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Review
 국내 발달장애인 식생활 및 영양교육 연구동향: 주제범위 문헌고찰(2015–2025)
곽나경1),*orcid, 박원영2),*orcid, 김유리3)orcid, 오지은4),†orcid
Research trends in dietary behaviors and nutrition education among individuals with developmental disabilities in Korea: a scoping review (2015–2025)
Nakyung Kwak1),*orcid, Wonyeong Park2),*orcid, Yu-Ri Kim3)orcid, Jieun Oh4),†orcid
Korean Journal of Community Nutrition 2026;31(1):1-20.
DOI: https://doi.org/10.5720/kjcn.2025.00374
Published online: February 28, 2026

1)이화여자대학교 임상보건학과 석사과정생

2)이화여자대학교 식품영양학과 석사과정생

3)이화여자대학교 특수교육학과 교수

4)이화여자대학교 신산업융합대학 교수

1)M.S. Student, Department of Clinical Healthcare, Ewha Womans University, Seoul, Korea

2)M.S. Student, Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Korea

3)Professor, Department of Special Education, Ewha Womans University, Seoul, Korea

4)Professor, College of Science and Industry Convergence, Ewha Womans University, Seoul, Korea

†Corresponding author: Jieun Oh College of Science and Industry Convergence, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea Tel. +82-2-3277-6586 Fax: +82-2-3277-6586 Email: oje96@ewha.ac.kr
*

These authors contributed equally to this work.

• Received: December 31, 2025   • Revised: February 1, 2026   • Accepted: February 23, 2026

