Adolescents with autism spectrum disorder (ASD) are more likely to have limited food repertoire and may consume more energy-dense foods than their neurotypical counterparts. Nutrition interventions may improve diet quality of adolescents with ASD by decreasing ultra-processed food (UPF) intake and increasing minimally processed food (MPF) intake.
To assess whether UPF intake and diet quality in adolescents with ASD changed after an 8-week virtual nutrition education intervention.
Study Design, Setting, Participants
This is a secondary analysis of data collected from a pre-post intervention study with 22 adolescents with ASD aged 12-21 years. The intervention consisted of eight weekly sessions based on social cognitive theory.
The Block Kids Food Frequency Questionnaire was completed by each adolescent at pre-/post-intervention. Dietary data were coded based on NOVA food processing classifications to determine daily servings of UPF and MPF. The Healthy Eating Index-2015 (HEI-2015) was calculated to assess diet quality. Participants were categorized into high/low UPF/MPF based on pre-intervention medians. Descriptive statistics and paired t-tests were performed.
Those who had high UPF at baseline significantly decreased UPF from 14.0-7.7 servings/day (P = 0.002), but those who had low UPF increased UPF from 8.0-10.9 (P = 0.023). The low-UPF group improved HEI-defined refined grain intake (P = 0.029) at post-intervention. In the low-MPF group, MPF intake did not change after the intervention (5.1-6.8, P = 0.188), but HEI significantly increased (50.2-56.5, P = 0.025). MPF decreased in the high-MPF group (11.4-9.8, P = 0.034), due to decreased total fruit (P = 0.031) but not whole fruit consumption as defined by the HEI, indicating a decrease in fruit juice intake. There were no other differences in UPF or MPF intake and the HEI scores.
Further research is needed to investigate the relationships between food processing categories and diet quality. Future virtual nutrition interventions for this population may emphasize strategies to reduce energy-dense UPF and increase MPF.
University of South Florida College of Public Health