본문 바로가기
KERD
논문KCI 등재

자폐성 장애인의 영양 중재에 관한 국외 연구의 효과성 분석

Analysis of the Effectiveness of Foreign Studies on Nutritional Interventions for Individuals with Autism Spectrum Disorder

박미영|김정민
한국정서행동장애학회 (The Korean Society of Emotional and Behavioral Disorders)|2023.09|정서·행동장애연구 (JOURNAL OF EMOTIONAL & BEHAVIORAL DISORDERS)|제39권 제3호|pp. 21-45|DOI 10.33770/JEBD.39.3.2

0

조회

0

다운로드

2

인용

0

참고문헌

키워드

메타분석Effectiveness효과크기Meta-analysisAutism Spectrum Disorder자페성 장애영양Nutrition

초록

본 연구는 자폐 스펙트럼 장애(ASD)을 대상으로 한 영양 중재 프로그램이 ASD 주요 특성에 어떠한 영향을 미쳤는지 알아보기 위함이다. 직접적인 영양과 관련된 국외의 연구 16편은 PRISMA를 활용하여 수집되었으며 RevMan 5.3을 활용하여 전반적인 연구의 특성과 글루텐 제거 식이, 글루텐 및 카제인 첨가 식이, 보충제 및 그 외 식이조절을 활용한 사례들을 구분하여 효과 크기를 구하였다. 주요 분석 결과는 다음과 같다. 첫째, 글루텐 제거 식이 연구들에서 글루텐 자체만 제거한 식이에서는 유의적인 효과가 없었고 글루텐과 카제인을 모두 제거한 중재에서는 ASD 주요 특성에 효과가 있는 것으로 나타났으며, 글루텐 제거와 MCT 보충 식이에서는 차이가 없었다. 둘째, 글루텐 및 카제인 첨가 식이는 ASD 증상을 감소시키는 데 효과적이었으며, 마지막으로 보충제 및 식이조절 중재는 비타민 무기질 식이를 제외한 저탄수화물과 오메가-3 보충제에서는 ASD 증상에 영향을 미치지 못하는 것으로 나타났다. 또한 사례수의 한계로 인한 일반화의 어려움과 이상의 메타 연구를 통한 결과를 바탕으로 추후 연구 방향과 시사점을 제언하였다.

Abstract

This study aimed to determine whether a nutritional intervention program targeting autism spectrum disorder (ASD) is effective for ASD symptoms. Sixteen foreign studies directly related to nutrition were collected using PRISMA, and using RevMan 5.3, the characteristics of the overall experimental studies using gluten-free diet, gluten, and casein-added diet, supplements, and other dietary adjustments were classified, and the effects were analyzed. The primary analysis results are as follows. First, studies on gluten-free diets showed improvement in ASD symptoms in the diet with only gluten removed and the dietary intervention with both gluten and casein removed, but there was no difference between gluten-free and MCT diets. Second, gluten and casein-supplemented diets effectively reduced ASD symptoms, and finally, supplements and dietary interventions were found not to affect ASD symptoms in low-carbohydrate and omega-3 supplements, except vitamin-mineral diets. Based on the results of the above meta-study, the direction and implications of future research were suggested.

참고문헌 (53)

