Nutritional approaches used in the complex therapy of children with autism spectrum disorder
M.V. BELOUSOVA, E.A. MOROZOVA, E.G. GOMSINA
Kazan State Medical Academy — Branch Campus of the FSBEI FPE RMACPE MOH Russia, Kazan
Contact details:
Belousova M.V. — PhD (medicine), Associate Professor of the Department of Psychotherapy and Narcology, Associate Professor of the Department of Pediatric Neurology
Address: 36 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7 (843) 273-49-09, e-mail: belousova.marina@mail.ru
The article discusses the modern scientific data demonstrating the influence of intrauterine and early postnatal macro- and microelement deficiency on fetal neurogenesis and further cognitive development of the child. The features of the development of children with autism spectrum disorder (ASD) are given, including the formation of eating behavior, manifestations of selectivity in food within the framework of sensory disintegration, self-restriction of the diet due to «novelty avoidance». Nutritional disorders in children with ASD, observed from an early age, are often accompanied, or cause the manifestation of gastroenterological disorders that require timely treatment, including diet therapy. The feeding difficulties faced by the family of a child with ASD often push parents to self-treat with various diets, the balance and effectiveness of which are often very questionable. The article discusses the positive effects of diets prescribed and controlled by nutritionists and discusses the risks of self-treatment. The authors emphasize the necessity of correcting eating disorders in children with ASD and the importance of a gastroenterologist and nutritionist participation in the interdisciplinary complex support of children with ASD.
Key words: nutritionology, neurogenesis, macro- and micronutrient deficiency, gluten-free casein-free diet, cognitive functions, autism spectrum disorders (ASD).
REFERENCES
- Klinicheskie rekomendatsii “Rasstroystva autisticheskogo spektra v detskom vozraste: diagnostika, terapiya, profilaktika, reabilitatsiya” [Clinical guidelines «Autism spectrum disorders in childhood: diagnosis, therapy, prevention, rehabilitation»]. Rossiyskoe obshchestvo psikhiatrov, 2020, 127 p., available at: http://www.ncpz.ru/siteconst/userfiles/file/PDF/%D0%9A%D0%A0%20%D0%A0%D0%90%D0%A1%20-%20%D0%94%D0%9B%D0%AF%20%D0%9C%D0%97%20%D0%A0%D0%A4%2011.06.2020.pdf
- Olakunle J.O., Adejoke Y.O. Nutrition in autism spectrum disorders: A review of evidences for an emerging central role in aetiology, expression, and management. AIMS Medical Science, 2018, vol. 5 (2), pp. 122–144. DOI: 10.3934/medsci.2018.2.122
- Fombonne E. Epidemiology of pervasive developmental disorders. Pediatr Res, 2009 Jun, vol. 65 (6), pp. 591–598. DOI: 10.1203/PDR.0b013e31819e7203
- Weintraub K. Autism counts. Nature, 2011, Nov 2, vol. 479 (7371), pp. 22–24. DOI: 10.1038/479022a
- Nazeer A., Ghaziuddin M. Autism spectrum disorders: Clinical features and diagnosis. Pediatr Clin North Am, 2012, vol. 59 (1), pp. 19–25. DOI: 10.1016/j.pcl.2011.10.007
- Klinicheskie rekomendatsii “Rasstroystva autisticheskogo spectra” [Clinical guidelines «Autism Spectrum Disorders»]. Assotsiatsiya psikhiatrov i psikhologov za nauchno-obosnovannuyu praktiku. Odobreno nauchno-prakticheskim Sovetom MZ RF, 2020, 72 p., available at: https://cr.minzdrav.gov.ru/recomend/594_1)
- Jukić V., Arbanas G. Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition (DSM-5). Int J, 2013, vol. 57, p. 1546. DOI: 10.1176/appi.books.9780890425596
- Reber M. Rasstroystva autisticheskogo spektra. Nauchnye podkhody k terapii [Autism Spectrum Disorders. Scientific approaches to therapy]. Moscow: Izdatel’skiy dom BINOM, 2017. 424 p.
- Pavlova N.G., Konstantinova N.N. Fetal Neurology — Research Opportunities and Prospects. Zhurnal akusherstva i zhenskikh bolezney, 2003, vol. LII, no. 2, pp. 86–93 (in Russ.), available at: https://cyberleninka.ru/article/n/nevrologiya-ploda-vozmozhnosti-i-perspektivy-issledovaniya (accessed on: 03.03.2023).
