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New guideline for nutritional management of GI symptoms in autistic children

Posted:  Friday, July 31, 2015

Children with autism can breathe a sigh of relief. These children face a high risk of feeding and gastrointestinal (GI) problems compared with normal children of the same age which can be tackled through nutritional management. An expert panel has now laid down an evidenced based nutritional guideline to help manage GI problems in children with autism spectrum disorders.

The expert panel convened at Marcus Autism Centre (affiliate of Children's Healthcare of Atlanta) consisted of six expert dieticians with a combined experience of 125 years in the area of nutrition and autism.

Published in the Journal of the Academy of Nutrition and Dietetics, the paper covered a decision-making flowchart, thoroughly described intervention, and examples of the management of two GI concerns, namely constipation and eosinophilic esophagitis (a chronic allergic inflammatory disease).

Concerns associated with children with autism such as high rates of food selectivity, frequent use of caregiver-initiated complementary/alternative diets (gluten-free, casein-free, etc.), and potential nutritional deficits and excesses formed the basis of the guideline. Previous research has shown that these children face a higher risk of obesity and poor bone growth.

In some cases, food selectivity can cause GI symptoms, however it is also used to deal with food allergy or gastroesophageal reflux. Alternative diets may limit or completely avoid entire food groups. The new guideline suggests the following:

•   In cases of severe food selectivity, nutrition therapy and feeding therapy must be carried out simultaneously

•  Children facing severe food selectivity must consume nutritional supplements or liquid formulas

William Sharp, a co-author of the guideline said, "Our goal was to establish a standard manual of care for nutrition management which clinicians around the world could refer to." The experts concluded that nutrition management in autism must be a key component in a child's overall plan of care. A registered dietician must always be consulted to plan a diet for children with autism to ensure that it is both useful for elimination of GI symptoms as well as nutritionally balanced.

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