Maureen E. Geraghty

Brief Report: Further Evidence of Sensory Subtypes in Autism

Distinct sensory processing (SP) subtypes in autism have been reported previously. This study sought to replicate the previous findings in an independent sample of thirty children diagnosed with an Autism Spectrum Disorder. Model-based cluster analysis of parent-reported sensory functioning (measured using the Short Sensory Profile) confirmed the triad of sensory subtypes reported earlier. Subtypes were differentiated from each other based on degree of SP dysfunction, taste/smell sensitivity and vestibular/proprioceptive processing. Further elucidation of two of the subtypes was also achieved in this study. Children with a primary pattern of sensory-based inattention could be further described as sensory seekers or non-seekers. Children with a primary pattern of vestibular/proprioceptive dysfunction were also differentiated on movement and tactile sensitivity.

Nutritional Intake and Therapies in Autism A Spectrum of What We Know: Part 1

Autism is one of the fastest growing developmental disabilities in the United States. With every 1 in 100 children diagnosed with autism, this condition is more common than pediatric cancer, diabetes, and AIDS combined. Core deficits of autism limit functioning in social interaction, communication, and daily activity participation. Individuals with autism typically require significant levels of supervised care, special education resources, and health service throughout life. The nutritional status of children with autism is receiving increasing attention in the field. Nutrient deficiencies have been proposed as a causative factor in the manifestation of the disorder. Further, characteristic autism behaviors and autism-specific interventions may increase the risk of suboptimal nutrition. Part 1 of this paper provides a review as to what is currently known regarding the nutrient intake and/or nutritional status of children with autism, and the myriad factors—both medical/nutritional and behavioral/ contextu...

NUTRITIONAL INTERVENTIONS AND THERAPIES IN AUTISM A SPECTRUM OF WHAT WE KNOW: PART 2

Part 1 in this series (“Nutritional Intake and Therapies in Autism”) addressed the nutrient intake of children with autism and the myriad factors likely to affect dietary intake and nutritional sta...

Cultural Perceptions of Health and Diabetes among Native American Men

Diabetes continues to affect minority populations disproportionately, especially Native Americans. Identifying culturally-specific definitions of health and diabetes is critically important for relevant and effective diabetes prevention programs. Qualitative interviews were conducted with 20 Native American men from two tribal clinics. Verbatim transcripts were analyzed by means of grounded theory, to identify culturally-specific definitions of health and diabetes. The men defined health in terms of physical capabilities and presence of disease. Conversely, the men viewed diabetes as an inexorable downward course that slowly manifests itself through various complications and ultimately results in death. Men feared for their own diagnoses as well as the diagnosis of family or community members whom they considered to be at-risk. Additional information about the perceptions of health and diabetes in racial and ethnic minority populations will significantly contribute to the development of effective diabetes prevention programs.

Problem Eating Behaviors in Autism Spectrum Disorder Are Associated With Suboptimal Daily Nutrient Intake and Taste/Smell Sensitivity

Thirty children with autism spectrum disorder (ASD) aged 3 to 10 years participated in this study exploring associations between problem eating behaviors, daily nutrient intake, and sensory disturbance. Parents completed surveys regarding the usual eating behaviors of their children. Children exhibiting more severe autism-specific disruptive behaviors at mealtimes were most at risk for suboptimal intake of select nutrients such as biotin, vitamin K, iodine, linolenic omega-3 fatty acids, and choline, which play a role in metabolism and bone and brain health. Children exhibiting food refusal tended to have increased caloric and nutrient intake. Picky eaters were more likely to consume adequate daily nutrients but experienced the highest levels of parent-reported taste/smell sensitivity. The findings of this preliminary study support a multifactorial approach to the management of problem eating behaviors in ASD.

Prader-Willi Syndrome A Review for Pediatric Nutrition Professionals

Prader-Willi syndrome is a complex, multidimensional disease affecting approximately 1 in 8000 to 1 in 50 000 individuals. Although there is an abundance of data available regarding Prader-Willi syndrome, there are few sources of compiled, nutritionally pertinent information. Nutrition intervention is currently the only treatment for Prader-Willi syndrome, and therefore it is critical that nutrition professionals have an understanding of the disease. This review provides background information regarding Prader-Willi syndrome and the causes of obesity and hyperphagia, as well as outlines current nutritional recommendations and strategies for working with individuals with Prader-Willi syndrome. It is recommended that the diet of these children be strictly controlled and structure provided, yet it is important to allow for some flexibility to enhance quality of life. Behavioral issues also need to be considered as they render it a challenge for parents to impose restrictions on their children’s eating patterns.

