Autism spectrum disorder and food neophobia: clinical and subclinical links

Background: Autism spectrum disorder (ASD) has been linked with eating- and feeding-related atypicalities, including food neophobia (FN) (refusal to try unfamiliar foods), since its earliest description. Nevertheless, whether associations between ASD traits and FN extend subclinically into the broader population of children and their potential additive health impacts remains unexplored. Objective: We examined ASD-control group differences in FN and ASD trait-FN trait associations, as well as the ability of FN and autistic traits to predict one index of later health-related outcomes [body mass index (BMI)]. Design: Participants in the present study were a large community-based sample of 8- to 11-y-olds (n = 4564), including a relatively small group of children diagnosed with ASD (n = 37). Parents of these 8- to 11-y-old children completed assessments of FN and autistic traits and provided height and weight metrics at 12 y of age. Results: Children with ASD were rated as more food neophobic than their same-age non-ASD peers (2.67 +/- 0.83 compared with 2.22 +/- 0.73; P < 0.001), and there were subclinical associations between FN and ASD traits (social, communication, and restricted/repetitive behavior) in this community-based sample of children (P < 0.05). Moreover, whereas FN alone predicted lower BMI, the interaction of FN and ASD traits predicted higher BMI (P <= 0.01), suggesting that elevated ASD traits in combination with FN exert opposing influences on weight compared with FN alone. Conclusions: These findings implicate clinical and subclinical connections between ASD traits and feeding behaviors that could affect health outcomes and therefore should be further explored in future studies of shared etiology and intervention strategy.