Food Selectivity, Nutritional Inadequacies, and Mealtime Behavioral Problems in Children with Autism Spectrum Disorder Compared to Neurotypical Children
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OBJECTIVE: To evaluate body composition, nutritional status through food selectivity and degree of inadequate intake, and mealtime behavior in children with autism spectrum disorder (ASD) compared to neurotypical children. METHOD: A cross-sectional case-control study was carried out in 144 children (N = 55 with ASD; N = 91 with neurotypical children) between 6 and 18 years of age. Body composition, nutritional intake, food consumption frequency (FFQ), and mealtime behavior were evaluated. RESULTS: Results showed a greater presence of children with a low weight (18.4% ASD vs. 3.20% comparison group) and obesity (16.3% ASD vs. 8.6% comparison group) in the ASD group for body mass index (BMI) categories (p = .003; number needed to take [NNT] = 8.07). The presence of obesity in ASD children compared to the comparison group was even higher when considering the fat component (47.5% ASD vs. 19.4% comparison group, p = .002; NNT = 10.3). ASD children had greater intake inadequacy (50% ASD vs. 22% comparison group, p = .014; NNT = 3.58), high food selectivity by FFQ (60.6% ASD vs. 37.9% comparison group, p < .037; NNT = 4.41), and more eating problems (food rejection, limited variety, disruptive behavior), compared to neurotypical children (p = .001). CONCLUSION: Children with ASD showed an unbalanced body composition toward both underweight and obesity, a greater degree of inadequate intake, high food selectivity as indicated by their consumption frequency, and more disturbed eating behavior than children with neurotypical development. We suggest monitoring nutritional inadequacies and implementing nutritional strategies to expand the variety of foods children with ASD consume.
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Molina-López et al. found food selectivity in 60.6% of ASD children versus 37.9% of neurotypical peers, defined as rejecting over 33% of offered foods.
“Molina-López et al. compared 55 ASD children to 91 neurotypical (NT) peers using the Food Frequency Questionnaire (FFQ) [16]. Results showed FS in 60.6% of the ASD group versus 37.9% of the NT group, with FS defined as rejecting over 33% of offered foods.”
From Unraveling the Connections: Eating Issues, Microbiome, and Gastrointestinal Symptoms in Autism Spectrum Disorder (2025) · cites this paper as [16]
The psycho-emotional state contributes to FS and other eating problems.
“Additionally, the psycho-emotional state contributes to FS and other eating problems [59].”
From Food Selectivity and Its Implications Associated with Gastrointestinal Disorders in Children with Autism Spectrum Disorders (2022) · cites this paper as [59]
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Valenzuela-Zamora, A. F., Ramírez-Valenzuela, D. G., & Ramos-Jiménez, A. (2022) · Nutrients · doi:10.3390/nu14132660 · Cited by 78 · see citing works
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- Authors
- Molina‐López, J., Leiva‐García, B., Planells, E., & Planells, P.
- Affiliations
- Universidad de Granada (ES)
- Universidad Complutense de Madrid (ES)
- Corresponding author
- Molina‐López, Jorge
- Planells, Elena
- Venue
- International Journal of Eating Disorders
- Publisher
- Wiley
- Published
- 2021-10-27
- Volume
- 54
- Issue
- 12
- Pages
- 2155-2166
- ISSN
- 0276-3478 (ISSN-L)
- 1098-108X
- OpenAlex
- W3208082730
- Cited by
- 108
- References
- 56
- Citations by year
- 2026: 26 · 2025: 35 · 2024: 22 · 2023: 16 · 2022: 9
- FWCI
- 8.36
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- International Journal of Eating Disorders (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Repositorio Institucional de la Universidad de Huelva (Universidad de Huelva) (submittedVersion)
- Institutional Repository of the University of Granada (University of Granada) (submittedVersion, cc-by)
- Hispana (submittedVersion, cc-by-nc-nd)
- Repositorio Institucional de la Universidad de Huelva (Universidad de Huelva) (submittedVersion, cc-by-nc-nd)
- Funders
- ASCRS Research Foundation
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- autism spectrum disorder, picky eating, nutritional deficiency, mealtime behavior, feeding difficulties, body composition, childhood obesity, underweight, dietary intake, food refusal, children
- MeSH terms
- Problem Behavior, Autism Spectrum Disorder, Child, Cross-Sectional Studies, Feeding Behavior, Humans, Case-Control Studies, Meals
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