  1. "장애인 등록 현황" (2022)[URL]
  2. 윤민아, "경북지역 발달장애아동의 식행동과 영양섭취 실태조사", 석사, 영양교육, pp.2009
  3. Adams, J. B., "Effect of a vitamin", mineral supplement on children and adults with autism, 2011, pp.12(11), 111~
  4. Alsubaiei, S. R. M., "Independent and combined effects of probiotics and prebiotics as supplements or food-rich diets on a propionic-acid-induced rodent model of autism spectrum disorder", Metabolites, 13(1), pp.50~ (2022)
  5. Ashwood, P., "Intestinal lymphocyte populations in children with regressive autism : Evidence for extensive mucosal immune pathology", Journal of Clinical Immunology, 23(6), pp.504~517 (2003)
  6. Barón-Mendoza, I., "Relationship between the effect of polyunsaturated fatty acids(PUFAs)on brain plasticity and the improvement on cognition and behavior in individuals with autism spectrum disorder", Nutritional Neuroscience, 25(2), pp.387~410 (2022)
  7. Baspinar, B., "Gluten-Free Casein-Free Diet for Autism Spectrum Disorders : Can it be effective in solving behavioural and gastrointestinal problems", The Eurasian Journal of Medicine, 52(3), pp.292~297 (2020)
  8. Bough, K. J., "Mitochondrial biogenesis in the anticonvulsant mechanism of the ketogenic diet", Annals of Neurology, 60(2), pp.223~235 (2006)
  9. Buie, T., "Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: A consensus report", Pediatrics, 125(1), pp.S1~S18 (2010)
  10. Cermak, S. A., "Food selectivity and sensory sensitivity in children with autism spectrum disorders", American Dietetic Association, 110, pp.238~246 (2010)
  11. Cheng, N., "Metabolic dysfunction underlying autism spectrum disorder and potential treatment approaches", Frontiers in Molecular Neuroscience, 21(10), pp.34~ (2017)
  12. Cheng, Y. S., "Supplementation of omega 3 fatty acids may improve hyperactivity, lethargy, and stereotypy in children with autism spectrum disorders : A meta-analysis of randomized controlled trials", Neuropsychiatric Disease and Treatment, 4(13), pp.2531~2543 (2017)
  13. Cruchet, S., "Truths, myths and needs of special diets : Attention-Deficit", Hyperactivity Disorder, Autism, non-celiac gluten sensitivity, and vegetarianism, 2016, pp.68(1), 43~50
  14. Egan, A. M., "Obesity in young children with autism spectrum disorders : Prevalence and associated factors", Childhood Obesity, 9(2), pp.125~131 (2013)
  15. Elder, J. H., "The gluten-free, casein-free diet in autism : results of a preliminary double blind clinical trial", Journal of Autism and Developmental Disorders, 36(3), pp.413~420 (2006)
  16. Fraguas, D., "Dietary interventions for Autism Spectrum Disorder : A Meta-analysis", Pediatrics, 144(5), pp.e20183218~ (2019)
  17. Hamazaki, K., "Effect of omega-3 fatty acid-containing phospholipids on blood catecholamine concentrations in healthy volunteers : A randomized, placebo-controlled, double-blind trial", Nutrition, 21(6), pp.705~710 (2005)
  18. Hediger, M. L., "Reduced bone cortical thickness in boys with autism or autism spectrum disorder", Journal of Autism and Developmental Disorders, 38(5), pp.848~856 (2008)
  19. Hibbeln, J. R., "Essential fatty acids predict metabolites of serotonin and dopamine in cerebrospinal fluid among healthy control subjects, and early-and late-onset alcoholics", Biological Psychiatry, 44(4), pp.235~242 (1998)
  20. Horvath, A., "ω-3 Fatty acid supplementation does not affect autism spectrum disorder in children : A systematic review and meta-analysis", The Journal of Nutrition, 147(3), pp.367~376 (2017)
  21. Ioannidis, J. P., "Comparison of evidence of treatment effects in randomized and non-randomized studies", Journal of the American Medical Association, 286(7), pp.821~830 (2001)
  22. Jäger, A. K., "Flavonoids and the CNS", Molecules, 16(2), pp.1471~1485 (2011)
  23. Jennings, L., "Amino acids, B vitamins, and choline may independently and collaboratively influence the incidence and core symptoms of autism spectrum disorder", Nutrients, 14(14), pp.2896~ (2022)
  24. Kałużna-Czaplińska, J., "Tryptophan status in autism spectrum disorder and the influence of supplementation on its level", Metabolic Brain Disease, 32(5), pp.1585~1593 (2017)
  25. Karoly Horvath, K., "Autistic disorder and gastrointestinal disease", Current Opinion in Pediatrics, 14(5), pp.583~587 (2002)
  26. Kawicka, A., "How nutritional status, diet and dietary supplements can affect autism : A review", Roczniki Państwowego Zakładu Higieny, 64(1), pp.1~12 (2013)
  27. Keech, B., "Intranasal oxytocin, social cognition and neuro developmental disorders : A meta-analysis", Psychoneuroendocrinology, 87, pp.9~19 (2018)
