A number of epidemiological studies have shown that autism spectrum disorder (ASD) have a complex and multifactorial etiology (origin). However, a definable etiological factor has been identifiable in only 15 to 20 percent of persons with ASD. Recently, vitamin D deficiency was suggested as one of the environmental factors in the etiology of ASD, as it participates in homeostatic, immune and neuro-developmental processes in the brain and in gene regulation.
Currently, it is well known that vitamin D plays a crucial role in child neuro-development and mental health, and it has been proposed that vitamin D may have a therapeutic effect on autism. To date 8 studies have explored the association between vitamin D deficiency and autism. Folic acid is another suspected environmental etiological factor in ASD. Folic acid is an essential metabolite that plays a crucial role in methylation reactions throughout the body. It has been reported that some symptoms of autism may be improved and folate metabolism normalises with folic acid supplements. Interestingly, children born to women taking prenatal vitamin supplements also have lower scores of autistic behaviours compared to children with mothers who never or rarely took supplements.
In a recent study undertaken by Ankara University School of Medicine (2014), researchers investigated the serum levels of vitamin D and folate in 54 young children (3-8 years of age) with ASD. Serum levels in the ASD group were compared to 54 "normal" control children, selected from three kindergarten and primary schools, according to their age and gender. Children taking vitamin D during the previous 6 months or on a casein free diet were excluded from the study. Moreover, children with any chronic conditions (epilepsy, metabolic disorders), malignancies or taking medication (anti-epileptics) that could affect vitamin D serum levels were also excluded.
In the above study, no difference in vitamin D was noted between children with ASD and controls. In addition, no significant association among symptom severity (autism), problematic behaviours, mental/developmental levels of children with ASD and the serum level of vitamin D was found. Although previous studies have indicated a benefit for vitamin D administration in children with ASD, variables included ethnicity and co-morbidities (schizophrenia), possible factors to address in isolation for a subset of children diagnosed with ASD.
Regarding folate, the data outlined in the above study showed that serum folate levels in children with ASD are not different from those in healthy controls, and that folate levels are not associated with the severity of symptoms, problem behaviours or developmental level in children with ASD. The authors note that serum assessment, undertaken in this current study, is not comparable to previous research addressing central nervous system folate deficiency (associated with ASD) or reduced levels of 5-methyltetrahydrofolate in the cerebrospinal fluid (often, serum folate levels are normal).
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