Assessment of Dietary Intake of Zinc and its Association with the Immune Status and Gut Health in Children Diagnosed with Autism Spectrum Disorder (ASD) Aged 6-14 Years

Background: Autism Spectrum Disorder (ASD) is often accompanied by immune dysfunction, gastrointestinal disturbances, and selective eating behaviors, which can lead to micronutrient deficiencies, particularly zinc. Zinc is a vital trace element required for immune function, intestinal integrity, and neurodevelopment. Children with ASD are at a heightened risk for zinc deficiency due to restricted diets and poor dietary diversity. Methods: A cross-sectional observational study was conducted among 30 children aged 6–14 years diagnosed with ASD at a special education institute in Mumbai, India. Data collection involved structured dietary and health assessment tools, including a 24-hour dietary recall, semi-quantitative Food Frequency Questionnaire (FFQ), Immune Status Questionnaire (ISQ), and Gastrointestinal Health Assessment Questionnaire. Dietary intake was analyzed against the ICMR-NIN (2020, updated 2024) Recommended Dietary Allowances (RDA). Statistical analysis was performed using SPSS (version 21). Results: Zinc intake was found to be inadequate in 73.3% of participants and was significantly associated with lower intake of energy (p = 0.001), protein (p = 0.001), fats (p = 0.004), and carbohydrates (p = 0.044). Children with lower zinc intake exhibited a higher prevalence of immune-related symptoms (e.g., recurrent upper respiratory tract infections and diarrhea) and gastrointestinal complaints, although these differences were not statistically significant. Among dietary components, only the consumption of dals (lentils) showed a statistically significant association with better zinc intake (p = 0.05). No significant differences in anthropometric parameters were observed between the poor and adequate zinc intake groups. Conclusion: This study highlights a high prevalence of suboptimal zinc intake among children with ASD, likely driven by dietary selectivity and limited nutritional variety. Although statistical significance was not established for immune and gastrointestinal health outcomes, observed trends reinforce zinc's critical role in these functions. Early dietary interventions and targeted nutritional planning are essential to address zinc deficiency and support overall health in children with ASD