{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T18:13:53Z","timestamp":1778696033027,"version":"3.51.4"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015501","name":"Qu\u1ef9 \u0110\u1ed5i m\u1edbi s\u00e1ng t\u1ea1o Vingroup","doi-asserted-by":"publisher","award":["VINIF.2024.ThS.74"],"award-info":[{"award-number":["VINIF.2024.ThS.74"]}],"id":[{"id":"10.13039\/501100015501","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Children with autism spectrum disorder (ASD) in low- and middle-income countries may face multiple forms of malnutrition, but data to guide targeted nutrition interventions are limited. We conducted a cross-sectional baseline survey to inform a micronutrient-focused intervention in 48 children aged 2\u20139 years diagnosed with ASD, recruited from five intervention centers in Central Vietnam. Caregivers completed a 24-hour dietary recall and a one-month food frequency questionnaire. Anthropometric measurements were collected and converted to World Health Organization z-scores. Fasting blood samples were analyzed for hemoglobin, serum ferritin, and serum zinc concentrations. Non-parametric tests and bootstrap confidence intervals were used to compare preschool-aged children (&lt;5 years) with those 5\u20139 years. Undernutrition was identified in 16.7% (underweight) and 20.8% (stunting), while 6.3% of participants were overweight or obese. Zinc deficiency affected 45.8% of children, low ferritin was found in 16.7%, and anemia in 10.4%. Two concurrent micronutrient deficiencies were present in 16.7%. The median energy intake met 84.6% of national recommendations. Dietary fiber intake was universally inadequate, and most children consumed less than the recommended levels of iodine (97.0%), zinc (64.6%), vitamin C (64.6%), and calcium (56.3%). Older children were significantly more likely to have inadequate calcium intake than younger ones (73.9% versus 40.0%). Dietary patterns were dominated by cereal-based foods, with infrequent intake of legumes, vegetables, dairy, and animal-source foods. These findings reveal a triple burden of undernutrition, micronutrient deficiencies, and emerging overnutrition among children with ASD. The results underscore the urgent need for early nutritional screening and dietary improvement strategies. These baseline data offer critical evidence for designing context-appropriate nutrition interventions in similar low-resource settings.<\/jats:p>","DOI":"10.1371\/journal.pgph.0006385","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T17:23:36Z","timestamp":1778693016000},"page":"e0006385","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Micronutrient status and dietary patterns among children with autism in Central Vietnam: A cross-sectional baseline survey to inform targeted intervention"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3128-4478","authenticated-orcid":true,"given":"Huyen Thu","family":"Doan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ngoc Thi Dieu","family":"Phan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2934-2688","authenticated-orcid":true,"given":"Hoa Thi","family":"Ho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lieu Thi Thu","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khanh Nam","family":"Do","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oanh Thi Phuong","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ngoc Bao","family":"Trinh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"pgph.0006385.ref001","doi-asserted-by":"crossref","DOI":"10.15585\/mmwr.ss7202a1","article-title":"Prevalence and characteristics of autism spectrum disorder among children aged 8 years \u2014 autism and developmental disabilities monitoring network, 11 sites, United States, 2020","volume":"72","author":"MJ Maenner","year":"2023","journal-title":"MMWR Surveill Summ"},{"key":"pgph.0006385.ref002","unstructured":"Institute for Health Metrics and Evaluation (IHME). GBD Compare [Internet]. Seattle: IHME, University of Washington. [cited 2025 Jun 16]. Available from: http:\/\/vizhub.healthdata.org\/gbd-compare"},{"key":"pgph.0006385.ref003","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s13033-019-0285-8","article-title":"Prevalence of autism spectrum disorders and their relation to selected socio-demographic factors among children aged 18\u201330 months in northern Vietnam, 2017","volume":"13","author":"VM Hoang","year":"2019","journal-title":"Int J Ment Health