Food preference of children with autism spectrum disorder in Selangor and Kuala Lumpur / Nur Hidayah Bidin @ Ghazali

Nutrition is one of the important contributors to the well-being of children with disability. Given the various data on the nutritional status of autism spectrum disorder (ASD) children, it is imperative to conduct a detailed nutritional assessment of the local population. This study compares ASD with typical developing (TD) children to determine the weight status, association of mealtime behaviour with dietary intake, food preference, and weight status predictors. This cross-sectional study recruited 106 children (ASD, n = 55; TD, n = 51) aged five to nine years old. Sociodemographic were assessed through self-administered questionnaires, and the body mass index (BMI) was computed from collected weight and height. A three-day food record, Brief Autism Mealtime Behaviour Inventory (BAMBI), and food frequency questionnaire data were obtained from the caretakers. More than one-third (39%) of the ASD children were overweight or obese compared to TD children (23%). Meanwhile, the total energy intake was statistically significant (X2=9.53, p=0.008) when the higher proportion of children with ASD, specifically 58.5%, exhibited excessive energy intake in comparison to TD children (41.8%). The majority (88.2%) of ASD children experience problems in mealtime behaviour characteristically limited food acceptance with a mean score of (28.78±6.80). Mealtime behaviour was not associated with energy, carbohydrate, protein, and fat when the p>0.05. Food preferences were evaluated by the frequency taken in a period of day, week, and month. As rice is a typical food in Malaysia, a total of 43.1% of ASD children consumed more than four times daily, compared to TD children who mostly took two-three times daily (92.7%). While in protein sources, fried chicken was the most preferable in ASD groups, 13.7% of them took it more than four times daily, and 39.22% took it five-six times per week. The findings indicate that a significant proportion (88.2%) of children with ASD have never consumed lamb, in contrast with TD children (49.1%) who frequently consumed at least once per month. Furthermore, most of the ASD (70.59%) and TD (61.82%) groups never took sayur kacang and the most preferred fruits were apple (33.3%) and banana (61.8%) respectively. A minority of ASD children (7.84%) ate sugar every day, while a greater percentage of 29.41% took it once a week or 27.45% never did. In contrast to TD children, most consumed sugar more than four times per week accounting for 10.9% in total. None of the tested factors affected ASD children's weight. Even while mealtime behaviour did not affect dietary intake and no characteristics could predict weight status, excessive daily calories significantly affected BMI. Nutritional interventions would improve AS children's nutritional status because