Dietary challenges and supplement use in children with autism spectrum disorder in the West Bank-Palestine: a cross-sectional study

Abstract Background Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that is frequently accompanied by severe feeding difficulties, such as food refusal, selectivity, and disruptive mealtime behaviors. These difficulties might have a negative impact on the child’s nutritional status and cause significant emotional stress for caregivers. Methods A cross-sectional survey of 99 parents of children with ASD was undertaken in the West Bank. Data were gathered parent-reported structured questionnaires. Descriptive statistics detailed participant characteristics, whereas chi-square tests, t-tests, ANOVA, and multiple regression analyses investigated the relationships between feeding behaviors, parental stress, and supplement use. Results Feeding difficulties were quite common among the children, with nearly one third of children diagnosed with ASD experiencing food selectivity (31.3%, n = 31) and about one-third showing poor appetite (31.3%, n = 31). Parents reported higher stress levels when mealtimes involved disruptive behaviors, and this relationship was statistically significant (p < 0.05). Food selectivity was also linked to an earlier age of autism diagnosis and low birth weight (p < 0.05). Regression analysis further revealed that parents with higher education and greater household income were more likely to provide dietary supplements to their children (p < 0.05). However, supplement use did not appear to improve feeding behaviors or lessen parental stress (p > 0.05). Conclusion Feeding difficulties are widespread among children with ASD in the West Bank. Despite some reliance on supplements, benefits were limited. Small sample size and convenience sampling are key limitations. Culturally tailored behavioral interventions are urgently needed. Importantly, this research is one of the limited studies that investigates feeding challenges associated with autism within the framework of political occupation, presenting a unique addition to the worldwide body of literature.