Improving meal acceptance of subjects with autism spectrum disorder(AUT-MENU project): protocol for a bicentric intervention study .

Background: Individuals with autism spectrum disorder (ASD) often exhibit low dietary diversity due to food selectivity, leading to various forms of malnutrition, such as obesity or micronutrient deficiencies. Objective: The main objective of the AUT-MENU project is to improve meal acceptance among individuals with ASD. A secondary goal is to evaluate the effectiveness of a nutrition education course for parents of enrolled participants to reduce food selectivity. Methods: The study is a bicentric intervention conducted in 3 care centers (Pavia and Milan) and 1 secondary school (Rome), involving approximately 200 participants with ASD aged 3 to 35 years. The study consists of an observational phase (T0) and an intervention phase (T1). At T0, biographical data, clinical characteristics, and dietary patterns of participants are collected. Based on T0 findings and existing nutritional recommendations for individuals with ASD, targeted menus are developed and tested. At T1, the same assessment tools used at T0 will be applied to evaluate intervention effects. Additionally, a nutrition education course for caregivers will be implemented between T0 and T1, with a pre- and postcourse knowledge questionnaire to assess its effectiveness. Results: Due to different timelines depending on the centers and schools involved, participant enrollment and data collection will take place at different times between Pavia, Milan, and Rome. In September 2024, enrollment was held in the Pavia and Milan care centers for a total of 74 participants enrolled. In Rome, the enrollment phase has not yet started; activities are expected to be carried out similar to those in Pavia and Milan. Conclusions: The AUT-MENU study is expected to yield significant insights and improvements in meal acceptance among individuals with ASD, particularly through the introduction of targeted menus in collective catering settings both in care centers and schools.