爱心餐导致自闭症，伊党议员说错了吗
Title: Does Rahmah Menu Cause Autism? Did the PAS MP say something wrong?"
Quote: 薄利多销的爱心餐单，对B40家庭来说，是很好的援助策略，前提是食材素质不成问题。但因政治因素而胡乱瞎说，就必须受到谴责。
Quote: "The Rahmah menu with small profits and high sales is a good aid strategy for B40 families, provided that the quality of the ingredients is not a problem. But if it is arbitrarily said due to political factors, it must be condemned."
爱心餐单（Menu Rahmah）的菜色品质会不会导致自闭症？这是这几天朋友们在群组的热门话题。
Can the quality of the dishes on the "Menu Rahmah" (Compassion Menu) cause autism? This has been a hot topic among my friends in our group chat in the past few days.
事缘伊斯兰党议员哈丽玛医生在国会下议院，对爱心餐单的质量问题“可能”让B40人口暴露于癌症、自身免疫疾病和自闭症潜在风险表示担忧，因而饱受民众和其他议员的批评。在人们的嘲笑、批判声中，连国会下议院副议长也说她的言论不可取，会对社会上特殊群体造成二度伤害。
"Recently, Dr. Halimah, a member of the Islamic Party, expressed concerns about the quality of the "Menu Rahmah" in the lower house of Parliament, suggesting that it may expose the B40 population to potential risks of cancer, autoimmune diseases, and autism. Her comments were criticized by the public and other members of Parliament. Even the deputy speaker of the lower house of Parliament said that her remarks were inappropriate and could cause secondary harm to vulnerable groups in society amid the ridicule and criticism."
爱心套餐的质量有保障，据说是毋庸置疑的，但哈丽玛说错了吗？
The quality of the Rahmah Menu is guaranteed and is said to be beyond doubt. However, is Halimah wrong?
一般互联网搜索引擎和ChatGPT，对这些科学讯息的搜寻会有所不足，甚至产生误导。
The general internet search engines and ChatGPT may be inadequate in searching for this scientific information and may even lead to misinformation.
但对读者而言，尤其是大学毕业生，使用PubMed和Google Scholar等学术文献库平台来核实公众人物的声明，应不是件难事；这不但可以取得较可靠信息，更能清楚理解诸如自闭症的复杂科学议题。
"However, for readers, especially college graduates, it should not be difficult to use academic literature databases such as PubMed and Google Scholar to verify public figures' statements. This can not only obtain more reliable information but also provide a clearer understanding of complex scientific issues such as autism.
既然民众对哈丽玛的批评多聚焦于自闭症，这里简单梳理一些研究文献，来协助大家釐清“自闭症和饮食之间”的关系，并分为三个组别来讨论。
Since the public's criticism of Halimah largely focuses on autism, here is a brief summary of some research literature to help clarify the relationship between autism and diet, divided into three groups for discussion.
（A）关于孕妇和新生儿的研究
(A) Studies on pregnant women and newborns
1。 美国University of California使用241个幼童数据的研究发现，已有自闭症孩子的孕妇在孕期服用各类维生素，可能降低第二次生下自闭症孩子的风险（引2019年2月《JAMA Psychiatry》论文）。
1. A study by the University of California in the United States, using data from 241 young children, found that pregnant women who had children with autism and who took various types of vitamins during pregnancy may reduce the risk of having another child with autism (citing a paper published in JAMA Psychiatry in February 2019).
2。 根据中国江苏师范大学（Jiangsu Normal University）评估310名自闭症患儿和1240个对照组的研究，维生素D水平较低的婴儿患自闭症的风险增加260%（引2017年11月《Journal of Bone and Mineral Research》论文）。
2. According to a study by Jiangsu Normal University in China, which evaluated 310 children with autism and 1,240 control groups, infants with lower levels of vitamin D have a 260% increased risk of developing autism (citing a paper published in the Journal of Bone and Mineral Research in November 2017).
3。 美国Drexel University School of Public Health发表的研究结果和过往研究一致，即新生儿维生素D低水平，可能与自闭症风险增加有关；新生儿样本包括1399个自闭症病例和1607个对照样本（引2021年5月《Molecular Psychiatry》论文）。
3. The research results published by Drexel University School of Public Health in the United States are consistent with previous studies, that low levels of vitamin D in newborns may be associated with an increased risk of autism; the newborn samples included 1,399 autism cases and 1,607 control samples (citing a paper published in Molecular Psychiatry in May 2021).
4。 以色列University of Haifa研究人员指出，在怀孕前和怀孕期间“服用叶酸和多种维生素补充剂”的孕妇，其孩子患自闭症风险比“没服用补充剂”的孕妇低。此研究共使用4万5300名儿童的数据，在出生后到8至12岁这段时间里，评估他们患自闭症的风险（引2019年2月《JAMA Psychiatry》论文）。
4. Researchers at the University of Haifa in Israel pointed out that pregnant women who took folic acid and multiple vitamin supplements before and during pregnancy had a lower risk of having children with autism than pregnant women who did not take supplements. This study used data from 45,300 children and evaluated their risk of developing autism between the ages of 8 and 12 after birth (citing a paper published in JAMA Psychiatry in February 2019).