Syst"},{"issue":"9","key":"pgph.0006385.ref004","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1007\/s10803-013-1771-5","article-title":"Feeding problems and nutrient intake in children with autism spectrum disorders: a meta-analysis and comprehensive review of the literature","volume":"43","author":"WG Sharp","year":"2013","journal-title":"J Autism Dev Disord"},{"issue":"1","key":"pgph.0006385.ref005","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/1743-7075-8-34","article-title":"Nutritional and metabolic status of children with autism vs. neurotypical children, and the association with autism severity","volume":"8","author":"JB Adams","year":"2011","journal-title":"Nutr Metab (Lond)"},{"key":"pgph.0006385.ref006","article-title":"Nutrient intake from food in children with autism","author":"SL Hyman","year":"2012","journal-title":"Pediatrics"},{"issue":"1","key":"pgph.0006385.ref007","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s10803-014-2205-8","article-title":"Nutritional status of children with autism spectrum disorders (ASDs): a case-control study","volume":"45","author":"S Mar\u00ed-Bauset","year":"2015","journal-title":"J Autism Dev Disord"},{"issue":"2","key":"pgph.0006385.ref008","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.jada.2009.10.032","article-title":"Food selectivity and sensory sensitivity in children with autism spectrum disorders","volume":"110","author":"SA Cermak","year":"2010","journal-title":"J Am Diet Assoc"},{"key":"pgph.0006385.ref009","unstructured":"World Health Organization. From awareness to action: How global health is embracing the growing challenge of autism. [cited 2025 Jun 15]. Available from: https:\/\/www.who.int\/southeastasia\/news\/feature-stories\/detail\/from-awareness-to-action--how-global-health-is-embracing-the-growing-challenge-of-autism"},{"issue":"1","key":"pgph.0006385.ref010","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1177\/02601060231152278","article-title":"Nutritional status and eating behavior of children with autism spectrum disorders in Vietnam: a case-control study","volume":"31","author":"NB Trinh","year":"2025","journal-title":"Nutr Health"},{"key":"pgph.0006385.ref011","unstructured":"National Statistics Office. Statistical Yearbook of Viet Nam 2024. Living Standards, Health, Culture, Sport, Social Order and Safety, and Environment in 2024. Hanoi: Statistical Publishing House; 2024. pp. 976\u20138. Available from: https:\/\/www.nso.gov.vn\/wp-content\/uploads\/2025\/06\/NGTK-Cuc-TK-2024_BQ.pdf"},{"issue":"9","key":"pgph.0006385.ref012","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1097\/NMD.0b013e3182a2168a","article-title":"Diagnostic and statistical manual of mental disorders, 5th edition, and clinical utility","volume":"201","author":"MB First","year":"2013","journal-title":"J Nerv Ment Dis"},{"key":"pgph.0006385.ref013","unstructured":"World Health Organization. Preterm and low birth weight [Internet]. [cited 2025 Jul 3]. Available from: https:\/\/www.who.int\/teams\/maternal-newborn-child-adolescent-health-and-ageing\/newborn-health\/preterm-and-low-birth-weight"},{"issue":"5","key":"pgph.0006385.ref014","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1097\/DBP.0b013e31821bd06a","article-title":"The prevalence of gastrointestinal problems in children across the United States with autism spectrum disorders from families with multiple affected members","volume":"32","author":"LW Wang","year":"2011","journal-title":"J Dev Behav Pediatr"},{"issue":"11","key":"pgph.0006385.ref015","doi-asserted-by":"crossref","DOI":"10.1111\/ijpo.12951","article-title":"Child ADHD and autistic traits, eating behaviours and weight: A population-based study","volume":"17","author":"HA Harris","year":"2022","journal-title":"Pediatr Obes"},{"key":"pgph.0006385.ref016","unstructured":"World Health Organization. Diarrhoeal disease. [cited 2025 Dec 15]. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/diarrhoeal-disease"},{"issue":"2","key":"pgph.0006385.ref017","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1093\/ajcn\/88.2.324","article-title":"The US department of agriculture automated multiple-pass method reduces bias in the collection of energy intakes","volume":"88","author":"AJ Moshfegh","year":"2008","journal-title":"Am J Clin Nutr"},{"key":"pgph.0006385.ref018","volume-title":"Conversion factors and food portion table","author":"National Institute of Nutrition (Vietnam)","year":"2017"},{"key":"pgph.0006385.ref019","volume-title":"Recommended dietary allowances for Vietnamese people","author":"National Institute of