© 2026 The Korean Society of Community Nutrition

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Objectives
    We mapped trends in studies on dietary behaviors, nutritional status, and nutrition-related education among individuals with developmental disabilities in Korea over the past decade to identify research gaps and inform future research and policy development.
  • Methods
    A scoping review was conducted using three major Korean academic databases (RISS, KISS, and DBpia). Studies published between 2015 and September 2025 were identified using combinations of keywords related to developmental disabilities, dietary behavior, nutrition, and health-related interventions. Eligible studies included empirical studies and secondary research (e.g., systematic or scoping reviews) conducted in Korea that focused on dietary behaviors, nutrition, health promotion, or nutrition-related education for individuals with developmental disabilities. Thirty-six studies met our inclusion criteria and were analyzed based on study design, study population, disability type, research topic, and publication period.
  • Results
    Observational quantitative, qualitative, intervention-based experimental, and evidence synthesis accounted for 27.8%, 13.9%, 22.2%, and 36.1% of all included studies, respectively. Children and adolescents (27.8%) and adults (25.0%) were the most frequently studied populations, with limited studies focusing on professionals or teachers. Most studies targeted individuals with developmental disabilities as a combined group (61.1%), followed by those specifically targeting autism spectrum disorder. Research topics included dietary behaviors and nutritional status, nutrition-related education and interventions, health promotion, and medical or clinical issues, with many small-scale and short-term intervention studies.
  • Conclusion
