Nutritional and Health Status of Autistic Children: Assessing the Efficacy of Gluten-Free High-Protein Bread in Improving Biochemical Parameters
DOI:
https://doi.org/10.52783/jns.v14.1857Keywords:
Okara, chickpeas, autistic children, BMI, metabolic indexAbstract
Background: The issue of the nutritional and health status of children with autism spectrum disorders (ASD) is intricate and encompasses dietary factors. High gluten foods consumption is a significant concern due to its potential influence on health and autism symptoms. Investigating this connection can offer valuable information for enhancing the well-being of autistic children.
Methods: This study investigated the effects of gluten-free, high-protein meals on autistic children by examining changes in biochemical markers pre and post a three-month regimen of thrice-daily consumption of chickpea and okra-based bread. The study involved 100 boys with ASD between the ages of 9 and 11. Their physical measurements, health problems, socioeconomic background, dietary habits, and metabolic index were examined.
Results: The study found common health issues in ASD children, including lethargy, solitary eating habits, decreased appetite, and bloating. In terms of body weight, 51% were within a normal range, while 48% were overweight/obese. Significant discrepancies were observed in their consumption of energy, carbohydrates, and fats when compared to standard dietary guidelines. After the dietary change, there was a marked improvement in the levels of essential minerals and vitamins. Enhanced levels of GSH, GSSG, and CoQ10, alongside reduced NADPH, NADH, and ATP levels were noted, which were likely due to increased protein and fiber in the gluten-free bread.
Conclusions: The introduction of a gluten-free and high-protein bread using chickpeas and okara demonstrated positive outcomes, enhancing essential mineral and vitamin levels. Additionally, observed biochemical changes suggest potential benefits of this dietary intervention in addressing metabolic imbalances commonly associated with ASD.
Downloads
Metrics
References
Kittana M, Ahmadani A, Williams KE, Attlee A. Nutritional Status and Feeding Behavior of Children with Autism Spectrum Disorder in the Middle East and North Africa Region: A Systematic Review. Nutrients. 2023;15(3):711.
Gesundheit B, Rosenzweig JP. Autism Spectrum Disorders (ASD)-Searching for the Biological Basis for Behavioral Symptoms and New Therapeutic Targets. Front Neuroscience. 2017; 10:607.
Esteban-Figuerola P, Canals J, Fernández-Cao JC, Arija Val V. Differences in Food Consumption and Nutritional Intake Between Children with Autism Spectrum Disorders and Typically Developing Children: A Meta-analysis. Autism. 2019;23(5):1079-1095.
Bandini LG, Anderson SE, Curtin C, et al. Food Selectivity in Children with Autism Spectrum Disorders and Typically Developing Children. The Journal of paediatrics. 2010;157(2):259-264.
Bjørklund G, Meguid NA, Hemimi M, Sahakyan E, Fereshetyan K, Yenkoyan K. The Role of Dietary Peptides Gluten and Casein in the Development of Autism Spectrum Disorder: Biochemical Perspectives. Mol Neurobiol. 2024:1-12.
Hartman JS, Silver AH. Nutritional rickets due to severe food selectivity in autism spectrum disorder. J of Developmental and Behavioural Paediatrics. 2021;42(1):66-72.
Şahan AK, Öztürk N, Demir N, Karaduman AA, Serel Arslan S. A comparative analysis of chewing function and feeding behaviors in children with autism. Dysphagia. 2021:1-6.
Alamri ES. Efficacy of gluten-and casein-free diets on autism spectrum disorders in children. Saudi Med J. 2020;41(10):1041.
Esposito M, Mirizzi P, Fadda R, Pirollo C, Ricciardi O, Mazza M, Valenti M. Food selectivity in children with autism: guidelines for assessment and clinical interventions. Int J Environ Res Public Health. 2023;20(6):5092.
Segev A, Badani H, Kapulnik Y, Shomer I, Oren-Shamir M, Galili S. Determination of polyphenols, flavonoids, and antioxidant capacity in colored chickpea (Cicer arietinum L.). J Food Sci. 2010;75(2): S115-S119.
Jukanti AK, Gaur PM, Gowda CLL, Chibbar RN. Nutritional quality and health benefits of chickpea (Cicer arietinum L.): a review. British Journal of Nutrition. 2012;108(S1): S11-S26.
Bochenek H, Francis N, Santhakumar AB, Blanchard CL, Chinkwo KA. The antioxidant and anticancer properties of chickpea water and chickpea polyphenol extracts in vitro. Cereal Chem. 2023;100(4):895-903.
Villanueva MJ, Yokoyama WH, Hong YJ, Barttley GE, Rupérez P. Effect of high-fat diets supplemented with okara soybean by-product on lipid profiles of plasma, liver and faeces in Syrian hamsters. Food Chem. 2011;124(1):72-79.