  28. Knivsberg, A. M., "Autistic syndromes and diet : A follow-up study", Scandinavian Journal of Educational Research, 39, pp.223~236 (1995)
  29. Knivsberg, A. M., "A randomised, controlled study of dietary intervention in autistic syndromes", Nutritional Neuroscience, 5(4), pp.251~261 (2002)
  30. Lauritzen, L., "DHA effects in brain development and function", Nutrients, 8(1), pp.6~ (2016)
  31. Leader, G., "Feeding problems, gastrointestinal symptoms, challenging behavior and sensory issues in children and adolescents with autism spectrum disorder", Journal of Autism and Developmental Disorders, 50, pp.1401~1410 (2020)
  32. Matson, J. L., "The relationship of children’s feeding problems to core symptoms of autism and PDD-NOS", Research in Autism Spectrum Disorders, 3, pp.759~766 (2009)
  33. Mazahery, H., "Relationship between long chain n-3 polyunsaturated fatty acids and autism spectrum disorder : Systematic review and meta-analysis of case-control and randomized controlled trials", Nutrients, 9(2), pp.155~ (2017)
  34. Millward, C., "Gluten- and casein-free diets for autistic spectrum disorder", The Cochrane Database of Systematic Reviews, 16(2), pp.CD003498~ (2008)
  35. Moher D., "Preferred reporting items for systematic reviews and meta-analyses : The PRISMA statement", PLoS Med, 6, pp.e1000097~ (2009)
  36. Napoli, E., "Potential therapeutic use of the ketogenic diet in autism spectrum disorders", Frontiers in Pediatrics, 2, pp.69~ (2014)
  37. Qi, X., "Vitamin D status is primarily associated with core symptoms in children with autism spectrum disorder : A multicenter study in China", Psychiatry Research, 317, pp.114807~ (2022)
  38. Quan, L., "A systematic review and meta-analysis of the benefits of a gluten-free diet and", or casein-free diet for children with autism spectrum disorder, 2022, pp.80(5), 1237~1246
  39. Rhonda P., "Vitamin D hormone regulates serotonin synthesis. Part 1: Relevance for autism", Federation of American Societies for Experimental Biology Journal, 28(6), pp.2398~2413 (2014)
  40. Rossignol, D. A., "Mitochondrial dysfunction in autism spectrum disorders : A systematic review and meta-analysis", Molecular Psychiatry, 17(3), pp.290~314 (2012)
  41. Schreck, K. A., "A comparison of eating behaviors between children with and without autism", Journal of Autism and Developmental Disorders, 34(4), pp.433~438 (2004)
  42. Sharp, W. G., "Feeding problems and nutrient intake in children with autism spectrum disorders : A meta-analysis and comprehensive review of the literature", Journal of Autism and Developmental Disorders, 43(9), pp.2159~2173 (2013)
  43. Sonuga-Barke, E. J. S., "Nonpharmacological interventions for ADHD : Systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments", The American Journal of Psychiatry, 170(3), pp.275~289 (2013)
  44. Sørensen, H. T., "Beyond randomized controlled trials : A critical comparison of trials with nonrandomized studies", Hepatology, 44(5), pp.1075~1082 (2006)
  45. Suarez, M. A., "Longitudinal follow-up of factors associated with food selectivity in children with autism spectrum disorders", Autism, 18(8), pp.924~932 (2014)
  46. Tyler, C. V., "Chronic disease risks in young adults with autism spectrum disorder : Forewarned is forearmed", American Journal on Intellectual and Developmental Disabilities, 116(5), pp.371~380 (2011)
  47. Valente, F. X., "B vitamins related to homocysteine metabolism in adults celiac disease patients : A cross-sectional study", Nutrition Journal, 20(14), pp.110~ (2015)
  48. Weissman, J. R., "Mitochondria disease in autism spectrum disorder patients : A cohort analysis", PLoS One, 3(11), pp.1~6 (2008)
  49. Whiteley, P., "The ScanBrit randomised, controlled, single-blind study of a gluten-and casein-free dietary intervention for children with autism spectrum disorders", Nutritional Neuroscience, 13(2), pp.87~100 (2010)
  50. Whiteley, P., "Feeding patterns in autism", Autism, 4(2), pp.207~211 (2000)
  51. Wobido, K. A., "Non-specific effect of omega-3 fatty acid supplementation on autistic spectrum disorder : Systematic review and meta-analysis", Nutritional Neuroscience, 25(9), pp.1995~2007 (2022)
  52. Ye, X., "The synaptic and circuit functions of vitamin D in neurodevelopment disorders", Neuropsychiatric Disease and Treatment, 3(19), pp.1515~1530 (2023)
  53. Żarnowska, I., "Therapeutic use of carbohydrate-restricted diets in an autistic child : A case report of clinical and 18FDG PET findings", Metabolic Brain Disease, 33(4), pp.1187~1192 (2018)