    Although research on dietary and nutrition-related issues among individuals with developmental disabilities in Korea has expanded in scope and methodology, significant limitations remain. Future research should adopt longitudinal and community-based approaches, incorporate diverse populations, and strengthen policy-oriented nutrition support systems to promote sustainable health and quality of life for individuals with developmental disabilities.
  • Keywords: developmental disabilities; feeding behavior; nutritional status; health behavior; health promotion
발달장애는 「장애인복지법」에서 지적장애와 자폐성장애를 포함하는 장애군으로 정의되며, 인지적•의사소통적•감각적 특성으로 인해 일상생활 전반에서 지속적인 지원을 필요로 한다. 2024년 기준 국내 등록 장애인은 2,631,356명이며, 이 중 발달장애인은 280,672명(지적장애 233,322명, 자폐성장애 47,350명)으로 전체의 약 10.6%를 차지한다[1]. 특히 발달장애인의 규모는 지속적으로 증가하고 있으며, 29세 이하 연령층에서는 발달장애인이 전체 장애인의 과반수를 차지하는 것으로 보고되는 등 저연령층에서의 비중이 높아지고 있다[2]. 해외에서도 자폐스펙트럼장애(autism spectrum disorder, ASD)의 진단률은 지속적으로 증가하는 경향을 보여[3], 발달장애인의 건강 및 일상생활 지원의 필요성은 전 세계적으로 확대되고 있다.
발달장애인의 식생활은 감각민감성, 음식선호의 제한, 섭식문제, 낮은 식품 다양성 등 장애 특성과 환경적 제약이 복합적으로 작용하여 취약한 패턴을 보이는 것으로 보고되고 있다[4-6]. 이러한 특성으로 인해 발달장애인은 일반인에 비해 과체중•비만 유병률이 높고, 채소 및 유제품 섭취 부족, 미량영양소 섭취 불균형과 같은 영양 문제 및 다양한 식행동 문제가 반복적으로 관찰된다[7, 8]. 이러한 식생활 문제는 신체적•정신적 건강뿐 아니라 가족관계와 사회적 참여를 포함한 삶의 질 전반에 영향을 끼칠 수 있다.
이처럼 식생활 취약성이 지속적으로 제기되고 있으나, 국내의 영양•식생활 교육은 제도적 기반이 충분히 마련되어 있지 않다. 2014년 「발달장애인 권리보장 및 지원에 관한 법률」 제정 이후 평생케어 종합대책, 활동서비스, 주간활동서비스 등 다양한 지원 정책이 도입되었으나[9-11] 영양•식생활 교육 영역은 여전히 제한적이다. 사회복지급식관리지원센터가 일부 복지시설을 중심으로 급식 및 영양관리 지원을 수행하고 있으나, 이는 시설 이용자에 국한된 서비스로 지역사회 혹은 재가 발달장애인을 포괄하는 영양지원 체계는 매우 부족한 실정이다[12, 13]. 특히 국내 영양교육 관련 연구는 장애인사회복지시설 입소•이용자를 대상으로 한 프로그램 개발 및 적용 연구에 집중되어 있어, 지역사회 기반으로의 확장성이 제한적이라는 구조적 한계가 제기되고 있다[12].
반면, 주요 국가에서는 장애 관련 공식 지원 범주에 영양서비스, 식사보조 및 건강관리 지원을 포함하여 제도적으로 보장하고 있으며, 예를 들어 미국의 Individuals with Disabilities Education Act, 영국의 National Health Service의 Learning Disability Programme, 호주의 National Disability Insurance Scheme 등이 이에 해당한다[14-16]. 또한 Autism MEAL Plan과 같은 ASD feeding program, 감각기반 modified Sequential Oral Sensory (M-SOS) 접근 및 응용행동분석(applied behavior analysis; ABA) 기반 feeding 중재를 비교한 연구 등 구조화된 섭식중재 연구가 지속적으로 수행되고 있다[17, 18]. 감각기반 M-SOS 접근은 음식의 맛•냄새•질감 등 감각 자극에 대한 민감성이 섭식거부로 이어질 수 있다는 관점에서, 감각 탐색과 점진적 음식 노출(food exposure)을 통해 음식 수용 범위를 확장하는 중재 전략이다. 