REVIEW

Terapia medicală nutriţională în tulburarea de spectru autist

 Nutritional medical therapy in autism spectrum disorder

First published: 20 decembrie 2023

Editorial Group: MEDICHUB MEDIA

DOI: 10.26416/Diet.4.4.2023.9096

Abstract

Objectives. This study aimed to assess the effectiveness of commonly used nutritional medical therapies in children with autism spectrum disorder (ASD). 
Method. The study explores the intricate relationship between ASD and nutritional medical therapy. Individuals with ASD often exhibit compromised gastrointestinal (GI) health, including issues with intestinal motility, adverse reactions to certain foods, and nutrient absorption deficiencies. These problems may be caused or exacerbated by restrictive eating behaviors, food preferences, and nutritional deficiencies. Those with GI conditions often display heightened behavioral deficits and imbalances in the overall composition of the intestinal microbiome. 
Results. The research underscores the importance of an individually tailored approach, considering the diverse nutritional needs and unique preferences of individuals with ASD. Analysis of current studies highlights the potential impact of personalized diets on the quality of life within the complex context of GI conditions associated with ASD. The benefits of current nutritional therapies are summarized, and the mixed results in addressing ASD are analyzed. Gluten-free and casein-free diets, the ketogenic diet, supplementation with fatty acids, and the use of pre-/probiotics demonstrate improvements in managing GI and behavioral symptoms associated with ASD. Customizing the diet is recommended as a multidisciplinary approach, given the complexity of GI-related conditions within the ASD diagnosis and their association with behavioral and neurological deficits. The significance of the results lies in supporting a personalized approach in managing specific ASD symptoms, with a focus on individual nutritional needs. 
Conclusions. Managing ASD symptoms requires a personalized approach, considering individual nutritional needs, food preferences, and different clinical manifestations. 
 

Keywords
nutritional medical therapy, autism spectrum disorder, intestinal microbiome

Rezumat

Obiective. Acest studiu şi-a propus să evalueze eficienţa terapiilor medicale nutriţionale utilizate frecvent în cazul copiilor cu tulburare de spectru autist (TSA). 
Metodă. Studiul explorează relaţia complexă dintre TSA şi terapia medicală nutriţională. Persoanele cu TSA adesea prezintă o stare de sănătate precară a sistemului gastrointestinal (GI), inclusiv probleme de motilitate intestinală, răspunsuri adverse la anumite alimente şi deficit de absorbţie a nutrienţilor. Aceste probleme pot fi cauzate sau accentuate de comportamente restrictive legate de preferinţe alimentare şi carenţe nutriţionale. Cei cu afecţiuni gastrointestinale manifestă adesea deficite comportamentale accentuate şi dezechilibre în compoziţia generală a microbiomului intestinal. 
Rezultate. Cercetarea subliniază importanţa unei abordări adaptate individual, având în vedere diversitatea nevoilor nutriţionale şi preferinţele unice ale persoanelor cu TSA. Analiza studiilor actuale pune în evidenţă potenţialul impact al dietei personalizate asupra calităţii vieţii în contextul complex al afecţiunilor GI asociate cu TSA. Sunt sumarizate beneficii ale terapiilor nutriţionale actuale şi sunt analizate rezultatele mixte în abordarea TSA. Dietele fără gluten şi fără cazeină, dieta ketogenică, suplimentarea cu acizi graşi şi administrarea de pre-/probiotice demonstrează îmbunătăţiri privind gestionarea simptomelor GI şi comportamentale asociate cu TSA. Personalizarea dietei este recomandată ca o abordare multidisciplinară, având în vedere complexitatea afecţiunilor corelate cu tractul gastrointestinal în cadrul diagnosticului de TSA şi asocierea acestora cu deficienţe comportamentale şi neurologice. Semnificaţia rezultatelor constă în susţinerea unei abordări personalizate în gestionarea simptomelor specifice TSA, cu accent pe necesităţile nutriţionale individuale.
Concluzii. Gestionarea simptomatologiei TSA necesită o abordare personalizată, fiecare individ având necesităţi nutriţionale individuale, preferinţe alimentare şi manifestări clinice diferite.

Bibliografie

  1. Karhu E, Zukerman R, Eshraghi RS, Mittal J, Deth RC, Castejon AM, Trivedi M, Mittal R, Eshraghi AA. Nutritional interventions for autism spectrum disorder. Nutr Rev. 2020 Jul 1;78(7):515-531. 2. 
  2. Taş A. Dietary strategies in Autism Spectrum Disorder (ASD). Progr in Nutr. 2018 Jan 20(4):554-562. 3.
  3. World Health Organization. Autism Spectrum Disorders. Who.int. Published March 29, 2023. https://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders 
  4. Valenzuela-Zamora AF, Ramírez-Valenzuela DG, Ramos-Jiménez A. Food ity and Its Implications Associated with Gastrointestinal Disorders in Children with Autism Spectrum Disorders. Nutrients. 2022;14(13):2660. .
  5. Brzóska A, Kazek B, Kozioł K, Kapinos-Gorczyca A, Ferlewicz M, Babraj A, Makosz-Raczek A, Likus W, Paprocka J, Matusik P, Emich-Widera E. Eating Behaviors of Children with Autism-Pilot Study. Nutrients. 2021 Aug 3;13(8):2687. . 
  6. Bandini LG, Curtin C, Phillips S, Anderson SE, Maslin M, Must A. Changes in Food ity in Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders. 2016;47(2):439-446. .
  7. Rodrigues JVS, Poli MCF, Petrilli PH, Dornelles RCM, Turcio KH, Theodoro LH. Food ity and neophobia in children with autism spectrum disorder and neurotypical development: a systematic review. Nutr Rev. 2023 Jul 10;81(8):1034-1050. .
  8. Leekam SR, Nieto C, Libby SJ, Wing L, Gould J. Describing the sensory abnormalities of children and adults with autism. J Autism Dev Disord. 2007 May;37(5):894-910.
  9. Suarez MA. Sensory Processing in Children with Autism Spectrum Disorders and Impact on Functioning. Pediatric Clinics of North America. 2012;59(1):203-214.
  10. National Institute of Mental Health. Autism spectrum disorder. National Institute of Mental Health. Published February 2023. https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd.
  11. Li Q, Liang J, Fu N, Han Y, Qin J. A Ketogenic Diet and the Treatment of Autism Spectrum Disorder. Front Pediatr. 2021 May 11;9:650624.
  12. Taniya MA, Chung HJ, Al Mamun A, Alam S, Aziz MA, Emon NU, Islam MM, Hong SS, Podder BR, Ara Mimi A, Aktar Suchi S, Xiao J. Role of Gut Microbiome in Autism Spectrum Disorder and Its Therapeutic Regulation. Front Cell Infect Microbiol. 2022 Jul 22;12:915701. doi:10.3389/fcimb.2022.915701.
  13. Berding K, Donovan SM. Microbiome and nutrition in autism spectrum disorder: current knowledge and research needs. Nutrition Reviews. 2016;74(12):723-736.
  14. Marotta R, Risoleo MC, Messina G, et al. The Neurochemistry of Autism. Brain Sciences. 2020;10(3):163. 
  15. Cekici H, Sanlier N. Current nutritional approaches in managing autism spectrum disorder: A review. Nutritional Neuroscience. 2017;22(3):145-155. 

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