관련 논문AI추천

자폐성장애 아동의 식행동 중재에 대한 문헌연구김나경, 김유리, 박지연, 안혜신, 이숙향, 정지훈한국특수아동학회 · 특수아동교육연구2021 · 제23권 제1호자폐스펙트럼 장애의 편식 치료에 대한 고찰: 행동적 기법을 중심으로김수연, 정경미한국행동분석학회 · 행동분석ㆍ지원연구2016 · 제3권 제1호자폐 스펙트럼 장애 아동의 섭식 특성과 섭식 치료 실태조사김지호, 유은영, 전주영, 채송은, 하예나대한신경계작업치료학회 · 재활치료과학2025 · 제14권 제1호Effects of Vitamin D Supplementation on Children with Autism Spectrum Disorder: A Systematic Review and Meta-analysisJian Yang, LaLa Mi, MeiYan Song, Min Zhang, Xiaodai Cui, XiaoLan Huang, YiRan Wu, ZhaoXu Lu대한정신약물학회 · Clinical Psychopharmacology and Neuroscience2023 · 제21권 제2호일반아동과 자폐성장애 아동의 식사생활 특성 비교 연구박미경, 정대영한국정서행동장애학회 · 정서·행동장애연구2009 · 제25권 제2호감각방어를 가진 자폐 범주성 장애 아동을 대상으로 한 감각식이가정프로그램이 감각조절과 사회적 능력에 미치는 영향: 사례보고허소영대한신경계작업치료학회 · 재활치료과학2015 · 제4권 제1호

이 간행물의 다른 논문 (14건)

국내 학교기반 ADHD 연구에 대한 분석이상훈pp. 1-20부모-자녀 상호작용 미술치료 프로그램이 부-자 상호작용과 아동의 문제행동에 미치는 효과이요나, 유고운pp. 47-73FGI를 통한 ‘아동복지시설 아동 치료⋅재활 지원사업’에 참여한 생활지도원의 경험: 사업의 평가 및 개선방안을 중심으로김은영, 하은혜pp. 75-98장애학생 학교적응 관련 연구동향분석: 2013년∼2022년 발행 국내 학술지 논문을 중심으로이윤정, 양영애pp. 99-119장애학생의 통합학급 내 수업방해행동에 대한 특수교사의 지원 및 대처 방식안예지, 변혜성, 안제춘, 이경원, 황지은pp. 121-143
원문 보기