Micronutrient status and dietary patterns among children with autism in Central Vietnam: A cross-sectional baseline survey to inform targeted intervention.

Children with autism spectrum disorder (ASD) in low- and middle-income countries may face multiple forms of malnutrition, but data to guide targeted nutrition interventions are limited. We conducted a cross-sectional baseline survey to inform a micronutrient-focused intervention in 48 children aged 2-9 years diagnosed with ASD, recruited from five intervention centers in Central Vietnam. Caregivers completed a 24-hour dietary recall and a one-month food frequency questionnaire. Anthropometric measurements were collected and converted to World Health Organization z-scores. Fasting blood samples were analyzed for hemoglobin, serum ferritin, and serum zinc concentrations. Non-parametric tests and bootstrap confidence intervals were used to compare preschool-aged children (<5 years) with those 5-9 years. Undernutrition was identified in 16.7% (underweight) and 20.8% (stunting), while 6.3% of participants were overweight or obese. Zinc deficiency affected 45.8% of children, low ferritin was found in 16.7%, and anemia in 10.4%. Two concurrent micronutrient deficiencies were present in 16.7%. The median energy intake met 84.6% of national recommendations. Dietary fiber intake was universally inadequate, and most children consumed less than the recommended levels of iodine (97.0%), zinc (64.6%), vitamin C (64.6%), and calcium (56.3%). Older children were significantly more likely to have inadequate calcium intake than younger ones (73.9% versus 40.0%). Dietary patterns were dominated by cereal-based foods, with infrequent intake of legumes, vegetables, dairy, and animal-source foods. These findings reveal a triple burden of undernutrition, micronutrient deficiencies, and emerging overnutrition among children with ASD. The results underscore the urgent need for early nutritional screening and dietary improvement strategies. These baseline data offer critical evidence for designing context-appropriate nutrition interventions in similar low-resource settings.