Evidence map›Paper›PMID 42157139›Full record

ReviewBMC pediatrics2026

Beyond the plate: nutritional gaps and health risks in selective eaters with ASD - a narrative review.

Ruzha Pancheva-Dimitrova, Rozalina Braykova, Albena Toneva, Fatme Ahmed, Violeta Iotova

Abstract readReview
In one paragraph

Review in BMC pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

5 authors.

Ruzha Pancheva-DimitrovaDepartment of Hygiene and Epidemiology, Faculty of Public Health, "Prof. Dr. Paraskev Stoyanov" Medical University, Varna, Bulgaria.
Rozalina BraykovaDepartment of Hygiene and Epidemiology, Faculty of Public Health, "Prof. Dr. Paraskev Stoyanov" Medical University, Varna, Bulgaria. rozalinabra@abv.bg.
Albena TonevaDepartment of Hygiene and Epidemiology, Faculty of Public Health, "Prof. Dr. Paraskev Stoyanov" Medical University, Varna, Bulgaria.
Fatme AhmedDepartment of Hygiene and Epidemiology, Faculty of Public Health, "Prof. Dr. Paraskev Stoyanov" Medical University, Varna, Bulgaria.
Violeta IotovaDepartment of Pediatrics, "Prof. Dr. Paraskev Stoyanov" Medical University, Varna, Bulgaria.

Funding

This study was funded by the European Union-NextGenerationEU, through the National Plan for Recovery and Resilience of the Republic of Bulgaria project No. BG-RRP-2.004-0009-C02.
6 · The paper itself

Abstract

backgroundFood selectivity (FS) is among the most frequent and challenging feeding difficulties in children with autism spectrum disorder (ASD). It is often driven by sensory processing differences and behavioral rigidity, leading to restricted diets, nutritional deficiencies, and psychosocial strain. This review synthesizes current evidence on the prevalence, mechanisms, and health consequences of FS in children with ASD.

methodsA comprehensive search was conducted in PubMed, Scopus, Web of Science, and Google Scholar. Eligible studies included children aged ≤ 18 years with ASD and assessed FS or related eating difficulties. After screening 503 abstracts, 24 studies were included. Data were extracted on prevalence, mechanisms, nutritional and health outcomes, and family impact.

resultsFS prevalence ranged from 21% to 77%, most often related to texture, taste, and color sensitivities. Sensory over-responsivity and behavioral rigidity were consistent predictors, while parental feeding practices and gastrointestinal symptoms were contributing factors. Reported consequences included deficiencies in vitamin D, calcium, and fiber, unbalanced macronutrient intake, and both undernutrition and overweight/obesity. Families reported increased stress, mealtime conflict, and limited coping strategies. Only one behavioral intervention demonstrated short-term improvement without long-term dietary diversification.

conclusionsFood selectivity in ASD is highly prevalent, primarily sensory-driven, and maintained by behavioral contingencies. It contributes to nutritional inadequacies, growth alterations, and family distress. Future research should focus on standardized assessments, longitudinal follow-up, and multidisciplinary interventions addressing both child and family contexts.

Indexed as

Autism Spectrum DisorderFeeding and Eating DisordersFeeding BehaviorFood PreferencesChildHumansAutism spectrum disorderFamily stressFood selectivityInterventionNutritionPicky eatingSensory processing

Identifiers

PMID42157139
PMCPMC13360861

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.