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Meal patterns in children and adolescents with autism spectrum disorder.

Nutrition (Burbank, Los Angeles County, Calif.)2026

Hoffmann Laura Vargas, Silva Eduarda, Roman Laura, Castro Kamila, Vilela Ana Amélia Freitas, Valle Sandra Costa, Vaz Juliana S

What this study means for families

Researchers studied eating patterns in 361 children and teens with autism. They found meals typically included traditional foods like bread and rice, plus processed foods like biscuits and chips. Children weren't eating fruits at any meals, and vegetables only appeared at lunch and dinner. Afternoon snacks provided the most calories of any meal. Family background, child's weight, and certain medications affected eating patterns.

Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.

Research summary

This cross-sectional study examined meal patterns in 361 children and adolescents with autism spectrum disorder (ASD) aged 2-19 years using 24-hour dietary recalls. Principal component analysis identified distinct eating patterns across meals, characterized by traditional Brazilian foods (coffee, bread, rice, beans, meat) and ultra-processed foods (spreads, biscuits, sweets, chips, beverages). Notably, fruits were absent from all meal patterns, while vegetables appeared only in lunch and dinner. Afternoon snacks contributed the highest proportion of daily energy intake (30.3%) with highest energy density.

Sociodemographic factors, anthropometric status, and antipsychotic medication use were associated with pattern adherence, highlighting the complex factors influencing dietary behaviors in this population.

Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.

Key findings

  • 1

    Afternoon snacks contributed 30.3% of daily energy intake with highest energy density (1.6 kcal/g)

    Confidence: moderateRelevance: High energy density snacking may contribute to nutritional imbalances and weight management challenges
  • 2

    Fruits were completely absent from all identified meal patterns

    Confidence: moderateRelevance: Indicates significant nutritional deficiency requiring targeted dietary intervention
  • 3

    Meal patterns included both traditional Brazilian foods and ultra-processed foods across all meals

    Confidence: moderateRelevance: Suggests need for balanced approach in dietary recommendations respecting cultural preferences

Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.

Clinical implications

Findings suggest need for culturally-sensitive nutritional interventions addressing fruit intake deficiency and high-energy snacking patterns. Clinicians should consider sociodemographic factors and medication effects when developing dietary recommendations for autistic children and adolescents.

Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.

Limitations

Cross-sectional design prevents causal inferences. Brazilian population may limit generalizability to other cultural contexts. The abstract doesn't specify methodology details or potential confounding factors. Sample characteristics beyond age and diagnosis are not fully described.

Summary by AutismInsights from published abstract. This is not a substitute for reading the original paper.

Original abstract

Eating difficulties associated with autism spectrum disorder (ASD) influence food choices and mealtime routines, making it essential to investigate meal characteristics in this population. This study aimed to identify and examine factors associated with the meal patterns of children and adolescents with ASD. A total of 361 patients diagnosed with ASD, aged 2 to under 19 years, were included. Dietary intake was assessed using three non-consecutive 24-hour recalls.

Food items were grouped based on nutritional similarity. Principal component analyses were conducted for each meal (breakfast, lunch, afternoon snack, and dinner), with food group intake (g/d) as the input variable. Crude and adjusted regression models were used to evaluate the association of selected variables with meal patterns. Two patterns were identified for breakfast, while three were identified for lunch, afternoon snack, and dinner.

Traditional Brazilian foods, including coffee, bread, rice, beans, and meat; and ultra-processed foods, such as fat spreads, biscuits, sweets, chips, beverages, and processed meat, were observed across meals. Fruits were absent from all patterns, while vegetables were identified in lunch and dinner patterns. The afternoon snack had the highest energy intake (30.3% of daily energy) and energy density (1.6 kcal/g) compared to the other meals. Sociodemographic variables, anthropometric status, and antipsychotic use were associated with adherence to most patterns.

Meal patterns included traditional Brazilian foods and ultra-processed items. Given the influence of meal composition on health, these findings may support the development of nutritional interventions for this population.

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Evidence Grade

Emerging

limited

Grade assigned by AutismInsights based on study type and published abstract.

Study Details

Journal
Nutrition (Burbank, Los Angeles County, Calif.)
Year
2026
PMID
40972240
DOI
10.1016/j.nut.2025.112932

MeSH Terms

HumansChildAdolescentAutism Spectrum DisorderMaleFemaleMealsFeeding BehaviorChild, PreschoolDietEnergy IntakeBrazilSnacks