Faustino M, Veiga M, Sousa P, Costa E, Silva S, Pintado M. Agro-Food Byproducts as a New Source of Natural Food Additives. Molecules. 2019;24(6):1056.
Correddu F, Lunesu MF, Buffa G, Atzori AS, Nudda A, Battacone G, Pulina G. Can agro-industrial by-products rich in polyphenols be advantageously used in the feeding and nutrition of dairy small ruminants? Animals. 2020;10(1):131.
Pešić MB, Pešić MM, Bezbradica J, Stanojević AB, Ivković P, Milinčić DD, et al. Okara-Enriched Gluten-Free Bread: Nutritional, Antioxidant and Sensory Properties. Molecules. 2023;28(10):4098.
Ćurić D, Ðugum J, Bauman I. The influence of fungal α-amylase supplementation on amylolytic activity and baking quality of flour. International journal of food science & technology. 2002;37(6):673-680.
Pyler EJ. Baking Science and Technology. Siebel Publ Co; 1973:428.
Horwitz W. Official Methods of Analysis of AOAC International. Volume I, Agricultural Chemicals, Contaminants, Drugs. Gaithersburg (MD): AOAC International; 2010.
FAO, UN. Food Composition Tables for the Near East. FAO Food and Nutrition Paper. 1982;(25).
Schopler E. The childhood autism rating scale. Western Psychological Services. 1994:12031, 900251251.
Patterson RE, Kristal AR, Tinker LF, Carter RA, Bolton MP, Agurs-Collins T. Measurement characteristics of the Women’s Health Initiative food frequency questionnaire. Annals of epidemiology. 1999;9(3):178-187.
Institute of Medicine, Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Uses of dietary reference intakes. In: Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. National Academies Press (US); 1998.
Meyers LD, Hellwig JP, Otten JJ, eds. Dietary reference intakes: the essential guide to nutrient requirements. National Academies Press; 2006.
World Health Organization. WHO Anthro for personal computers, version 3.2. Software for assessing growth and development of the world's children. 2010:2, 2011.
Pérez-Ruiz T, Martínez-Lozano C, García MD, Martín J. High-performance liquid chromatography–photochemical reduction in aerobic conditions for determination of K vitamins using fluorescence detection. Journal of Chromatography. 2007;1141(1):67-72.
Gimeno E, Castellote AI, Lamuela-Raventos RM, De La Torre MC, Lopez-Sabater MC. Rapid determination of vitamin E in vegetable oils by reversed-phase high-performance liquid chromatography. Journal of Chromatography. 2000;881(1-2):251-254.
Wittig M, Krings U, Berger RG. Single-run analysis of vitamin D photoproducts in oyster mushroom (Pleurotus ostreatus) after UV-B treatment. Journal of Food Composition and Analysis. 2013;31(2):266-274.
Parbhunath OL, Rautenbach F, Davison G, Marnewick JL. Optimization and validation of a reverse-phase high performance liquid chromatography assay with ultra-violet detection for measuring total L-ascorbic acid in food and beverage products. J Anal Bioanal Techniq. 2014; 5:201.
Fotsing L, Fillet M, Bechet I, Hubert P, Crommen J. Determination of six water-soluble vitamins in a pharmaceutical formulation by capillary electrophoresis. J Pharm Biomed Anal. 1997;15(8):1113-1123.
Causon R. Validation of chromatographic methods in biomedical analysis viewpoint and discussion. J Chromatogr B Biomed Sci Appl. 1997;689(1):175-180.
Gorman MW, Feigl EO, Buffington CW. Human plasma ATP concentration. Clin Chem. 2007;53(2):318-325.
Klemm A, Steiner T, Flötgen U, Cumme GA, Horn A. Determination, purification, and characterization of α-NADH and α-NADPH. In: Methods in Enzymology. Vol 280. Academic Press; 1997:171-186.
Melnyk S, Pogribna M, Pogribny IP, Yi P, James SJ. Measurement of plasma and intracellular S-adenosylmethionine and S-adenosylhomocysteine utilizing coulometric electrochemical detection: alterations with plasma homocysteine and pyridoxal 5′-phosphate concentrations. Clin Chem. 2000;46(2):265-272.
Lang JK, Gohil K, Packer L. Simultaneous determination of tocopherols, ubiquinols, and ubiquinones in blood, plasma, tissue homogenates, and subcellular fractions. Anal Biochem. 1986;157(1):106-116.
Alvares GA, Licari MK, Stevenson PG, et al. Investigating associations between birth order and autism diagnostic phenotypes. J Child Psychol Psychiatry. 2021;62(8):961-970.
Aishworiya R, Goh TJ, Sung M, Tay SKH. Correlates of adaptive skills in children with autism spectrum disorder. Autism. 2021;25(6):1592-1600.
