David Fraguas1,2, Covadonga M Díaz-Caneja3,2, Laura Pina-Camacho3,2,4, Carmen Moreno3,2, Manuel Durán-Cutilla3, Miriam Ayora3, Emiliano González-Vioque2,5, Mario de Matteis3, Robert L Hendren6, Celso Arango3,2, Mara Parellada3,2. 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.
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.
Authors: Spyridon Siafis; Oğulcan Çıray; Hui Wu; Johannes Schneider-Thoma; Irene Bighelli; Marc Krause; Alessandro Rodolico; Anna Ceraso; Giacomo Deste; Maximilian Huhn; David Fraguas; Antonia San José Cáceres; Dimitris Mavridis; Tony Charman; Declan G Murphy; Mara Parellada; Celso Arango; Stefan Leucht Journal: Mol Autism Date: 2022-03-04 Impact factor: 7.509
Authors: Inge van der Wurff; Anke Oenema; Dennis de Ruijter; Claudia Vingerhoets; Thérèse van Amelsvoort; Bart Rutten; Sandra Mulkens; Sebastian Köhler; Annemie Schols; Renate de Groot Journal: Nutrients Date: 2022-03-26 Impact factor: 5.717
Authors: Spyridon Siafis; Oğulcan Çıray; Johannes Schneider-Thoma; Irene Bighelli; Marc Krause; Alessandro Rodolico; Anna Ceraso; Giacomo Deste; Maximilian Huhn; David Fraguas; Dimitris Mavridis; Tony Charman; Declan G Murphy; Mara Parellada; Celso Arango; Stefan Leucht Journal: Mol Autism Date: 2020-08-26 Impact factor: 7.509