Nutrition (Vietnam), Ministry of Health","year":"2016"},{"issue":"19","key":"pgph.0006385.ref020","doi-asserted-by":"crossref","first-page":"3996","DOI":"10.3390\/nu14193996","article-title":"Development and validation of the Vietnamese Children\u2019s Short Dietary Questionnaire to Evaluate Food Groups Intakes and Dietary Practices among 9-11-Year-Olds Children in Urban Vietnam","volume":"14","author":"TMT Mai","year":"2022","journal-title":"Nutrients"},{"key":"pgph.0006385.ref021","volume-title":"Decision No. 2429\/Q\u0110-BYT dated 14 October 2017 on criteria for evaluating the quality level of medical laboratories","author":"Ministry of Health (Vietnam)","year":"2017"},{"key":"pgph.0006385.ref022","unstructured":"World Health Organization. Iron deficiency anaemia: assessment, prevention and control. A guide for programme managers [Internet]. Geneva: WHO; 2001 [cited 2025 Jul 3]. Available from: https:\/\/cdn.who.int\/media\/docs\/default-source\/2021-dha-docs\/ida_assessment_prevention_control.pdf?sfvrsn=fb8c459c_1"},{"key":"pgph.0006385.ref023","volume-title":"WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations [Internet]","author":"World Health Organization","year":"2020"},{"key":"pgph.0006385.ref024","unstructured":"International Zinc Nutrition Consultative Group (IZiNCG). IZiNCG Technical Documents [Internet]. [cited 2025 May 6]. Available from: https:\/\/www.izincg.org\/technical-documents"},{"issue":"3","key":"pgph.0006385.ref025","doi-asserted-by":"crossref","first-page":"279","DOI":"10.4300\/JGME-D-12-00156.1","article-title":"Using effect size-or why the P value is not enough","volume":"4","author":"GM Sullivan","year":"2012","journal-title":"J Grad Med Educ"},{"key":"pgph.0006385.ref026","unstructured":"National Institute of Nutrition. General Nutrition Survey 2019\u20132020: Key Findings. Hanoi (Vietnam): National Institute of Nutrition; 2021."},{"issue":"8","key":"pgph.0006385.ref027","doi-asserted-by":"crossref","DOI":"10.1016\/j.jneb.2025.05.088","article-title":"Ultra-processed food consumption and associated factors in toddlers with autism spectrum disorder","volume":"57","author":"F Ginampos","year":"2025","journal-title":"J Nutr Educ Behav"},{"key":"pgph.0006385.ref028","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.rasd.2014.08.012","article-title":"Anthropometric measurements and nutritional assessment in autism spectrum disorders: a systematic review","volume":"9","author":"S Mar\u00ed-Bauset","year":"2015","journal-title":"Res Autism Spectr Disord"},{"key":"pgph.0006385.ref029","article-title":"Feeding difficulties in Asian children with autism spectrum disorder","author":"YQ Kang","journal-title":"Pediatrics Neonatol"},{"issue":"5","key":"pgph.0006385.ref030","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1002\/erv.2920","article-title":"Sensory processing and eating behaviours in autism: a systematic review","volume":"30","author":"E Nimbley","year":"2022","journal-title":"Eur Eat Disord Rev"},{"key":"pgph.0006385.ref031","doi-asserted-by":"crossref","first-page":"153","DOI":"10.2147\/PHMT.S85717","article-title":"Gastrointestinal symptoms and autism spectrum disorder: links and risks - a possible new overlap syndrome","volume":"6","author":"J Wasilewska","year":"2015","journal-title":"Pediatric Health Med Ther"},{"key":"pgph.0006385.ref032","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.1093\/jn\/138.9.1664","article-title":"Zinc deficiency induces membrane barrier damage and increases neutrophil transmigration in Caco-2 cells","volume":"138","author":"A Finamore","year":"2008","journal-title":"J Nutr"},{"key":"pgph.0006385.ref033","doi-asserted-by":"crossref","DOI":"10.1111\/jhn.70099","article-title":"Nutritional status of children diagnosed with autism spectrum disorder: a systematic review and meta\u2010analysis","volume":"38","author":"A Alhrbi","year":"2025","journal-title":"J Hum Nutr Diet"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0006385","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T17:23:44Z","timestamp":1778693024000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0006385"}},"subtitle":[],"editor":[{"given":"Akim Tafadzwa","family":"Lukwa","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,5,13]]},"references-count":33,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,13]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0006385","relation":{},"ISSN":["2767-3375"],"issn-type":[{"value":"2767-3375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,13]]}}}