Yin W, Pulakka A, Reichenberg A, Kolevzon A, Ludvigsson JF, Risnes K, et al. Association between parental psychiatric disorders and risk of offspring autism spectrum disorder: a Swedish and Finnish population-based cohort study. Lancet Reg Health Eur. 2024;40.
Manohar H, Pravallika M, Kandasamy P, Chandrasekaran V, Rajkumar RP. Role of exclusive breastfeeding in conferring protection in children at-risk for autism spectrum disorder: results from a sibling case–control study. J Neurosci Rural Pract. 2018;9(1):132-136.
Alasiri RM, Albarrak DA, Alghaith DM, Alsayari OS, Alqahtani YS, Bafarat AY, Tashkandi NF. Quality of Life of Autistic Children and Supported Programs in Saudi Arabia: A Cross-Sectional Study. Cureus. 2024;16(1).
Xie S, Karlsson H, Dalman C, Widman L, Rai D, Gardner RM, et al. Family history of mental and neurological disorders and risk of autism. JAMA network open. 2019;2(3): e190154-e190154.
Li X, Huang Y, Yin R, Pan C, Cai Y, Wang Z. Visualized nutrition education and dietary behavioral change: A systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2019;59(12):1976-1985.
Jiménez A, Organista-Juárez D, Rocha L, Estudillo E, Fernández-Sánchez V, Cureño-Díaz MA, et al. Dysfunction of olfactory structures: A conserved mechanism of neurodegeneration? Brain Behav Immun Integr. 2024;100053.
Vissoker RE, Latzer Y, Stolar O, Rabenbach A, Gal E. Eating problems and patterns among toddlers and young boys with and without autism spectrum disorders. Res Autism Spectr Disord. 2019; 59:1-9.
Park HJ, Choi SJ, Kim Y, Cho MS, Kim YR, Oh JE. Mealtime behaviors and food preferences of students with autism spectrum disorder. Foods. 2021;10(1):49.
Wenzell ML, Pulver SL, McMahon MX, Rubio EK, Gillespie S, Berry RC, et al. Clinical correlates and prevalence of food selectivity in children with autism spectrum disorder. J Pediatr. 2024;114004.
McCoy SM, Jakicic JM, Gibbs BB. Comparison of obesity, physical activity, and sedentary behaviors between adolescents with autism spectrum disorders and without. J Autism Dev Disord. 2016; 46:2317-2326.
Şengüzel S, Cebeci AN, Ekici B, Gönen İ, Tatlı B. Impact of eating habits and nutritional status on children with autism spectrum disorder. J Taibah Univ Med Sci. 2021;16(3):413-421.
Canals-Sans J, Esteban-Figuerola P, Morales-Hidalgo P, Arija V. Do children with autism spectrum disorders eat differently and less adequately than those with subclinical ASD and typical development? EPINED epidemiological study. J Autism Dev Disord. 2022;52(1):361-375.
Hubbard KL, Anderson SE, Curtin C, Must A, Bandini LG. A comparison of food refusal related to characteristics of food in children with autism spectrum disorder and typically developing children. J Acad Nutr Diet. 2014;114(12):1981-1987.
Proctor KB, Volkert VM, Klin A, Vickery BP, Sharp WG. The intersection of autism spectrum disorder, food allergy, and avoidant/restrictive food intake disorder: A clinical case study. J Pediatr. 2024.
Lindsay RL, Eugene Arnold L, Aman MG, et al. Dietary status and impact of risperidone on nutritional balance in children with autism: a pilot study. J Intellect Dev Disabil. 2006;31(4):204-209.
Mousain-Bosc M, Siatka C, Bali JP. Magnesium, hyperactivity and autism in children. In: Magnesium in the Central Nervous System. University of Adelaide Press, Adelaide (AU); 2018. PMID: 29920003.
Walecki P, Kawala-Janik A, Siwek J. Autism in children connected with gastrointestinal symptoms. Gut Microbiota-Brain Axis.2018.
Barry MJ, Nicholson WK, Silverstein M, et al; US Preventive Services Task Force. Folic acid supplementation to prevent neural tube defects: US preventive services task force reaffirmation recommendation statement. Jama. 2023;330(5):454-459.
Suarez MA, Nelson NW, Curtis AB. Longitudinal follow-up of factors associated with food selectivity in children with autism spectrum disorders. Autism. 2014;18(8):924-932.
Evans EW, Must A, Anderson SE, et al. Dietary patterns and body mass index in children with autism and typically developing children. Res Autism Spectr Disord. 2012;6(1):399-405.
Lakhan TR. Navigating the Nexus: Understanding Overweight and Obesity among Children with Autism Spectrum Disorder. Eur J Soc Sci. 2024;64(1).
WHO. Fruit and vegetables for health: report of the Joint FAO.2005.