여기서 점진적 음식 노출은 기피 음식에 대한 반복적•단계적 노출을 통해 수용성을 높이는 접근으로 감각기반 섭식중재 연구에서 핵심적으로 활용된다. 한편 ABA 기반 섭식중재는 섭식 회피 행동을 감소시키고 적절한 섭식 행동을 강화하는 행동분석 이론에 근거한 접근으로, 해외에서는 다양한 감각•행동 중재와의 비교 연구가 이루어지고 있다. 국내에서도 응용행동분석 이론을 적용하여 섭식 또는 삼킴 문제를 중재한 연구와, ASD 아동•청소년의 섭식 문제를 대상으로 ABA 기반 중재 연구의 설계와 효과를 종합적으로 고찰한 연구가 보고된 바 있으나, 대부분 국내 연구는 단기 중재나 소규모 실태조사 중심으로 이루어져 장기적 효과, 일반화 가능성, 중재 충실도 등을 충분히 검증하지 못하고 있으며, 생애주기별•장애유형별 특성을 체계적으로 파악하기에는 여전히 한계가 있다[19].
따라서 발달장애인의 건강한 식생활 형성과 자립역량 강화를 위해서는, 최근 10년간 국내에서 수행된 관련 연구의 흐름을 종합적으로 분석하여 정책적 공백을 확인할 필요가 있다. 이에 본 연구는 2015년부터 2025년까지 국내에서 발표된 발달장애인의 식생활 및 식생활 교육 관련 연구를 검토하여, 연구유형•대상•장애유형•연구주제•시기별 동향을 분석하고 향후 연구 및 정책 발전 방향을 제시하고자 한다.
Ethics statement
This study was conducted as a scoping review and did not involve human participants or the collection of personal data. Therefore, Institutional Review Board (IRB) approval and informed consent were not required.
1. 연구설계
본 연구는 발달장애인의 식생활 및 영양교육과 관련하여 국내에서 수행된 연구의 범위와 특성을 체계적으로 파악하기 위한 주제범위 문헌고찰(scoping review) 연구이다.
2. 문헌 검색 절차
본 연구는 2015년부터 2025년까지 국내에서 발표된 발달장애인의 식생활 및 영양 관련 학술연구를 대상으로 하였다. 본 문헌고찰은 주제범위 문헌고찰의 목적과 절차에 따라 수행되었으며, 기존 연구의 범위와 특성을 포괄적으로 파악하는 데 중점을 두었다. 문헌 검색은 2015년부터 2025년 9월까지 RISS, KISS, DBpia 등 주요 국내 학술데이터베이스를 활용하여 수행하였으며, 최종 문헌 검색은 2025년 9월 30일에 완료되었다.
검색 전략은 발달장애인의 식생활 전반과 식생활 교육 및 영양중재 관련 문헌을 포괄적으로 탐색하기 위하여 다음 두 범주의 키워드를 중심으로 구성하였다. 첫째, 식생활 관련 키워드는 발달장애인의 식행동, 영양섭취, 건강 및 생활습관 등 식생활 전반을 포함하도록 설정하였으며, “영양”, “영양상태”, “식생활”, “식품”, “섭취”, “식사태도”, “건강문제”, “비만”, “만성질환”, “음식기호”, “식이패턴”, “식이”, “체중관리”, “건강증진” 등의 용어를 사용하였다. 둘째, 식생활 교육 및 영양중재 관련 키워드는 교육∙중재 프로그램 및 건강증진 활동을 포함하도록 구성하였으며, “영양중재”, “영양교육프로그램”, “보호자 인식” 등의 용어를 사용하였다.
각 범주의 키워드는 발달장애 관련 진단명인 “발달장애”, “지적장애”, “자폐스펙트럼”과 AND 연산으로 결합하여 검색하였다. 대표적으로 사용된 검색식은 다음과 같다: (발달장애 OR 지적장애 OR 자폐스펙트럼) AND (식생활 OR 영양상태 OR 식이패턴 OR 건강증진), (발달장애 OR 지적장애 OR 자폐스펙트럼) AND (영양중재OR 영양교육프로그램 OR 보호자 인식). 문헌 검색에 사용된 데이터베이스, 키워드 범주 및 키워드 조합에 따른 검색 전략은 Table 1에 제시하였다.
검색된 문헌은 제목, 초록, 본문 순으로 단계적으로 검토하였다. 초기 검색을 통해 확보된 문헌 중 중복 문헌을 제외한 후, 제목과 초록 검토를 통해 연구 주제와의 관련성을 1차적으로 판단하였으며, 이후 원문 검토를 통해 최종 분석 대상 논문을 선정하였다. 검색 누락을 최소화하기 위해 다양한 키워드 조합을 적용하여 문헌을 폭넓게 탐색하였다. 문헌 선정 과정은 주제범위 문헌고찰의 일반적인 절차에 따라 수행되었으며, Joanna Briggs Institute에서 제시한 주제범위 문헌고찰 방법론을 참고하여 Fig. 1로 제시하였다[20].
