Feeding Symptoms, Dietary Patterns, and Growth in Young Children With Autism Spectrum Disorders
Abstract
OBJECTIVE: To investigate the feeding, diet and growth of young children with autism spectrum disorders (ASD). METHOD: Data on feeding and food frequency were collected by questionnaires completed at 6, 15, 24, 38 and 54 months by participants in the Avon Longitudinal Study of Parents and Children. A food variety score was created, and the content of the diet was calculated at 38 m. The feeding and dietary patterns of 79 children with ASD were compared with 12 901 controls. RESULTS: The median ages of ASD children were 28 months at referral and 45 months at diagnosis. ASD infants showed late introduction of solids after 6 months (p = .004) and were described as “slow feeders” at 6 months (p = .04). From 15–54 months ASD children were consistently reported to be “difficult to feed” (p < .001) and “very choosy” (p < .001). From 15 months, the ASD group had a less varied diet than controls, were more likely to have different meals from their mother from 24 months, and by 54 months 8% of ASD children were taking a special diet for “allergy.” ASD children consumed less vegetables, salad and fresh fruit, but also less sweets and fizzy drinks. At 38 months intakes of energy, total fat, carbohydrate and protein were similar, but the ASD group consumed less vitamins C (p = .02) and D (p = .003). There were no differences in weight, height or BMI at 18 months and 7 years, or in hemoglobin concentrations at 7 years. CONCLUSIONS: ASD children showed feeding symptoms from infancy and had a less varied diet from 15 months, but energy intake and growth were not impaired.
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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 [128]
Due to repetitive and restricted dietary behaviours, ASD children are at increased risk of low dietary vitamin D intake.
“Moreover, due to repetitive and restricted dietary behaviours, ASD children are at increased risk of low dietary vitamin D intake [128,129].”
From Vitamin D and Autism Spectrum Disorder: A Literature Review (2016) · cites this paper as [128]
Both Emond and Zimmer studies showed that children with ASD had significantly lower dietary intakes of vitamin D than controls.
“Both studies showed that children with ASD had significantly lower dietary intakes of vitamin D than controls.”
From Vitamin D and Autism Spectrum Disorder: A Literature Review (2016) · cites this paper as [128]
Emond et al. (2010) and Zimmer et al. (2012) reported that children with ASD had late introduction of solids after six months, were difficult to feed and very choosy from 15-54 months, had less varied diet from 24 months, and ate fewer food on average at older ages, all of which affected their nutritional status.
“Emond et al. (2010) and Zimmer et al. (2012) reported that children with ASD had late introduction of solids after six months, were difficult to feed and very choosy from 15–54 months, had less varied diet from 24 months, and ate fewer food on average at older ages, all of which affected their nutritional status [128,129].”
From Vitamin D and Autism Spectrum Disorder: A Literature Review (2016) · cites this paper as [128]
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 [128]
Emond et al. found individuals with ASD had feeding difficulties from infancy and less diversified diets from the age of 15 months.
“A questionnaire study conducted by Emond et al. indicated that individuals with ASD exhibited feeding difficulties from infancy and had diets that were less diversified from the age of 15 months.”
From Unraveling the Connections: Eating Issues, Microbiome, and Gastrointestinal Symptoms in Autism Spectrum Disorder (2025) · cites this paper as [49]
At six months of age, parents of children with ASD reported challenges with introduction of solid foods and described their children as slow eaters; children consumed less fruit and vegetables, sweets, and carbonated beverages; no differences were observed in weight, height, or BMI at 18 months and seven years.
“At six months of age, parents reported challenges with the introduction of solid foods and described their children as “slow eaters”. Additionally, children consumed less fruit and vegetables, sweets, and carbonated beverages. However, no differences were observed in weight, height, or BMI at 18 months and seven years between the ASD patients and the control group [49].”
From Unraveling the Connections: Eating Issues, Microbiome, and Gastrointestinal Symptoms in Autism Spectrum Disorder (2025) · cites this paper as [49]
Protein intake in ASD children is adequate or quite similar to that of typically developing children.
“Protein intake was adequate or quite similar to that of typically developing children [69,72,73,74,75,76,77].”
From Autism, Gastrointestinal Symptoms and Modulation of Gut Microbiota by Nutritional Interventions (2019) · cites this paper as [72]
Many studies show ASD children have a considerably smaller variety of foods but no overall differences in total calories, carbohydrates, or fat intakes compared with typically developing children, suggesting satiety mechanisms are not impaired.
“However, in many studies children with ASDs show a considerably smaller variety of foods, but authors report no overall differences in their total calories, carbohydrates, or fat intakes [62,71,72,73,74], suggesting that their satiety mechanisms are not impaired.”
From Autism, Gastrointestinal Symptoms and Modulation of Gut Microbiota by Nutritional Interventions (2019) · cites this paper as [72]
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- Authors
- Emond, A., Emmett, P., Steer, C., & Golding, J.
- Affiliations
- University of Bristol (GB)
- Corresponding author
- Golding, Jean
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2010-08-01
- Volume
- 126
- Issue
- 2
- Pages
- e337-e342
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2099347248
- Cited by
- 338
- References
- 3
- Citations by year
- 2026: 12 · 2025: 19 · 2024: 23 · 2023: 30 · 2022: 24 · 2021: 32 · 2020: 25 · 2019: 17 · 2018: 38 · 2017: 15 · 2016: 15 · 2015: 23 · 2014: 17 · 2013: 22 · 2012: 13
- FWCI
- 10.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Explore Bristol Research (publishedVersion)
- Bristol Research (University of Bristol) (submittedVersion)
- Funders
- University of Bristol
- Medical Research Council
- 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, dietary habits, child growth, dietary diversity, food frequency, picky eating, special diets, vitamin intake, energy intake, hemoglobin
- MeSH terms
- Autistic Disorder, Body Height, Body Weight, Child, Preschool, Diet, Feeding Behavior, Food Hypersensitivity, Growth Disorders, Hemoglobins, Humans, Infant, Prospective Studies, Confidence Intervals
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