Holistic approach to Turkish children with autism spectrum disorder: diet quality and diversity, gastrointestinal and nutritional problems and quality of life perspective

Because of behaviors specific to autism spectrum disorder (ASD), children with ASD may have a poor quality of life, and maintain their nutritional and gastrointestinal (GI) health can be quite challenging. This study aimed to holistically examine the diet quality and diversity, quality of life, and nutritional and GI problems in children with ASD and compare their outcomes with healthy peers. Nutritional and GI problems were evaluated through a questionnaire according to the parents’ responses. Healthy Eating Index-2015 (HEI-2015) was used to evaluate diet quality, diet diversity score (DDS) was used to examine the food groups consumed, and Pediatric Quality of Life (PedsQL) was used to evaluate the quality of life. A total of 56.0% of children with ASD had a normal body weight for their age, 66.0% had a normal height for their age, and 70.0% had a normal body mass index (BMI) for their age. Various parameters were evaluated for ASD and healthy children, respectively and children with ASD had lower BMI Z scores (ASD = 0.35 ± 0.90, Healthy = 1.03 ± 1.44), lower quality of life (5–7 years ASD = 49.0 ± 5.94, Healthy = 89.0 ± 13.24; 8–12 years ASD = 47.1 ± 7.59, Healthy = 86.9 ± 14.07) and lower diet quality (Healthy = 73.8 ± 3.92, ASD = 71.5 ± 4.11) (p < 0.05). No significant difference was found between the two groups in terms of diet diversity (p > 0.05). Gastrointestinal system problems, food refusal, food neophobia, food obsession and fast eating were seen more frequently in children with ASD compared to healthy children (p < 0.05). In conclusion, children with ASD were found to have more nutritional and GI problems, a lower quality of life, and poorer diet quality compared to their peers. Growth curves, diet quality and diversity, quality of life, nutrition and GI problems of children with ASD should be carefully monitored and individualized nutrition strategies should be developed.