DIETARY HABITS AND NUTRITION STATUS OF CHILDREN 5-12 YEARS WITH AUTISM AT CITY PRIMARY SCHOOL NAIROBI COUNTY, KENYA

Abstract

The complex neurodevelopmental disease known as Autism Spectrum Disorder (ASD) is mostly linked to food refusal, a restricted food repertoire, and excessive single-meal intake in ASD children. Children with ASD are frequently described by their parents and caregivers as fussy, limited, troublesome eaters who also frequently have gastrointestinal issues which compromises their nutritional state. The current study aimed at determining the dietary habits and nutrition status of children with Autism aged 5-12 years at City Primary School in Nairobi County, Kenya. The specific objectives were; to assess the dietary habits, to assess the nutrition status and to determine the relationship between dietary habits and nutrition status of children with Autism aged 5-12 years attending City Primary School, Nairobi. A cross-sectional study was conducted at City Primary School among 44 ASD children with their caregivers/parents as respondents. Data was collected using a self-administered semi-structured questionnaire. A 24-hour recall was used to collect and assess data on food consumption, dietary diversity score and food variety score. The nutrition status was determined using BMI-for-age scores and Mid Upper Arm Circumference (MUAC), categorized according to the WHO cut-offs. Nutrient deficiency was collected through clinical signs and symptoms checklist. Statistical Package for Social Sciences ( SPSS) software version 26 was used in the entry and analysis of the data. Sociodemographic characteristics and dietary habits were analyzed descriptively using frequencies, percentages and means. Pearson’s chi-square and Spearman’s Correlation were used to determine the relationship between the age of the child, dietary habits, nutrition status and the strength of the relationships between the variables respectively. Out of the 44 children with Autism 33(75%) were male while 11(25%) were female, the mean age was 10.4. Among the food group’s fats and oils, grains, grain products, other starches and other vegetables were the most consumed daily (97.7%, 95.5% and 93.2 % respectively). The children had an adequate Dietary Diversity Score (DDS). Food variety scores showed that more than half had fair food variety scores 24(54.5%), 8(18.2%) good and 10(22.7%) very good. The majority of children showed disruptive behaviors during mealtimes (77.3%), 90.9% of the caregivers indicated that they prepared special meals for children with Autism. The mean height and weight were 140.8cm and 35.3 kg. According to BMI -for-Age Z-Scores, less than half (n=18, 40.9%) of the children were normal, 29.7% (n=13) were moderately malnourished, 22.7% (n=10) were overweight and 6.8% (n=3) were severely malnourished. There was no significant association between nutrition status and age in children with Autism, (1, n=44) =1.337, with a p-value of 0.720. However, there was a significant relationship between picky eating and nutrition status (3, n=44) =8.255 with a p-value of 0.041. IIn conclusion, picky eating behaviors significantly influence the dietary habits and nutritional status of children with autism, increasing the risk of malnutrition. Addressing these challenges requires specialized training for healthcare providers and teachers to manage feeding difficulties effectively. Additionally, further research with larger sample sizes is necessary to better understand the relationship between food preferences and nutritional status among children with Autism in Kenya and globally.