Lack of significant changes in nutrition‐related parameters with tumor necrosis factor treatment of cancer

Cancer and its therapies frequently produce anorexia and cachexia. In this study, the acute (3 days) and chronic (4 wks) nutrition-related effects of cancer therapy with recombinant human tumor necrosis factor (rHuTNF) were investigated and described. Nutritional status, as measured by body weight and body composition (body fat and lean-to-fat ratio) with use of bioelectrical impedance, did not appear to deteriorate. None of the serum lipids changed significantly, but triglycerides did rise modestly over four weeks of therapy. Glucose and the peptide hormones (insulin, C-peptide, glucagon, and pancreatic polypeptide) thought to affect appetite did not change with rHuTNF therapy. Therefore, although TNF is thought to contribute to wasting in animal models, it had no negative effect on nutritional status in our small sample. The lack of adverse effect noted in this study is possibly due to the low dose level of rHuTNF or to adaptation.

Quantitative Ultrasonography of Calcaneal Bone Mass and Its Relationship to Calcium Consumption Among Impoverished Hispanic Women

Perimenopausal Hispanic women need to be able to build and sustain peak bone mass, but this may be affected by their low socioeconomic status. This feasibility research study provided descriptive information on the relationship between calcium consumption and bone mass measured with sonography at the calcaneus. Little research exists to examine bone health with this specific age or ethnic group of women. This research found a strong positive correlation between the amount of self-reported calcium food consumed and the bone stiffness index recorded using quantitative sonography. The translational impact of this project will inform the development of culturally relevant patient education for Hispanic women of low socioeconomic status to encourage the development of peak bone mass.

Mitochondrial Disease in the Pediatric Patient

Long referred to as the powerhouses of human cellular function, mitochondria are responsible for converting nutrients derived from food into adenosine triphosphate, the principal intracellular energy source on which normal eukaryotic cell function is entirely dependent. Although disease of the mitochondria is still considered to be relatively rare, diagnosis of the many mitochondrial respiratory chain disorders is on the rise, and it remains the most prevalent group of inherited neurometabolic diseases. Diagnosis is complicated by poor differentiation between signs and symptoms of other diseases, and the testing process is rigorous at best. Along with pharmaceutical intervention, nutrition is the primary means of support in these individuals, with a focus on adequate energy intake coupled with cofactor and vitamin supplementation. Unfortunately, as with all rare diseases, there is a distinct lack of adequate research to support one treatment over another. This article examines the current research regardi...

The Factors Associated with Dietary Supplement Use in College Students

Dietary supplement use has increased over the past decade in college students. Many have received formal health education concerning effects of alcohol consumption or drug use, but few have studied the efficacy and safety of dietary supplements. To assess the supplement intake patterns of college students at a major Midwestern university, an online survey was available for students in a business and allied medical professions survey course. An e-mail was sent from the instructors inviting students to participate, providing a study description, participation criteria, and an embedded link to the survey. Questions were modified from a previous survey to identify the proportion of students using dietary supplements, the specific supplements taken, indications, and side effects. Of the 335 students completing the survey, approximately 37.6% reported current or previous use of dietary supplements. The most common supplement types were dietary/herbal supplements without vitamins/minerals (33.8%); dietary/herbal supplement with vitamins/minerals (23.9%); vitamin supplements alone (21%); mineral supplements alone (3.2%); vitamin and mineral supplements combined (22.5%); and others that did not fit into any category (4.5%). The most frequently cited reasons for taking dietary supplements were to: increase energy; lose weight; ensure adequate nutritional status; prevent illness; and enhance athletic performance. Side effects reported included nausea, light-headedness and jitteriness and tachycardia. Family members were the most common source of information/recommendation regarding dietary supplements, with twice the influence than friends or health food stores. The prevalence of the use of dietary supplements warrants the availability of Student Health Center RD consultations as well as the development and strategic marketing of evidence-based dietary supplement curricular offerings.