10):1201-1206.
[11] Hyman SL,Stewart PA,Schmidt B,et al.Nutrient intake from food in children with autism[J].Pediatrics,2012,130(S2):145-153.
[12] Adams JB,Audhya T,McDonough-Means S,et al.Nutritional and metabolic status of children with autism vs.neurotypical children,and the association with autism severity[J].Nutrition & Metabolism,2011,8(1):34-66.
[13] James SJ,Melnyk S,Fuchs G,et al.Efficacy of methylcobalamin and folinic acid treatment on glutathione redox status in children with autism[J].Am J Clin Nutr,2009,89(1):425-430.
[14] Ali A,Waly MI,Al-Farsi YM,et al.Hyperhomocysteinemia among Omani autistic children:a case-control study[J].Acta Biochim Pol,2011,58(4):547-551.
[15] Buie T,Campbell DB,Fuchs GJ,et al.Evaluation,diagnosis,and treatment of gastrointestinal disorders in individuals with ASDs:a consensus report[J].Pediatrics,2010,125(S):1-18.
基金
国家自然科学基金项目(81072298);黑龙江省教育厅项目(12531409)
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