Cooking for Disability: A Pilot Study on Nutritional Interventions for Mental Health Support in Adults with Autism Spectrum Disorder

Johanna MC Blom^1*Ciro Ruggerini²Franco Caroli³Carla Ferreri⁴Annalisa Masi⁵Veronica Rivi⁶Pierfrancesco Sarti¹Mauro Rebecchi⁷Chiara Arletti⁷

• ¹Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
• ²Department of Education and Human Sciences, University of Modena and Reggio Emilia, Modena, Italy
• ³Association for the inclusion of people with severe disabilities, Controvento, Modena, Italy
• ⁴Consiglio Nazionale delle Ricerche (CNR) - ISOF,, Bologna, Italy
• ⁵Consiglio Nazionale delle Ricerche, Bologna, Emilia-Romagna, Italy
• ⁶Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
• ⁷ASP Charitas Modena, Modena, Lombardy, Italy

Background: Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition often accompanied by chronic inflammation and metabolic dysfunction, which are increasingly recognized as key contributors to symptom severity and behavioral challenges. Despite these insights, targeted nutritional interventions in adults with severe ASD remain understudied. Aim: This pilot study investigated whether a precision, biomarker-guided dietary intervention could improve both behavioral symptoms and underlying biological dysregulations in adults with Level 3 ASD. Methods:Seven adults with severe ASD residing at the ASP Charitas residential facility in Modena (Italy) participated in a 12-month dietary intervention aimed at reducing inflammation, optimizing fatty acid profiles, and supporting metabolic health.Behavioral assessments-including CARS-2-ST, DASH-II, ABC, and SSP-and biological markers such as IL-6, fecal calprotectin, vitamin D, HbA1c, and erythrocyte lipid profiles were collected at baseline, 6 months, and 12 months.Results: Baseline assessments confirmed severe ASD symptoms, psychiatric comorbidities, sensory processing abnormalities, systemic and intestinal inflammation, metabolic impairment, and a pro-inflammatory lipid profile.Following the intervention, significant reductions were observed in core autism symptoms (CARS-2-ST, ABC), alongside decreased frequency and severity of behavioral symptoms (DASH-II). Sensory processing (SSP) stabilized or modestly improved. Biochemical markers shifted toward normalization, including increased vitamin D, improved insulin sensitivity (HbA1c), and reduced inflammatory markers (IL-6, fecal calprotectin). Lipidomic profiling revealed elevated antiinflammatory omega-3 fatty acids (DHA, EPA) and a decreased omega-6/omega-3 ratio. Correlational analyses linked these biological changes to behavioral improvements, suggesting a mechanistic connection. Conclusions: This pilot study suggests that a targeted dietary intervention, based on biological markers reflective of neurobiological dysfunctions, may offer a promising complementary approach to managing ASD symptoms in adults. The findings indicate that dietary modifications can lead to improvements in both biological and behavioral markers, but further research is needed to refine personalized nutritional strategies for individuals with ASD.