A new study in Nutrients reveals that up to 40% of children with autism spectrum disorder (ASD) in Singapore suffer from deficiencies in vitamin D and iron, underscoring the need for routine nutritional screening in this population.
Researchers conducted a retrospective analysis of 241 children with ASD, aged 1 to 10 years, treated at a tertiary developmental pediatric center in Singapore between 2018 and 2022. ASD diagnosis was confirmed using DSM-5 criteria or the Autism Diagnostic Observation Schedule (ADOS-2).
The study aimed to investigate nutrient deficiencies in this multi-ethnic cohort, as children with ASD are known for selective eating habits, though the nutritional consequences of these behaviors remain poorly understood.
The findings were striking. Among the 222 children tested for vitamin D, 36.5% were either insufficient (32%) or deficient (4.5%). Similarly, 37.7% of the 236 children tested had low iron levels, with 15.6% of 122 children with complete blood counts developing iron deficiency anemia.
Older age and non-Chinese ethnicity significantly increased the risk of vitamin D deficiency. For each additional month of age, the odds of low vitamin D rose by 4%, and children of Indian ethnicity faced nearly 21 times higher odds compared to Chinese children. Iron deficiency was not strongly associated with demographics or eating habits, though older children were more likely to develop iron deficiency anemia.
Surprisingly, picky eating—a hallmark behavior in many children with ASD—was not a reliable predictor of either vitamin D or iron deficiency, challenging the assumption that dietary selectivity alone signals nutritional risk.
The study highlights that vitamin D and iron deficiencies are alarmingly common among children with ASD in Singapore, affecting between 30% and 40% of those tested. Researchers suggest younger children may benefit from formula milk fortified with vitamins and iron, while older children and those of certain ethnic backgrounds remain at higher risk.
“These findings emphasize the importance of routine nutritional screening for all children with ASD, regardless of eating habits,” the authors wrote, noting that results should be interpreted cautiously due to sampling limitations.
The study provides valuable insights for clinicians, helping to identify high-risk subgroups and reinforcing the need for proactive nutritional monitoring in the ASD population.
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