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Pediatrics. 2019 Nov;144(5). pii: e20183218. doi: 10.1542/peds.2018-3218. Epub 2019 Oct 4.

Dietary Interventions for Autism Spectrum Disorder: A Meta-analysis.

Author information

1
Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón and School of Medicine, Universidad Complutense de Madrid, Madrid, Spain; david.fraguas@iisgm.com.
2
Centro de Investigaciòn Biomédica en Red Salud Mental, Madrid, Spain.
3
Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón and School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
4
Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.
5
Unit of Diagnosis and Treatment of Congenital Metabolic Diseases, Hospital Clínico Universitario de Santiago de Compostela, Health Research Institute of Santiago de Compostela, Santiago, Spain; and.
6
Department of Psychiatry, University of California, San Francisco, San Francisco, California.

Abstract

CONTEXT:

Dietary interventions such as restrictive diets or supplements are common treatments for young people with autism spectrum disorder (ASD). Evidence for the efficacy of these interventions is still controversial.

OBJECTIVE:

To assess the efficacy of specific dietary interventions on symptoms, functions, and clinical domains in subjects with ASD by using a meta-analytic approach.

DATA SOURCES:

Ovid Medline, PsycINFO, Embase databases.

STUDY SELECTION:

We selected placebo-controlled, double-blind, randomized clinical trials assessing the efficacy of dietary interventions in ASD published from database inception through September 2017.

DATA EXTRACTION:

Outcome variables were subsumed under 4 clinical domains and 17 symptoms and/or functions groups. Hedges' adjusted g values were used as estimates of the effect size of each dietary intervention relative to placebo.

RESULTS:

In this meta-analysis, we examined 27 double-blind, randomized clinical trials, including 1028 patients with ASD: 542 in the intervention arms and 486 in the placebo arms. Participant-weighted average age was 7.1 years. Participant-weighted average intervention duration was 10.6 weeks. Dietary supplementation (including omega-3, vitamin supplementation, and/or other supplementation), omega-3 supplementation, and vitamin supplementation were more efficacious than the placebo at improving several symptoms, functions, and clinical domains. Effect sizes were small (mean Hedges' g for significant analyses was 0.31), with low statistical heterogeneity and low risk of publication bias.

LIMITATIONS:

Methodologic heterogeneity among the studies in terms of the intervention, clinical measures and outcomes, and sample characteristics.

CONCLUSIONS:

This meta-analysis does not support nonspecific dietary interventions as treatment of ASD but suggests a potential role for some specific dietary interventions in the management of some symptoms, functions, and clinical domains in patients with ASD.

PMID:
31586029
DOI:
10.1542/peds.2018-3218

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Dr Fraguas has been a consultant and/or has received fees from Angelini, Eisai, IE4 Lab, Janssen, Lundbeck, and Otsuka. He has also received grant support from Instituto de Salud Carlos III (Spanish Ministry of Science, Innovation, and Universities) and from Fundación Alicia Koplowitz. Drs Díaz-Caneja and Pina-Camacho have received grants from Instituto de Salud Carlos III (Spanish Ministry of Science, Innovation, and Universities) and from Fundación Alicia Koplowitz. Dr Moreno reports grants from European Union Funds, Instituto de Salud Carlos III (Spanish Ministry of Science, Innovation, and Universities), and consultancy for Janssen, Servier Laboratories, Lundbeck, Nuvelution, and Otsuka unrelated to the submitted work. Drs Durán-Cutilla and Ayora hold a Río-Hortega grant from Instituto de Salud Carlos III (Spanish Ministry of Science, Innovation, and Universities). Dr de Matteis has been a consultant and/or has received fees from Servier, Qualigen, Otsuka, Lunbeck, Janssen, and Fundación Patología Dual. Mr Hendren has received research grants from Curemark, Roche, Sunovion, and Shire in the past year and is a consultant for Curemerk, BioMarin, Janssen, and Axial Therapeutics. Dr Arango has been a consultant to or has received honoraria or grants from Acadia, Abbot, Ambrosetti, Amgen, AstraZeneca, Bristol-Myers Squibb, Sumitomo Dainippon Pharma, Forum, Gedeon Richter, Janssen-Cilag, Lundbeck, Merck, Otsuka, Pfizer, Roche, Servier, Shire, Schering-Plough, Sunovio, and Takeda. Dr Parellada has received educational honoraria from Otsuka, research grants from Fundación Alicia Koplowitz and Mutua Madrileña, and travel grants from Otsuka and Janssen. Dr González-Vioque has indicated he has no potential conflicts of interest to disclose.

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