Background/Objectives: Iron plays an important role in cognitive, behavioral, and motor development. This study aims to assess the iron nutritional status of Bulgarian children with cerebral palsy (CP) and autism spectrum disorder (ASD), focusing on iron deficiency (ID) and its impact on children’s development. We hypothesized that children with CP and ASD suffer from iron deficiency. Methods: The cross-sectional study includes 95 children from northeastern Bulgaria. Data were collected in two periods (2017–2018 and 2023–2024). Demographic questionnaires, food frequency questionnaires, and laboratory tests for hemoglobin, serum iron, serum ferritin, serum albumin, and CRP were conducted. Anthropometric measurements were evaluated. The Gross Motor Function Classification System scale was used to assess motor function in children with CP. Statistical analysis was performed using Jamovi software, ver. 2.6.44, with a significance level of p < 0.05. Results: Of the 95 children, 62.1% had CP and 37.9% had ASD. Most children had normal hemoglobin and serum iron levels, but 62.7% of those with CP and 36.8% of those with ASD had low serum ferritin levels, indicating latent ID. A higher proportion of children with CP than those with ASD consumed meat daily, while fish was more commonly consumed by children with ASD. Anthropometric data showed delayed growth and lower height-for-age scores in children with CP. Conclusions: The study identifies latent ID in children with CP and ASD. An evaluation of dietary habits highlights the need for interventions to improve nutritional status and development. The observed deficiencies emphasize the need for regular monitoring and targeted dietary programs for children in these groups.

Purpose: To investigate aspects of insulin resistance in children with autism. Material/Methods: In January 2024, the search was conducted using three bibliographic databases: PubMed, Scopus, Google Scholar, and Mendeley. The objective of the search was to find relevant sources on metabolic diseases Insulin resistance (IR) in Autism spectrum disorders (ASD) from 2016 to 2023. The search technique involved using the terms and keywords: "(IR OR Insulinopathie) AND (child OR toddler OR adolescent OR school age) AND (ASD OR Autism)." The two independent reviewers (RB and AT) systematically conducted the data extraction process. Results: There is no conclusive evidence that prenatal insulin resistance is a risk factor for the onset of autism. Poor eating habits, lack of physical activity, presence of other medical conditions, and use of medications can contribute to increased obesity rates in children with ASD, leading to potential health issues like diabetes, insulin problems, and heart disease. Some experts highlight the metabolic risks, specifically insulin resistance, associated with prescribing antipsychotic drugs to children with autism. Risperidone causes a notable increase in weight and serum triglyceride levels, even when used briefly. Teenagers with autism spectrum disorder demonstrate increased HOMA-IR levels, possibly indicating decreased glucose utilization in certain areas of the brain. Conclusion: Understanding how insulin resistance affects peripheral metabolism and the CNS could lead to extensive research to enhance the neuropsychological development of children with autism and have implications for public health.

Background/Objectives: Autism Spectrum Disorder (ASD) is characterized by social communication challenges and repetitive behaviors. Children with ASD often exhibit selective eating habits that may result in nutritional deficiencies and exacerbate developmental issues. While food frequency questionnaires (FFQs) are effective for dietary assessment, the links between food preferences, ASD severity, and developmental outcomes remain underexplored, particularly in Bulgaria. This study examines these relationships using validated tools. Methods: The present report constitutes a pilot, hypothesis-generating substudy of the broader NutriLect project. This substudy involved 49 children aged 2–12 years diagnosed with ASD. Dietary patterns were evaluated with a modified FFQ, while ASD severity and developmental profiles were assessed using the Childhood Autism Rating Scale, Second Edition (CARS-2) and the Developmental Profile 3 (DP-3). Results: Among 49 ASD children (mean age = 6.89 ± 2.15 years; 86% boys), 73.4% consumed grains/potatoes daily. Only 34.7% met combined fruit and vegetable recommendations. Only 36.7% met the recommendation for daily milk or other dairy product consumption. Fish was consumed at least twice weekly by only 22,4%. Furthermore, children with more severe autism were approximately 9.4 times more likely to consume grains daily (χ² = 14.319, p = 0.006). Logistic regression analyses indicated that higher cognitive scores were strongly associated with lower grain (OR ≈ 0.044) and other dairy products consumption (OR ≈ 0.337), yet with greater fish intake (OR ≈ 3.317). In contrast, better communication skills corresponded to increased milk consumption (OR ≈ 5.76), and higher physical development scores predicted more frequent egg consumption (OR ≈ 4.40). Conclusions: The pronounced preference for grain and meat products, which are frequently ultra-processed, and avoidance of nutrient-dense foods in children with severe ASD symptoms underscore the need for tailored dietary interventions. These interventions must address sensory sensitivities, nutritional inadequacies, and the risks that selective nutrition can have on the nutritional status and development of the children.

Profile of organic food consumers in Bulgaria

Food selectivity (FS) is among the most frequent and challenging feeding difficulties in children with autism spectrum disorder (ASD). It is often driven by sensory processing differences and behavioral rigidity, leading to restricted diets, nutritional deficiencies, and psychosocial strain. This review synthesizes current evidence on the prevalence, mechanisms, and health consequences of FS in children with ASD. A comprehensive search was conducted in PubMed, Scopus, Web of Science, and Google Scholar. Eligible studies included children aged ≤ 18 years with ASD and assessed FS or related eating difficulties. After screening 503 abstracts, 24 studies were included. Data were extracted on prevalence, mechanisms, nutritional and health outcomes, and family impact. FS prevalence ranged from 21% to 77%, most often related to texture, taste, and color sensitivities. Sensory over-responsivity and behavioral rigidity were consistent predictors, while parental feeding practices and gastrointestinal symptoms were contributing factors. Reported consequences included deficiencies in vitamin D, calcium, and fiber, unbalanced macronutrient intake, and both undernutrition and overweight/obesity. Families reported increased stress, mealtime conflict, and limited coping strategies. Only one behavioral intervention demonstrated short-term improvement without long-term dietary diversification. Food selectivity in ASD is highly prevalent, primarily sensory-driven, and maintained by behavioral contingencies. It contributes to nutritional inadequacies, growth alterations, and family distress. Future research should focus on standardized assessments, longitudinal follow-up, and multidisciplinary interventions addressing both child and family contexts.

Organic production labelling and the increased popularity of organic foods