3. 연구 선정 기준
본 연구의 논문 선정 기준은 다음과 같다. 첫째, 발달장애(지적장애•ASD 등)를 주요 연구대상으로 한 연구를 포함하였다. 둘째, 식행동, 식습관, 영양섭취, 영양교육, 건강행동, 중재 등 식생활 및 영양 관련 변인을 하나 이상 포함한 연구를 선정하였다. 셋째, 국내에서 수행된 실증연구 또는 문헌연구를 대상으로 하였다. 이러한 기준에 따라 문헌을 검토한 결과, 최종적으로 36편의 논문이 분석 대상에 포함되었으며, 각 연구의 주요 특성은 Table 2 [19, 21-55]에 제시하였다.
4. 자료 추출 및 분석 틀
본 연구에서 사용한 연구유형, 연구대상, 장애유형, 주요 주제, 연구시기 분류 기준은 발달장애 및 재활•특수교육 분야에서 수행된 선행 국내 리뷰연구들의 분류 체계를 토대로, 본 연구의 목적에 맞게 재구성한 것이다[21]. 특히 발달장애인의 식생활•건강 관련 연구는 연구설계와 개입 형태, 대상자 특성, 장애 진단 범주, 다루는 주요 내용 영역에 따라 연구의 성격이 비교적 명확하게 구분되므로, 다음과 같은 원칙에 따라 코딩을 실시하였다. 자료 정리와 코딩은 Microsoft Excel 2019 (Microsoft Corp.)를 활용하여 수행하였다. 자료 추출과 분류는 2인의 연구자가 독립적으로 수행하였으며, 분류 결과가 일치하지 않는 경우에는 상호 논의를 통해 합의에 도달하는 방식으로 조정하였다.
연구유형은 각 논문의 연구설계와 분석방법을 기준으로 분류하였다. 이 분류 기준은 발달장애인 식행동과 영양섭취 관련 국내 연구동향을 분석한 선행연구의 연구유형 분류 체계를 참고하여 설정하였다[21].
설문조사, 신체계측, 영양섭취량 분석 등 양적 자료를 수집하여 통계적으로 분석한 연구는 ‘관찰 기반 양적연구’로 분류하였다. 연구자가 교육, 운동, 행동, 심리 프로그램 등을 설계하여 사전•사후 비교 또는 실험군-대조군 비교를 통해 효과를 검증한 경우는 ‘개입 기반 실험연구’로 분류하였다. 심층면담, 포커스그룹 인터뷰, 자문화기술지 등 질적 자료를 활용하여 보호자, 교사, 전문가 또는 발달장애인의 경험과 인식을 탐색한 연구는 ‘탐색적 질적연구’로 분류하였다. 선행연구를 체계적으로 수집•정리•분석한 문헌고찰, 체계적 문헌고찰, 메타분석 및 주제범위 문헌고찰은 ‘근거통합 연구’로 구분하였다.
연구대상은 각 논문에서 명시한 주요 참여자의 특성을 기준으로 ‘아동•청소년 발달장애인’, ‘성인 발달장애인’, ‘부모•보호자’, ‘전문가•교사’로 분류하였다. 연구에 발달장애인과 부모, 교사, 전문가 등이 함께 포함된 경우에는 복수 코딩을 허용하되, 분석 시에는 ‘기타(중복)’ 범주로 별도 표시하였다.
장애유형은 원 논문에서 사용한 진단명과 연구대상 설명을 토대로 분류하였다. 자폐범주성장애, ASD 등으로 명시된 경우는 ‘자폐’로, 정신지체, 지적장애로 제시된 경우는 ‘지적’으로 코딩하였다. 두 진단이 포괄된 ‘발달장애’ 또는 ‘발달장애인’으로 기술된 연구는 ‘발달장애(통합)’으로 분류하였으며, 자폐•지적장애•정신장애 등 둘 이상의 진단 범주가 동시에 포함된 연구는 ‘혼합(자폐+지적+정신장애 등)’으로 구분하였다.
주요 주제는 제목, 초록, 연구목적, 주요 변수 및 결과 영역을 중심으로 1차 개방코딩(open coding)을 실시한 뒤, 반복적 비교 과정을 통해 유사한 내용끼리 묶는 축코딩 과정을 거쳐 네 가지 대분류로 정리하였다. 이러한 코딩 및 분류 과정은 컴퓨터 기반 자동 분류가 아닌 연구자 중심의 질적 분석 절차에 따라 수행되었으며, 2인의 연구자가 독립적으로 코딩과 주제 분류를 실시하였다. 이후 분류 결과를 상호 비교하여 일치 여부를 확인하였고, 분류가 일치하지 않는 경우에는 충분한 논의를 통해 합의에 도달하는 방식으로 최종 주제를 확정하였다. 분류된 주제는 식생활 및 영양실태 연구, 영양•식생활 교육 및 중재 연구, 신체활동•건강증진 관련 연구, 의학•보건•임상 관련 연구였다. 하나의 연구가 두 개 이상의 주제를 포함하는 경우에는 연구목적과 논의에서 가장 비중 있게 다루는 영역을 중심으로 1차 주제를 결정하였다.
