Feeding behavior and dietary intake of male children and adolescents with autism spectrum disorder: A case-control study

• This study provides further evidence of food selectivity in ASD patients.
• Diet quality rather than higher calorie intake could be related to unhealthy weight and other nutritional inadequacies.
• Feeding problems must be evaluated in the clinical routine.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder associated with restrictive or repetitive behaviors and difficulties with verbal and interpersonal communication, in which some problems involving nutrition may be present. This study aims to evaluate dietary intake and identify feeding behavioral problems in male children and adolescents with ASD when compared to matched controls, as well as parents or caregivers’ feelings about strategies for dealing with eating problems. A 3-day food record was performed and nutrient intake was compared to the Dietary Reference Intake according to age. To evaluate children feeding behavior and parents or caregivers’ feelings, the Behavior Pediatrics Feeding Assessment Scale (BPFA) was used. ASD patients consumed in average more calories than controls (though with a high patient’s frequency above and below calorie range references), had a limited food repertoire, high prevalence of children with inadequate calcium, sodium, iron vitamin B5, folate, and vitamin C intake. BPFA scores were also higher in the ASD group when compared to controls for all frequencies (child behavior, parents and total). These findings lead us to endorse the importance of evaluating feeding problems in the clinical routine, considering also the singular features of the patients.