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Cited by 13Child Nutrition and Feeding IssuesAutism Spectrum Disorder ResearchVitamin D Research Studies

Nutritional Rickets Due to Severe Food Selectivity in Autism Spectrum Disorder

Hartman, Jacob S., Silver, Alyssa H.·2021·Journal of Developmental & Behavioral Pediatrics
DOI 10.1097/dbp.0000000000000856
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Abstract

OBJECTIVE: Studies have detected differences in various measures of bone health between individuals with autism spectrum disorder (ASD) and their peers. However, these measures do not amount to direct clinical evidence of increased orthopedic pathology in this population. Some of the most compelling evidence to this effect comes from case reports of nutritional rickets in children with ASD. We report on 1 such case that, to our knowledge, is the first report of nutritional rickets in ASD necessitating corrective surgery. METHODS: Case report, review of relevant literature, and implications for further research. RESULTS: An 11-year-old girl with ASD was admitted for postoperative medical comanagement after successful repair of bilateral genu valgum (knock knees). On admission, the patient's mother reported that the patient was a "picky eater." No cause had been determined preoperatively, although the deformity had developed at 10 years of age, thereby qualifying as pathologic. The medical team considered rickets because of the patient's limited diet. Subsequent laboratory work demonstrated hypocalcemia, vitamin D deficiency, and secondary hyperparathyroidism. The patient was diagnosed with nutritional rickets due to inadequate vitamin D intake, a consequence of severe food selectivity associated with ASD. CONCLUSION: This case exemplifies the extreme orthopedic and metabolic complications that can result from food selectivity in children with ASD, pointing to the need for further research into the prevalence and causes of orthopedic pathology and nutritional rickets in this population. The case also underscores the need for evidence-based guidelines to prevent orthopedic pathology in children with ASD.

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  • It is common for subjects with ASD, or their parents and caregivers, to attribute food selectivity to sensory aversions to smell, taste, texture, temperature, color, and appearance, and to the distribution of food.

    “It is common for subjects with ASD, or their parents and caregivers, to attribute FS to sensory aversions to smell (36%), taste (45%), texture (69%), temperature (22%), color, and appearance (58%), and even to the distribution of food.”

    From Food Selectivity and Its Implications Associated with Gastrointestinal Disorders in Children with Autism Spectrum Disorders (2022) · cites this paper as [60]

  • Eating behavior based on sensory preferences includes only tolerable foods, or foods with manageable textures and organoleptic characteristics, which usually includes foods rich in starches, saturated fats, and dense in calories.

    “The above leads to eating behavior based on sensory preferences that includes only tolerable foods, or foods with manageable textures and organoleptic characteristics, which usually includes foods rich in starches, saturated fats, and dense in calories [60].”

    From Food Selectivity and Its Implications Associated with Gastrointestinal Disorders in Children with Autism Spectrum Disorders (2022) · cites this paper as [60]

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Authors
Hartman, J. S., & Silver, A. H.
Affiliations
Albert Einstein College of Medicine (US)
Corresponding author
  • Hartman, Jacob S.
  • Silver, Alyssa H.
ORCID
Silver, Alyssa H.
Venue
Journal of Developmental & Behavioral Pediatrics
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2020-09-02
Volume
42
Issue
1
Pages
66-72
ISSN
0196-206X (ISSN-L)
DOI
10.1097/dbp.0000000000000856
OpenAlex
W3083090059
Cited by
13
References
27
Citations by year
2026: 1 · 2025: 5 · 2024: 3 · 2023: 1 · 2022: 3
FWCI
0.73
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Developmental & Behavioral Pediatrics (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
Keywords
nutritional rickets, autism spectrum disorder, picky eating, vitamin D deficiency, hypocalcemia, secondary hyperparathyroidism, genu valgum, orthopedic complications, bone health, pediatric surgery
MeSH terms
Autism Spectrum Disorder, Child, Diet, Female, Humans, Rickets, Prevalence

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