Evidence map›Paper›PMID 41247394›Full record

ArticleJournal of autism and developmental disorders2025

The Mediating Role of Eating Behaviors Between Autistic Symptoms and Dietary Issues Among Chinese Children With Autism.

Yuqi Wu, Sandra S M Chan, Patrick W L Leung, Holly H L Lo, Stephy W S Ho, Flora Y M Mo, Carol S W Ho, Caroline K S Shea, Qi Su, Ting Fan Leung and 3 more

Abstract read
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In one paragraph

Article in Journal of autism and developmental disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Yuqi WuMicrobiota I-Center (MagIC), Hong Kong SAR, China.
Sandra S M ChanDepartment of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China.ORCID http://orcid.org/0000-0002-5916-139X
Patrick W L LeungDepartment of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China.ORCID http://orcid.org/0000-0002-0415-0124
Holly H L LoDepartment of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China.
Stephy W S HoThe D.H. Chen Foundation Hub of Advanced Technology for Child Health (HATCH), The Chinese University of Hong Kong, Hong Kong SAR, China.
Flora Y M MoDepartment of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, Hong Kong SAR, China.ORCID http://orcid.org/0009-0007-1004-6343
Carol S W HoDepartment of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, Hong Kong SAR, China.
Caroline K S SheaDepartment of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, Hong Kong SAR, China.ORCID http://orcid.org/0000-0002-1867-1924
Qi SuMicrobiota I-Center (MagIC), Hong Kong SAR, China.ORCID http://orcid.org/0000-0001-9100-387X
Ting Fan LeungThe D.H. Chen Foundation Hub of Advanced Technology for Child Health (HATCH), The Chinese University of Hong Kong, Hong Kong SAR, China.ORCID http://orcid.org/0000-0002-6469-1926
Francis K L ChanMicrobiota I-Center (MagIC), Hong Kong SAR, China.ORCID http://orcid.org/0000-0001-7388-2436
Siew Chien NgMicrobiota I-Center (MagIC), Hong Kong SAR, China.ORCID http://orcid.org/0000-0002-6850-4454
Oscar W H WongDepartment of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China. oscarwhwong@cuhk.edu.hk.ORCID http://orcid.org/0000-0002-0499-6082

Funding

InnoHK , the Government of Hong Kong, Special Administrative Region of the People's Republic of China InnoHK , the Government of Hong Kong, Special Administrative Region of the People's Republic of ChinaThe D.H. Chen Foundation The D.H. Chen FoundationThe Hong Kong PhD Fellowship Scheme PF22-77807
6 · The paper itself

Abstract

purposeEating and dietary challenges are common among children with autism, but their associations with clinical symptoms remain unclear. This study aims to describe dietary issues, including nutritional problems and overexposures to food additives in autistic children, and their associations with clinical symptoms.

methodsThis case-control study involved 836 children (469 with autism and 367 without autism; mean age = 8.3 years) profiled on autistic symptoms, eating behaviors, and dietary patterns with parent-reported questionnaires. Nutritional insufficiencies, dietary quality and food additives exposures were compared using regression models adjusted for age and sex. Multivariate logistics or linear regression models were used to identify clinical symptoms that predict dietary issues, with mediation analyses examining eating behaviors' roles.

resultsAutistic children had lower protein intake, more vitamin and mineral insufficiencies, higher exposure to food additives, and poorer diet quality. They consumed fewer fruits/vegetables and more animal-based fats, with 38.2% exceeding 125% of the Estimated Energy Requirement (vs. 22.9% controls), suggesting energy-dense, ultra-processed food preferences. Diminished food enjoyment and increased food fussiness mediated between low social motivation and nutritional insufficiencies, as well as poorer diet quality. Further, difficulties with food responsiveness and emotional eating patterns mediated between more restricted and repetitive behaviors and higher exposures to emulsifiers/thickeners.

conclusionAutistic children, especially those with severe core symptoms, are susceptible to multifaceted dietary issues such as preference for low-quality food and nutrient deficiencies. It is crucial to implement personalized treatment strategies that target their specific eating behaviors to effectively address dietary challenges.

Indexed as

AutismEating behaviorsFood additivesNutritional problemsPersonalized treatment

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.