연구시기는 분석 대상 기간인 2015부터 2025년까지를 연구동향 변화 양상을 비교하기에 적절한 세 시기로 구분하였다. 즉, 초기 실태 중심 연구가 수행된 2015–2018년, 중재 및 질적연구가 본격적으로 확산된 2019–2021년, 체계적 문헌고찰과 주제범위 문헌고찰을 포함한 통합•정책연구가 증가한 2022–2025년으로 나누어 분석하였다. 이러한 시기 구분을 통해 연구량의 변화뿐 아니라 연구유형과 주제의 질적 변화를 함께 살펴보고자 하였다.
최종적으로 연구유형은 ‘관찰 기반 양적연구’, ‘개입 기반 실험연구’, ‘탐색적 질적연구’, ‘근거통합 연구’로 연구대상은 ‘아동•청소년 발달장애인’, ‘성인 발달장애인’, ‘부모•보호자’, ‘전문가•교사’, ‘기타(중복)’로, 장애유형은 ‘자폐’, ‘지적’, ‘발달장애(통합)’, ‘혼합(자폐+지적+정신장애)’으로 분류하였다. 주요 주제는 ‘식생활 및 영양실태연구’, ‘영양,식생활 교육 및 중재연구’, ‘신체활동∙건강증진 관련 연구’, ‘의학∙보건∙임상 관련 연구’로 연구시기는 ‘2015–2018년’, ‘2019–2021년’, ‘2022–2025년’으로 구분하였다.
1. 연구 설계별 연구 동향
본 연구에 포함된 36편의 논문에 대한 연구유형별 분포는 Table 3과 같다. 전체 연구 중 관찰 기반 양적연구는 27.8%, 탐색적 질적연구는 13.9%, 개입 기반 실험연구는 22.2%, 근거통합 연구는 36.1%로 분류되었으며, 최근에는 근거통합 연구의 비중이 가장 높게 나타났다. 시기별로 살펴보면, 2015년–2017년에는 관찰 기반 양적연구를 중심으로 발달장애인의 식습관, 영양섭취량, 체중상태 및 건강문제를 객관적 지표를 통해 파악하는 실태 중심 연구가 주로 수행되었으며, 이들 연구에서는 지적•자폐성 장애인을 대상으로 과체중•비만 비율이 72%에 이른다는 점과 함께 칼슘•비타민 B군을 포함한 미량영양소 섭취 부족, 채소 및 유제품 섭취 저조와 같은 문제가 반복적으로 보고되었다[22]. 또한 사회경제적 요인, 식습관 특성, 시설생활 여부, 보호자 지원 수준에 따른 식행동 차이를 분석한 연구들도 포함되어, 발달장애인의 식생활과 관련된 다양한 개인적•환경적 요인이 함께 다루어졌다. 2018년 이후에는 이러한 양적 실태 연구를 보완하기 위해 탐색적 질적연구와 개입 기반 실험연구의 비중이 점차 증가하였다. 탐색적 질적연구에서는 발달장애인, 부모, 교사, 복지시설 종사자 등을 대상으로 한 심층면담과 포커스그룹 인터뷰를 통해 식생활 경험과 건강관리 과정에서의 어려움을 보다 입체적으로 탐색하였다. 예를 들어, 발달장애인의 의료서비스 이용과 자기결정 경험을 다룬 연구에서는 당사자–보호자 짝 면담을 통해 질병에 대한 의사표현의 어려움, 건강관리 및 진료 과정에서의 제약, 의료서비스 이용과 관련된 자기결정의 한계가 주요 주제로 도출되었으며, 자기결정 증진과 의료서비스 개선에 대한 지원 요구가 제시되었다[23]. 또한, 자폐범주성장애 학생을 대상으로 한 연구에서는 특수교사, 영양교사, 전문의를 대상으로 한 면담을 통해 편식과 이식 행동, 특이한 식사 패턴과 같은 식행동 유형과 함께 비만•변비 등 건강 문제, 식행동 지도 과정에서의 어려움과 다학문적 협업의 필요성이 보고되었다[24]. 이러한 질적연구들에서는 자기결정성, 자기옹호, 가정•학교•지역사회 연계와 같은 개념들이 반복적으로 언급되었다. 개입 기반 실험연구는 영양교육, 운동 및 행동중재 프로그램을 통해 발달장애인의 식습관과 건강행동 변화를 실험적으로 검증한 연구들로 구성되었으며, 대표적으로 학교 기반 건강 자기옹호 프로그램[25]과, 가상현실(virtual reality, VR) 기반 운동중재 연구[26]가 포함되었다. 이들 연구는 대부분 4–30회기의 단기 프로그램과 사전•사후 설계, 소규모 실험군–대조군 비교 형태로 이루어졌고, 체중 감소, 영양섭취 개선, 자기결정성 향상, 건강관리 행동 증가 등 긍정적인 효과가 보고되었으며, 단순 정보전달형 교육보다 체험•참여형 중재가 더 효과적이고 가정–학교–교사 연계형 접근이 중재 효과의 지속성 측면에서 우수한 것으로 나타났다. 