Food Selectivity in Children with Autism Spectrum Disorders and Typically Developing Children
Open accessAbstract
Objectives To define food selectivity and compare indices of food selectivity among children with autism spectrum disorders (ASDs) and typically developing children, and to assess the impact of food selectivity on nutrient adequacy.Study design Food selectivity was operationalized to include food refusal, limited food repertoire, and high-frequency single food intake using a modified food frequency questionnaire and a 3-day food record. Food selectivity was compared between 53 children with ASDs and 58 typically developing children age 3-11 years. Nutrient adequacy was assessed relative to the dietary reference intakes.Results The children with ASDs exhibited more food refusal than typically developing children (41.7% of foods offered vs 18.9% of foods offered; P <.0001). They also had a more limited food repertoire (19.0 foods vs 22.5 foods; P <.001). Only 4 children with ASDs and 1 typically developing child demonstrated high-frequency single food intake. Children with a more limited food repertoire had inadequate intake of a greater number of nutrients.Conclusions Our findings suggest that food selectivity is more common in children with ASDs than in typically developing children, and that a limited food repertoire may be associated with nutrient inadequacies.
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Children with ASD may receive less sunlight due to lower outdoor activity and have inadequate intake of vitamin D, i.e., reverse causality.
“Furthermore, children with ASD may receive less sunlight due to lower outdoor activity and have inadequate intake of vitamin D [114,118,126,127,128,129,130,131,132,133,134,135,136], i.e., reverse causality.”
From Vitamin D and Autism Spectrum Disorder: A Literature Review (2016) · cites this paper as [130]
Several case-control studies have shown that children with ASD have lower vitamin D intakes than typically developing controls.
“However, several case-control studies have shown that children with ASD have lower vitamin D intakes than typically developing controls [114,128,129,130].”
From Vitamin D and Autism Spectrum Disorder: A Literature Review (2016) · cites this paper as [130]
More children with ASD did not meet the estimated average requirement (EAR) for vitamin D intake than healthy controls (79% vs. 55%, p = 0.01), and more selective eaters with ASD were at increased risk for inadequate intake (58% vs. 5%, p = 0.01).
“More children with ASD did not also meet the estimated average requirement (EAR) for vitamin D intake than healthy controls (79% vs. 55%, p = 0.01) [130], and more selective eaters with ASD were at increased risk for inadequate intake (58% vs. 5%, p = 0.01) [129].”
From Vitamin D and Autism Spectrum Disorder: A Literature Review (2016) · cites this paper as [130]
Bandini et al. found ASD children aged 3-11 rejected 41.7% of foods compared to 18.9% in neurotypical peers.
“Bandini et al. also observed this trend in a study comparing 53 ASD and 58 NT children aged 3–11, where ASD children rejected 41.7% of foods compared to 18.9% in NT peers [17].”
From Unraveling the Connections: Eating Issues, Microbiome, and Gastrointestinal Symptoms in Autism Spectrum Disorder (2025) · cites this paper as [17]
Selective children with ASD often prefer foods with low nutritional value and high in fat, salt, and sugar.
“Selective children with ASD often prefer foods with low nutritional value and high in fat, salt, and sugar [19].”
The characteristic pattern of behaviours, needs, and sensitivities associated with autism can give rise to a limited food repertoire, specific sensory preferences, and rigid rules regarding mealtimes.
“The characteristic pattern of behaviours, needs, and sensitivities associated with autism can give rise to a limited food repertoire, specific sensory preferences, and rigid rules regarding mealtimes.”
From Avoidant/Restrictive Food Intake Disorder and Severe Food Selectivity in Children and Young People with Autism: A Scoping Review (2022) · cites this paper as [11]
Some studies report a relationship between atypical oral sensory over-response and a rejection of the consumption of fruits and vegetables.
“Some studies report a relationship between atypical oral sensory over-response and a rejection of the consumption of fruits and vegetables [21,47].”
From Food Selectivity and Its Implications Associated with Gastrointestinal Disorders in Children with Autism Spectrum Disorders (2022) · cites this paper as [21]
Bandini et al. (2010) propose a definition of FS based on the eating patterns of children with ASD, classifying FS into three types: (1) food refusal, (2) limited food repertoire, and (3) high frequency of single food intake.
“Bandini et al. (2010) propose a definition of FS based on the eating patterns of children with ASD [57]. This definition includes the classification of FS into three types: (1) food refusal, (2) limited food repertoire, and (3) high frequency of single food intake (Table 2).”
From Food Selectivity and Its Implications Associated with Gastrointestinal Disorders in Children with Autism Spectrum Disorders (2022) · cites this paper as Bandini et al. (2010)
A substantial number of subjects with ASDs had inadequate intakes of micronutrients, including deficiencies of calcium, iron, zinc, potassium, copper, vitamin A, vitamin D, vitamin E, riboflavin, vitamin C, vitamin B-12, folic acid, and choline.
“Substantial number of subjects with ASDs had inadequate intakes of micronutrients.”
From Autism, Gastrointestinal Symptoms and Modulation of Gut Microbiota by Nutritional Interventions (2019) · cites this paper as [67]
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- Authors
- Bandini, L. G., Anderson, S. E., Curtin, C., Cermak, S., Evans, E. W., Scampini, R., Maslin, M., & Must, A.
- Affiliations
- Boston University (US)
- The Ohio State University (US)
- University of Massachusetts Chan Medical School (US)
- University of Southern California (US)
- Tufts University (US)
- Corresponding author
- Bandini, Linda G.
- ORCID
- Venue
- The Journal of Pediatrics
- Publisher
- Elsevier BV
- Published
- 2010-08
- Volume
- 157
- Issue
- 2
- Pages
- 259-264
- ISSN
- 0022-3476 (ISSN-L)
- PMC
- PMC2936505
- OpenAlex
- W2039063058
- Cited by
- 664
- References
- 24
- Citations by year
- 2026: 49 · 2025: 50 · 2024: 67 · 2023: 57 · 2022: 54 · 2021: 58 · 2020: 50 · 2019: 51 · 2018: 45 · 2017: 39 · 2016: 23 · 2015: 41 · 2014: 27 · 2013: 25 · 2012: 11
- FWCI
- 11.15
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- The Journal of the American Medical Association (JAMA) Network (American Medical Association) (submittedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK046200, R01DK056690)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P30HD004147, R21HD048989)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- picky eating, autism spectrum disorder, food refusal, nutritional adequacy, dietary intake, children, typically developing children
- MeSH terms
- Child, Child Development Disorders, Pervasive, Child, Preschool, Diet Surveys, Eating, Feeding Behavior, Female, Food Preferences, Humans, Male, Nutritional Status, Surveys and Questionnaires, Case-Control Studies, Child Nutrition Sciences
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