Seletividade alimentar em pacientes com transtorno do espectro autista

Abstract

Autism Spectrum Disorder (ASD) is a neurological condition that affects development, presenting challenges in social interaction, verbal communication and specific behaviors. It is generally identified in the first years of life and affects approximately 1% of the global population. Around 40 to 80% of children with autism, in particular, tend to show food selectivity to some degree, showing aversion to certain textures and smells, difficulty in accepting new foods, repertoire and food variety limited to a few foods and, normally, preference for foods with high energy value. These factors can promote nutritional inadequacies such as inadequacies in the intake of vitamins, mainly from the B complex, and excess weight for age, presenting overweight and obesity. The objective was to carry out a clinical-nutritional assessment and food selectivity in patients with ASD followed by the Foundation Integrated Center for Supporting People with Disabilities (FUNAD) in the city of João Pessoa-PB. This is an epidemiological study characterized as a Cross-Sectional Observational Study Analytical with a Quantitative and Qualitative approach carried out at FUNAD. Initially, participants were invited and instructed to fill out the Free and Informed Consent Forms (TCLE) and Free and Informed Assent Forms (TALE). Data collection was carried out with 125 autistic participants and their guardians, using as instruments the Socioeconomic Questionnaire, Eating Behavior Questionnaire in ASD and Physical Assessment Questionnaire (Weight, Height, Arm Circumference (BC) and Tricipital Skin Fold (DCT) ). Qualitative data are presented in the form of frequency (absolute and relative). Fisher's exact test was used to check possible associations between categorical variables, being considered significant when the p value < 0.05. As a result, there was a predominance of males (83.2%), with a ratio of boys to girls of 4.95:1, aged between 5 and 10 years (68.8%), of mixed ethnicity ( 56.8%), attending Elementary School I (65.6%). The majority (66.4%) had a family income of up to one minimum wage, and lived in João Pessoa (43.2%), in homes with several family members (48.8%), generally with an average of 4 people ( 36.8%). Regarding clinical aspects, 87.2% reported not having pathologies associated with autism; 72% were taking some medication, with Risperidone being among the most cited, classified as an Atypical Antipsychotic (49.6%). It was found that 91.2% of autistic people had some degree of food selectivity, with moderate (45.6%) being the highlight. In the physical assessment, high weight for age (52.6%) and overweight and obesity (45.9%) were observed. When relating food selectivity and nutritional status in autistic children, no significant relationship was found, suggesting that the presence of food selectivity in a child will not necessarily result in changes in the nutritional status profile, and there may be implicit malnutrition. Therefore, anthropometric nutritional assessment alone may not be a reliable and sufficient indicator in this population, highlighting the importance of using complementary instruments to assess the nutritional health of autistic patients, such as the assessment of nutrient deficiencies, such as vitamins and minerals.