Ahumada D, Guzmán B, Rebolledo S, et al. Eating Patterns in Children with Autism Spectrum Disorder. Healthcare. MDPI. 2022;10(10):1829.
Fattorusso A, Di Genova L, Dell’Isola GB, Mencaroni E, Esposito S. Autism spectrum disorders and the gut microbiota. Nutrients. 2019;11(3):521.
Xu Y, Thomas M, Bhardwaj HL. Chemical composition, functional properties and microstructural characteristics of three kabuli chickpea (C icer arietinum L.) as affected by different cooking methods. Int J Food Sci Technol. 2014;49(4):1215-1223.
Hall C, Hillen C, Garden Robinson J. Composition, nutritional value, and health benefits of pulses. Cereal Chem. 2017;94(1):11-31.
Gupta M, Bansal V. Development of gluten free snacks using chickpea flour and flax seeds for celiac patients. J Emerg Technol Innov Res. 2021; 8:223-238.
Gonzales IC, Gonzales FR, Quindara HL, Belino PL, Botangen ET. Chickpea (Garbanzos) Its Nutritional and Economical Value. IOSR J Econ Financ. 2016;7(4):01-06.
Surel O, Couplet B. Influence of the dehydration process on active compounds of okara during its fractionation. J Sci Food Agric. 2005;85(8):1343-1349.
Guimarães RM, Silva TE, Lemes AC, et al. Okara: A soybean by-product as an alternative to enrich vegetable paste. Lwt. 2018; 92:593-599.
Shewry PR, Tatham AS. Improving wheat to remove coeliac epitopes but retain functionality. J Cereal Sci. 2016; 67:12-21.
Sánchez D, Tučková L, Burkhard M, et al. Specificity analysis of anti-gliadin mouse monoclonal antibodies used for detection of gliadin in food for gluten-free diet. J Agric Food Chem. 2007;55(7):2627-2632.
Kakaei M, Rehman FU, Fazeli F. The effect of chickpeas metabolites on human diseases and the application of their valuable nutritional compounds suitable for human consumption. Cell Mol Biomed Rep. 2024;4(1):30-42.
Grasso N, Lynch NL, Arendt EK, O'Mahony JA. Chickpea protein ingredients: A review of composition, functionality, and applications. Compr Rev Food Sci Food Saf. 2022;21(1):435-452.
Colletti A, Attrovio A, Boffa L, Mantegna S, Cravotto G. Valorisation of by-products from soybean (Glycine max (L.) Merr.) processing. Molecules. 2020;25(9):2129.
Indika NLR, Frye RE, Rossignol DA, Owens SC, Senarathne UD, Grabrucker AM, et al. The Rationale for Vitamin, Mineral, and Cofactor Treatment in the Precision Medical Care of Autism Spectrum Disorder. J Personal Med. 2023;13(2):252.
Meguid NA, Hashish AF, Anwar M, Sidhom G. Reduced serum levels of 25-hydroxy and 1, 25-dihydroxy vitamin D in Egyptian children with autism. J Altern Complement Med. 2010;16(6):641-645.
Böckerman P, Bryson A, Viinikainen J, Viikari J, Lehtimäki T, Vuori E, et al. The serum copper/zinc ratio in childhood and educational attainment: a population-based study. J Public Health. 2016;38(4):696-703.
Ding M, Shi S, Qie S, Li J, Xi X. Association between heavy metals exposure (cadmium, lead, arsenic, mercury) and child autistic disorder: A systematic review and meta-analysis. Front Pediatr. 2023;11.
Wallace TC, Murray R, Zelman KM. The nutritional value and health benefits of chickpeas and hummus. Nutrients. 2016;8(12):766.
Adams JB, Audhya T, Geis E, Gehn E, Fimbres V, Pollard EL, et al. Comprehensive nutritional and dietary intervention for autism spectrum disorder—a randomized, controlled 12-month trial. Nutrients. 2018;10(3):369.
Adams JB, Audhya T, McDonough-Means S, Rubin RA, Quig D, Geis E, et al. Nutritional and metabolic status of children with autism vs. neurotypical children, and the association with autism severity. Nutr Metab. 2011; 8:1-32.
Hamlin JC, Pauly M, Melnyk S, Pavliv O, Starrett W, Crook TA, et al. Dietary intake and plasma levels of choline and betaine in children with autism spectrum disorders. Autism Res Treat. 2013.
Xie N, Zhang L, Gao W, Huang C, Huber PE, Zhou X, et al. NAD+ metabolism: pathophysiologic mechanisms and therapeutic potential. Signal Transduct Target Ther. 2020;5(1):227.
Ristori MV, Quagliariello A, Reddel S, Ianiro G, Vicari S, Gasbarrini A, Putignani L. Autism, gastrointestinal symptoms and modulation of gut microbiota by nutritional interventions. Nutrients. 2019;11(11):2812.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