- Talantova O.E. Features of the morphogenesis of the human fetal brain. Zhurnal akusherstva i zhenskikh bolezney, 2002, vol. 51, no. 2, pp. 89–94 (in Russ.). DOI: 10.17816/JOWD90422
- Prado E.L., Dewey K.G. Nutrition and brain development in early life. Nutr Rev., 2014, Apr, vol. 72 (4), pp. 267–284. DOI: 10.1111/nure.12102
- Keunen K., Elburg R.M.V., Bel F.V. et al. Impact of nutrition on brain development and its neuroprotective implications following preterm birth. Pediatr Res, 2015, Jan, vol. 77 (1-2), pp. 148–155. DOI: 10.1038/pr.2014.171
- Levitsky D.A., Strupp B.J. Malnutrition and the Brain: Changing Concepts, Changing Concerns. The Journal of Nutrition, 1995, vol. 125 (8), pp. 2212S–2220S. DOI: 10.1093/jn/125.suppl_8.2212S
- Sethi P., Prajapati A., Mishra T., Chaudhary T., Kumar S. Effects of Malnutrition on Brain Development. In: Mohamed, W., Kobeissy, F. (eds) Nutrition and Psychiatric Disorders. Nutritional Neurosciences. Springer, Singapore, 2022. DOI: 10.1007/978-981-19-5021-6_4
- Belousova M.V., Utkuzova M.A., Karpov A.M. Feeding disorders as a predictor of speech disorders. Prakticheskaya meditsina, 2015, no. 7 (92), pp. 36–40 (in Russ.).
- Narzisi A., Masi G., Grossi E. Nutrition and Autism Spectrum Disorder: Between False Myths and Real Research-Based Opportunities. Nutrients, 2021, Jun 17, vol. 13 (6), p. 2068. DOI: 10.3390/nu13062068
- Morozova E.A., Belousova M.V., Gomzina E.G. Utkuzova M.A. Microbiotic and nutritional patterns of formation of cognitive and behavioral functions of a child. Prakticheskaya meditsina, 2021, vol. 19, no. 5, pp. 32–36 (in Russ.).
- Ray K. Gut microbiota: microbial metabolites feed into the gut-brain-gut circuit during host metabolism. Nat Rev Gastroenterol Hepatol, 2014, vol. 11 (2), p. 76.
- Bavykina I.A. Features of physical development and nutrient levels in children with autism spectrum disorders. Ros. med.-biol. vestn. im. akad. I.P. Pavlova, 2019, vol. 27, no. 2, pp. 181–187 (in Russ.).
- Tkachuk E.A., Martynovich N.N., Globenko N.E. Features of the nutritional status and nutrition of children with autism spectrum disorders. Voprosy pitaniya, 2021, vol. 90, no. 5, pp. 67–76 (in Russ.). DOI: 10.33029/0042-8833-2021-90-5-67-76
- Dmitrieva Yu.A., Zakharova I.N., Radchenko E.R., Doroshina E.A. Gluten-free diet for neurological and psychiatric diseases: should we expect an effect? EiKG, 2021, no. 188 (4), pp. 170–177 (in Russ.).
- Lazaro C.P., Ponde M.P., Rodrigues L.E. Opioid peptides and gastrointestinal symptoms in autism spectrum disorders. Rev Bras Psiquiatr, 2016, vol. 38 (3), pp. 243–246.
- Zvyagin A.A., Bavykina I.A., Gubanova A.V. Non-celiac non-allergic gluten sensitivity. Pediatriya. Zhurnal im. G.N. Speranskogo, 2018, no. 97 (6), pp. 147–151 (in Russ.). DOI: 10.24110/0031-403X-2018-97-6-147-151
- Bavykina I.A., Popov V.I., Zvyagin A.A., Bavykin D.V. The frequency of detection of casein and gluten intolerance markers in children with autism spectrum disorders. Voprosy pitaniya, 2019, vol. 88, no. 4, pp. 41–47 (in Russ.).
