Reduced Bone Cortical Thickness in Boys with Autism or Autism Spectrum Disorder

Division-of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892-7510, USA.
Journal of Autism and Developmental Disorders (Impact Factor: 3.34). 09/2007; 38(5):848-56. DOI: 10.1007/s10803-007-0453-6
Source: PubMed


Bone development, casein-free diet use, supplements, and medications were assessed for 75 boys with autism or autism spectrum disorder, ages 4-8 years. Second metacarpal bone cortical thickness (BCT), measured on hand-wrist radiographs, and % deviations in BCT from reference medians were derived. BCT increased with age, but % deviations evidenced a progressive fall-off (p = .02): +3.1 +/- 4.7%, -6.5 +/- 4.0%, -16.6 +/- 3.4%, -19.4 +/- 3.7%,-24.1 +/- 4.4%, at ages 4-8, respectively, adjusting for height. The 12% of the boys on casein-free diets had an overall % deviation of -18.9 +/- 3.7%, nearly twice that of boys on minimally restricted or unrestricted diets (-10.5 +/- 1.3%, p < .04), although even for boys on minimally restricted or unrestricted diets the % deviation was highly significant (p < .001). Our data suggest that the bone development of autistic boys should be monitored as part of routine care, especially if they are on casein-free diets.

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Available from: Mary L Hediger, Feb 23, 2015
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    • "Several groups have found that children with ASD present normal heights for their age and gender, and no significant differences have been found between them and controls (Lainhart et al., 2006; Emond et al., 2010; Sadowska & Cierebiej, 2011). Our findings are consistent with those reported by Hediger et al. (2008) in that they observed boys with ASD to be shorter in height. These authors also found increased weights and BMIs. "
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    ABSTRACT: We aimed to compare body mass index( BMI) and healthy eating index( HEI) in children with autism spectrum disorder( ASD, n = 105) and typically developing (TD, n = 495) children.They were aged 6–9years,lived in Valencia (Spain) and came from similar cultural and socio-economic backgrounds.In this case–control study,the weight,height and BMI were measured for both groups.Three-day food records were used to assess dietary intake.Although the differences between children with ASD and TD children in raw BMI (p = 0.44),BMI z-score (p = 0.37),HEI(p = 0.43)and total energy intake (p = 0.86) were not significant,children with ASD and the boys subgroup were shorter (p = 0.01),but not the girls subgroup,compared to TD children of the same gender.Using the controls values as a reference,the BMI distribution in children with ASD be came distorted,with values below the 5th percentile (11%vs.4%, p = 0.03) and above the 95th percentile (8%vs.5%, p = 0.04).The gender-and age-adjusted odds ratios for being underweight in the groups of all children and boys with ASD were 3.03 and 2.39,respectively,vs.TD children.Our data suggest that routine monitoring of children with ASD should include anthropometric measurements and assessment of their dietary habits
    Research in Autism Spectrum Disorders 10/2014; 9(2015)26–33. DOI:10.1016/j.rasd.2014.09.013 · 2.96 Impact Factor
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    • "[34] oraz Hedigera i wsp. [35], w których wskazano, że bez względu na fakt wdrożenia diety eliminacyjnej bądź jej braku, u dzieci z opisywanymi zaburzeniami obserwuje się niskie spożycie wapnia, witaminy D i niedobory żelaza, a w konsekwencji upośledzony rozwój kości i zaburzenia snu. W tym aspekcie, wdrożenie diety eliminacyjnej pod kontrolą wykwalifikowanego dietetyka odbędzie się z korzyścią dla pacjenta, chociażby z uwagi na wprowadzenie pełnowartościowych produktów w codziennym żywieniu. "
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    ABSTRACT: The incidence of autism spectrum disorders is steadily growing. The ultimate cause of the disease still has not been determined. However with a high probability it is known that the pathogenesis of characterized disorders is multifactorial. One of the aspects that could have a negative impact on the patient's behavior is abnormal distribution of gluten, casein, and probably another nutrients, which is the result of epithelium of the small intestine enzymes deficiency. On this basis, so called opioid theory assumes that enzymatic deficiency leads to the formation of exorphins – substances with opioid activity. With proven coexistence of increased intestinal permeability in ASD patients, improperly digested food particles may be transported to the central nervous system (cerebrospinal axis – intestinal), adversely affecting the child's behavior. Reports of opioids food potential effects on the child's behavior, as well as frequently reported gastrointestinal disorders in ASD patients are the cause of the elimination diet implementation by a large group of parents and carers of children with ASD. Meanwhile, there is still no objective, randomized clinical trials, indicating elimination diet real impact for the patient with ASD. Reports regarding the effectiveness of nutritional therapy are derived mainly from therapists and parents/carers of children with autism spectrum disorders. The potential benefits, which may result from the possible modification of diet, point to the urgent need for well-designed clinical studies in this field.
    Pediatria polska 07/2014; 89(4). DOI:10.1016/j.pepo.2014.01.007
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    • "It also requires a financial commitment because GFCF foods such as rice pasta, GF bakery mixes, vegan cheese, and almond milk typically cost more than twice as much as their regular counterparts (Stevens & Rashid, 2008). Also, families must take special care to balance the nutritional needs of their growing children while eliminating many food staples, risking reduced bone density (Hediger et al., 2008) and other nutritional concerns. Finally, being on a special diet can have unintended negative social consequences when children are not able to participate conventionally in birthday celebrations and class treats or eat in restaurants or other people's homes. "
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    ABSTRACT: The gluten-free, casein-free (GFCF) diet is widely used by families of children with autism spectrum disorders (ASD). Despite its popularity, there is limited evidence in support of the diet. The purpose of this article was to identify and evaluate well-controlled studies of the GFCF diet that have been implemented with children with ASD. A review of the literature from 1999 to 2012 identified five studies meeting inclusion criteria. Research rigor was examined using an evaluative rubric and ranged from Adequate to Strong. In three of the studies, no positive effects of the diet were reported on behavior or development, even after double-blind gluten and casein trials. Two studies found positive effects after 1 year but had research quality concerns. Reasons why families continue to expend effort on GFCF diets despite limited empirical evidence are discussed. Recommendations are that families should invest time and resources in more robustly supported interventions and limit GFCF diets to children diagnosed with celiac disease or food allergies.
    Journal of Early Intervention 10/2013; 35(1):3-19. DOI:10.1177/1053815113484807 · 0.78 Impact Factor
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