RESUMEN
The objective of this chapter is to evaluate the latest research pertinent to nutritional management in the treatment of autism spectrum disorder (ASD) and discuss the effectiveness of dietary interventions, nutritional approaches, and supplementation in ASD. To date, the best conventional treatments for autism have been based on a combination of pharmacotherapy, behavioral treatments, and nutritional/dietary therapy, leading many parents and caregivers to opt for specific dietary interventions in the hope of alleviating the symptoms of their children and helping them cope with this disorder. Thus, the role of a registered dietitian and a nutrition specialist is crucial in planning specific nutritional and dietary interventions tailored to individual needs, to make sure the child's nutritional needs for growth and development are being met. In addition, a careful monitoring of the nutritional status and the positive or negative outcomes pertinent to the planned intervention is a must. Furthermore, numerous studies have also discussed how the maternal diet and specific dietary supplements might affect the behavioral development of children in the first few years of life. A review of the abovementioned nutrition-related key points is discussed in this chapter.
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Trastorno del Espectro Autista/dietoterapia , Dieta , Apoyo Nutricional , Suplementos Dietéticos , Humanos , Estado NutricionalRESUMEN
BACKGROUND AND OBJECTIVES: Protein-energy and micronutrient malnutrition are global public health problems which, when not prevented and severe, require medical management by clinicians with nutrition expertise, preferably as a collectively skilled team, especially when disease-related. This study aimed to investigate barriers and facilitators of clinical nutrition services (CNS), especially the use of oral, enteral (EN) and parenteral (PN) nutrition in institutional and home settings. METHODS AND STUDY DESIGN: An international survey was performed between January and December 2014 in twenty-six countries from all continents. Electronic questionnaires were distributed to 28 representatives of clinical nutrition (PEN) societies, 27 of whom responded. The questionnaire comprised questions regarding a country's economy, reimbursement for CNS, education about and the use of EN and PN. RESULTS: The prevalence of malnutrition was not related to gross domestic product (GDP) at purchasing power parity (PPP) per capita (p=0.186). EN and PN were used in all countries surveyed (100%), but to different extents. Reimbursement of neither EN nor PN use depended on GDP, but was associated with increased use of EN and PN in hospitals (p=0.035), although not evident for home or chronic care facilities. The size of GDP did not affect the use of EN (p=0.256), but it mattered for PN (p=0.019). CONCLUSIONS: A worldwide survey by nutrition support societies did not find a link between national economic performance and the implementation of medical nutrition services. Reimbursement for CNS, available through health insurance systems, is a factor in effective nutrition management.