Kids with autism are five times more likely than other children to experience food-related problems ranging from mealtime tantrums to extreme pickiness, issues with potentially long-term health consequences, researchers say.

Though many parents have long indicated concerns about the eating habits of their children with autism, a new analysis of existing research on the issue is believed to offer the first comprehensive look. In the review of 17 studies, researchers at Emory University and the Marcus Autism Center found that kids with the developmental disorder face serious risks of feeding and nutrition problems.

In addition to being pickier eaters, kids with autism often have mealtime rituals and other extreme behaviors surrounding feeding, the study found. What’s more, they have lower intake of calcium and protein and more overall nutritional deficits than other children, the researchers report this month in the Journal of Autism and Developmental Disorders.

“The results of this study have broad implications for children with autism,” said William Sharp, an assistant professor at Emory who led the study. “It not only highlights the importance of assessing mealtime concerns as part of routine health care screenings, but also suggests the need for greater focus on diet and nutrition in the autism community.”

The nutrition deficits and feeding problems found may be putting children with autism at risk for long-term medical concerns like obesity and cardiovascular disease, researchers said. Sharp and his colleagues also warn that the food-related problems uncovered in their study may be exacerbated by efforts to eliminate some foods from children’s diets in an attempt to treat autism.

“Our findings have immediate and important implications for the work of practitioners serving children and families with autism, who in the absence of such information, may struggle to address parents’ concerns, or, worse, may fill the void with alternative treatments that may be ill-conceived or even harmful to children and families,” Sharp said.