5。 美国California Department of Public Health团队涉及563名新生儿的研究，并不支持“新生儿低维生素D水平与自闭症风险增加”之间存在关联的说法（引2019年3月《Autism Research》论文）。
5. A study by the California Department of Public Health team involving 563 newborns did not support the claim that there is a link between low vitamin D levels in newborns and an increased risk of autism (citing a paper published in Autism Research in March 2019).
（B）涉及儿童的研究
(B) Studies involving children
埃及Assiut University研究人员对109名自闭儿童进行双盲随机对照试验（double-blinded randomized controlled trial），显示补充维生素D可能有助于改善症状（引2016年11月《Journal of Child Psychology and Psychiatry》论文）。必须注意的是，该论文已被撤回，此研究的可靠性存疑；目前仍没有研究证明儿童营养不良会导致自闭症。
Researchers from Assiut University in Egypt conducted a double-blinded randomized controlled trial on 109 children with autism, and found that supplementing with vitamin D may help improve symptoms (cited in a November 2016 article in the Journal of Child Psychology and Psychiatry). However, it is important to note that this paper has been retracted and the reliability of this study is questionable. Currently, there is still no research to prove that malnutrition in children can lead to autism.
（C）综述和元分析
(C) Review and Meta-Analysis.
1。 中国北京大学团队对已发表的10项研究进行元分析（meta-analysis），发现缺乏维生素D的儿童患自闭症的可能性，比维生素D水平充足的儿童高出5.2倍（引2021年1月《Nutrients》文章）。然而，这些研究之间存在很大异质性，对“维生素D缺乏”的定义也不一致。
1. A team from Peking University in China conducted a meta-analysis on 10 published studies and found that children who lack vitamin D are 5.2 times more likely to develop autism than those with sufficient levels of vitamin D (according to an article published in Nutrients in January 2021). However, there is significant heterogeneity among these studies, and the definition of "vitamin D deficiency" is also inconsistent.
2。 美国Icahn School of Medicine at Mount Sinai研究人员分析自闭症环境风险因素后，显示维生素D与儿童自闭症之间存在因果关系，而缺乏叶酸和omega 3脂肪酸引起自闭症的影响则尚未确定（引2017年3月《Molecular Autism》文章）。
2. Researchers from the Icahn School of Medicine at Mount Sinai in the United States analyzed environmental risk factors for autism and found a causal relationship between vitamin D and autism in children. However, the impact of folate and omega-3 fatty acid deficiency on autism is yet to be determined (according to an article published in Molecular Autism in March 2017).
根据以上研究，我们可作出以下推论：
Based on the above studies, we can draw the following conclusions:
（a）如果哈丽玛的“B40群体”指的是孕妇，那其论点其实有一些科学依据；但目前仍没有足够科学证据，能证明营养不良是自闭症的直接原因。
(a) If Halimah's "B40 group" refers to pregnant women, her argument actually has some scientific basis; however, there is still not enough scientific evidence to prove that malnutrition is a direct cause of autism.
（b）如果她指的是“B40儿童”，就更没有确凿的科学证据，来支持“饮食和自闭症的关联”论点。
(b) If she is referring to "B40 children", there is even less conclusive scientific evidence to support the argument that there is a link between diet and autism.
可惜，哈丽玛并没有上PubMed搜寻研究报告，也不懂得以研究数据为自己辩护，更在被希盟议员和民众轰炸后，自乱阵脚辩说“言论被歪曲原意”。
Unfortunately, Halimah did not search PubMed for research reports and did not know how to defend herself with research data. After being bombarded by Pakatan Harapan MPs and the public, she became disoriented and argued that her statement was misinterpreted.
自闭症是一种复杂的神经疾病，可能受各种遗传、环境和发育因素的相互影响。虽然产前营养素缺乏是可能风险因素，但它并不是自闭症的唯一原因，也需要进一步研究来确认其和自闭症的关联。值得注意的是，以上研究的自闭症儿童群体，可能因长期偏食等饮食因素，导致某些营养素（例：维生素B1、B6、B12、A、C、D、钙和锌）的缺乏，而不是营养缺乏引发自闭症。
Autism is a complex neurological disorder that may be influenced by various genetic, environmental, and developmental factors. While prenatal nutrient deficiencies may be a possible risk factor, they are not the sole cause of autism and further research is needed to confirm their association. It is worth noting that the autism children in the above studies may have lacked certain nutrients (such as vitamins B1, B6, B12, A, C, D, calcium, and zinc) due to long-term dietary factors such as picky eating, rather than a general lack of nutrition causing autism.
薄利多销的爱心餐单，对B40家庭来说，是很好的援助策略，前提是食材素质不成问题。但因政治因素而胡乱瞎说，就必须受到谴责。
A low-profit and high-turnover Rahmah Menu is a good assistance strategy for B40 families, provided that the quality of the ingredients is not an issue. However, making reckless and baseless statements due to political factors must be condemned.
https://research.monash.edu/en/persons/song-beng-kah
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