- Mukhutdinova G.M., Gomzina E.G., Imamov A.A. Vliyanie selenovogo statusa na immunnyy otvet pri virusnykh infektsiyakh (obzor literatury) [Influence of selenium status on the immune response in viral infections (literature review)]. Sysinskie chteniya-2021: Materialy II Natsional’nogo kongressa s mezhdunarodnym uchastiem po ekologii cheloveka, gigiene i meditsine okruzhayushchey sredy, Moskva, 17–19 noyabrya 2021 g. Moscow: FGBU «Tsentr strategicheskogo planirovaniya i upravleniya mediko-biologicheskimi riskami zdorov’yu», 2021. Pp. 293–296. EDN VPEEVG
- Bavykina I.A., Popov V.I., Zvyagin A.A., Bavykin D.V. Gliadomorphin, casomorphin, and intestinal fatty acid-binding protein in children with autism spectrum disorders. Voprosy pitaniya, 2021, vol. 90, no. 3, pp. 20–27 (in Russ.). DOI: 10.33029/0042-8833-2021-90-3-20-27
- Kasanave E.V., Khachatryan L.G., Kaminskaya T.S., Geppe N.A., Vadiyan D.E., Manukyan M.S. Somatic features and diet therapy for children with psychoverbal developmental delays on the autism spectrum. Doktor.Ru, 2022, no. 21 (3), pp. 58–65 (in Russ.).
- Bavykina I.A., Zvyagin A.A., Bavykin D.V. Compliance with diet therapy as a factor in changing eating behavior in children with autism spectrum disorders. Meditsina: teoriya i praktika, 2019, vol. 4, no. 1, pp. 183–187 (in Russ.).
- Ivannikova E.V., Altashina M.V., Troshina E.A. Ketogenic diet: history of occurrence, mechanism of action, indications. Probl. endokr, 2022, no. 68 (1), pp. 49–72 (in Russ.). DOI: 10.14341/probl12724
- Bezrodnyy S.L. Gut microbiota and autism spectrum disorder in children. Rossiyskiy pediatricheskiy zhurnal, 2019, no. 22 (1), pp. 51–56 (in Russ.). DOI: 10.18821/1560-9561-2019-22-1-51-56
- Gurevich K.G., Nikonov E.L., Zaborova V.A., Shelekhova T.Yu., Zol’nikova O.Yu. The use of probiotics as part of the complex therapy of dysbiotic disorders in some intestinal diseases. Voprosy pitaniya, 2019, vol. 88, no. 1, pp. 77–84 (in Russ.).
- Nogay N.H., Walton J., Roberts K.M., Nahikian-Nelms M., Witwer A.N. The Effect of the Low FODMAP Diet on Gastrointestinal Symptoms, Behavioral Problems and Nutrient Intake in Children with Autism Spectrum Disorder: A Randomized Controlled Pilot Trial. J Autism Dev Disord, 2021, vol. 51 (8), pp. 2800–2811. DOI: 10.1007/s10803-020-04717-8. PMID: 33057858
- Ristori M., Quagliariello A., Reddel S., Ianiro G., Gasbarrini A., Putignani L. Autism, Gastrointestinal Symptoms and Modulation of Gut Microbiota by Nutritional Interventions. Nutrients, 2019, vol. 11 (11), p. 2812. DOI: 10.3390/nu11112812
- Ristori M., Quagliariello A., Reddel S., Ianiro G., Gasbarrini A., Putignani L. Autism, Gastrointestinal Symptoms and Modulation of Gut Microbiota by Nutritional Interventions. Nutrients, 2019, vol. 11 (11):2812. doi: 10.3390/nu11112812
- Barnhill K., Devlin M., Moreno H.T., Potts A., Richardson W., Schutte C., Hewitson L. Brief Report: Implementation of a Specific Carbohydrate Diet for a Child with Autism Spectrum Disorder and Fragile X Syndrome. J Autism Dev Disord, 2020, vol. 50 (5), pp. 1800–1808. DOI: 10.1007/s10803-018-3704-9 PMID: 30076499.
- Abele S., Meija L., Folkmanis V., Tzivian L. Specific Carbohydrate Diet (SCD/GAPS) and Dietary Supplements for Children with Autistic Spectrum Disorder. Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences, vol. 75, pp. 417–425. DOI: 10.2478/prolas-2021-0062