Ferrara R, Iovino L, Ricci L, Avallone A, Latina R, Ricci P. Food selectivity and autism: A systematic review. World J Clin Pediatr 2025; 14(3): 101974 [DOI: 10.5409/wjcp.v14.i3.101974]
Corresponding Author of This Article
Rosaria Ferrara, PhD, Adjunct Professor, Department of Anatomy, Histological, Forensic and Orthopaedics Science, “Sapienza” University of Rome, Piazzale Aldo Moro 5, Rome 00185, Lazio, Italy. rosaria.ferrara@uniroma1.it
Research Domain of This Article
Psychology
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Rosaria Ferrara, Lidia Ricci, Department of Anatomy, Histological, Forensic and Orthopaedics Science, “Sapienza” University of Rome, Rome 00185, Lazio, Italy
Leonardo Iovino, Department of Economic and Legal Studies, Parthenope university of Naples, Naples 80133, Campania, Italy
Angiola Avallone, Organizzazione Italiana Studio E Monitoraggio Autismo, Rome 00162, Lazio, Italy
Roberto Latina, Department of Health Promotion Science, Mother and Child Care, Internal medicine and Medical specialities,University of Palermo, Palermo 90133, Sicilia, Italy
Pasquale Ricci, Department of Life Science, Health, Health Profession, "Link Campus" University of Rome, Rome 00165, Lazio, Italy
Author contributions: Ferrara R, Iovino L, Ricci L, Avallone A, Latina R, and Ricci P contributed to the manuscript; Ferrara R conceptualized the study and coordinated the research activities; Avallone A contributed to data analysis, literature review; Iovino L contributed to data collection, methodology section; Roberto L contributed to manuscript editing, proofreading reviewed and supervised the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rosaria Ferrara, PhD, Adjunct Professor, Department of Anatomy, Histological, Forensic and Orthopaedics Science, “Sapienza” University of Rome, Piazzale Aldo Moro 5, Rome 00185, Lazio, Italy. rosaria.ferrara@uniroma1.it
Received: October 3, 2024 Revised: February 15, 2025 Accepted: April 14, 2025 Published online: September 9, 2025 Processing time: 255 Days and 22.3 Hours
Abstract
BACKGROUND
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that manifests in the first years of life, with a complex pathogenesis influenced by biological, genetic and epigenetic factors. Many children with ASD display marked food selectivity, often restricting themselves to a narrow range of foods. The problems associated with feeding children with ASD can vary widely, from mild cases that pose no immediate health risks, to more severe situations with a risk of malnutrition or, conversely, overeating. This scoping review aims to provide an in-depth overview of the frequency, nature and factors related to food selectivity in children with autism.
AIM
To comprehensively review the literature on food selectivity in ASD.
METHODS
A systematic review of the literature was conducted using the PubMed, Web of Science and EBSCO databases, to identify articles published in English from 2014 until 2024. Studies on a sample diagnosed with ASD and food selectivity were included. The selected databases were chosen for their broad coverage of the scientific literature. These databases represent reliable sources of high-quality articles, ensuring a comprehensive and up-to-date search.
RESULTS
We evaluated 222 studies on food selectivity in autism, from which duplicates were removed and unrelated titles were filtered out. Finally, 9 articles were included in the review. Five articles provide a general overview of the phenomenon, analysing its nature and factors. Two studies delve into sensory sensitivity, in particular the impact of food textures, tastes and smells. Finally, two studies focus on problem behaviour during mealtimes.
CONCLUSION
Children with ASD have greater food selectivity than the neurotypical population. The diet should contain a greater variety of fruit, vegetables, yoghurt, while reducing the consumption of rice and pasta.
Core Tip: This scoping review explored food selectivity in autism spectrum disorder. Two main themes emerged: Eating behaviour (e.g., food refusal) during meals and sensory processing, in particular the smell, texture, taste, colour and temperature of food. Children with autism spectrum disorder have greater food selectivity than children with typical development and this makes them nutritionally vulnerable.
