Multicomponent Nutritional Support for Children with Autism Spectrum Disorder: An Exploratory Pilot Study in Vietnam

Background: Children with Autism Spectrum Disorder (ASD) frequently exhibit severe food selectivity and micronutrient deficiencies, impacting growth and nutritional status. Evidence on integrated nutritional interventions in resource-constrained settings remains limited. Objective: To assess the feasibility and preliminary pre–post changes associated with a 12-week multicomponent nutritional intervention among Vietnamese children with ASD. Methods: In this exploratory single-arm pilot study, 56 children with ASD (mean age 59.0 ± 22.3 months; 80.4% male) were recruited from five community centers in Nghe An Province, Vietnam. The intervention comprised caregiver nutrition education, individualized dietary counseling, and daily multi-micronutrient supplementation. Anthropometric indicators, biochemical markers, feeding behaviors, and dietary intake were assessed at baseline and after 12 weeks. Pre–post changes were evaluated using paired statistical tests, and multivariable linear regression examined factors associated with growth response. Results: The study achieved a 100% completion rate, with all 56 recruited participants finishing the 12-week intervention and all scheduled follow-up assessments. Among children < 60 months, mean Weight-for-Age Z-score (WAZ) increased from −0.66 to −0.28 and mean Height-for-Age Z-score (HAZ) from −1.18 to −0.97 (p < 0.001). For children older than 60 months, mean HAZ increased from −0.87 to −0.58 (p < 0.001) and Body Mass Index-for-Age Z-score (BAZ) from −0.20 to 0.06 (p = 0.006). Significant increases occurred in serum zinc (10.29 to 11.72 µmol/L; p = 0.001), ferritin (31.74 to 34.79 ng/mL; p = 0.001), and hemoglobin (122.73 to 124.77 g/L; p = 0.002), while albumin remained unchanged. Concurrent improvements were observed in feeding behaviors and nutrient-dense food intake. Regression analysis indicated that lower baseline anthropometric status was significantly associated with greater gains in WAZ and HAZ. Conclusions: This community-based multicomponent intervention was feasible and associated with short-term improvements in feeding behaviors, dietary intake, selected biomarkers, and growth measures in children with ASD, supporting further evaluation in randomized controlled trials.