한편 2021년 이후에는 개입 기반 실험연구 결과를 포함한 체계적 문헌고찰, 메타분석 및 주제범위 문헌고찰 등 근거통합 연구가 증가하였다. 가족 대상 정신건강(우울) 중재 프로그램을 분석한 메타분석 연구에서는 cognitive behavioral therapy와 긍정양육 중재의 평균 효과크기가 d = 0.81–0.87로 보고되었으며[27], 의료•건강서비스 관련 주제범위 문헌고찰에서는 건강검진 미충족률, 의료 접근성 저조, 만성질환 위험 등을 체계적으로 정리하며 향후 정책적 개선과 실무자 교육의 필요성을 강조하였다[28].
2. 연구 대상별 연구 동향
본 연구에 포함된 36편의 논문은 연구대상에 따라 다섯 가지 범주로 분류되었으며, 그 분포는 Table 4에 제시하였다. 연구대상별로는 아동•청소년 발달장애인을 대상으로 한 연구가 27.8%로 가장 많았고, 성인 발달장애인 대상 연구는 25.0%, 부모•보호자 대상 연구는 11.1%, 전문가•교사 대상 연구는 5.6%를 차지하였으며, 기타 또는 중복대상을 포함한 연구는 30.6%로 나타났다. 아동•청소년 발달장애인을 단일 대상으로 한 연구는 총 10편으로, 근거통합 연구 5편, 관찰 기반 양적연구 4편, 개입 기반 실험연구 1편으로 구성되었다. 근거통합 연구에는 아동•청소년 발달장애인을 대상으로 한 식습관 및 섭식 관련 주제를 다룬 문헌고찰 연구가 포함되었다[29, 30]. 관찰 기반 양적연구에서는 발달장애 청소년의 편식 요인을 포함한 식습관과 식이섭취, 식품 기호도 및 영양교육 요구도를 조사한 연구가 수행되었으며[31], 발달장애 아동의 부모를 대상으로 한 산과적 합병증과 삼킴장애의 식이•영양관리와 같은 임상적 주제를 다룬 연구도 포함되었다[32, 33]. 개입 기반 실험연구로는 학교–가정 연계 건강 자기옹호 프로그램을 적용한 연구가 포함되었으며, 위생, 운동, 식사•영양 등 6개 건강관리 영역으로 구성된 15회기 프로그램을 통해 발달장애 학생의 건강지식과 건강증진 행동 점수가 유의하게 향상되고, 참여 학생의 93%가 기대 수준 이상의 건강관리 목표를 달성한 것으로 보고되었다[25]. 성인 발달장애인을 단일 대상으로 한 연구는 총 9편으로, 관찰 기반 양적연구 4편, 개입 기반 실험연구 4편, 근거통합 연구 1편으로 구성되었다. 관찰 기반 양적연구에서는 발달장애 성인의 비만 정도가 생활만족도에 미치는 영향, 카로티노이드 및 미량영양소 섭취 수준, 건강상태와 문제행동 간의 상관성을 분석한 연구와 함께, 장내미생물 대사특성을 중심으로 생리•대사적 특성과 영양 관련 지표 간의 관련성을 분석한 임상적 연구도 포함되었다[22, 34, 35]. 개입 기반 실험연구는 아동•청소년 대상 연구와 달리 성인 발달장애인에서 가장 높은 비중을 차지하였으며, 운동 중심 중재와 영양교육 중심 중재로 구분되었다. 운동 중심 중재 연구에서는 체육 프로그램과 비디오게임 기반 VR 운동 프로그램을 통해 유연성(P < 0.001), 근력(P = 0.045), 순발력(P = 0.013) 등의 체력 지표에서 유의한 향상이 나타났고[36], 근육량 증가, 체지방 감소, 심폐지구력 향상 효과도 보고되었다[26]. 한편 영양교육 중심 중재 연구로는 VR을 활용한 음악치료 중재 연구가 포함되었으며, 실제 식사 상황을 기반으로 한 VR 프로그램을 적용한 결과 지적장애인의 식사태도 목표행동 수행 항목 수가 기초선 대비 중재 및 유지 단계에서 뚜렷하게 증가하여 중재 효과가 유지되는 것으로 보고되었다[37]. 근거통합 연구는 발달장애 성인을 대상으로 한 건강증진 프로그램의 효과를 분석한 문헌고찰 연구로 구성되었다[19]. 부모•보호자를 단일 대상으로 한 연구는 총 4편으로, 관찰 기반 양적연구 2편, 개입 기반 실험연구 1편, 근거통합 연구 1편으로 이루어졌다. 관찰 기반 양적연구에서는 자폐아동의 식생활에 대한 어머니의 인식과 경험, 자녀의 건강상태 및 도전적 행동이 부모의 돌봄 부담에 미치는 영향을 중심으로 조사하여 부모가 영양관리 과정에서 영양지식 부족, 시간 제약, 정서적 어려움 등을 경험하고 있음을 보고하였다[38, 39]. 개입 기반 실험연구에서는 발달장애 아동 어머니를 대상으로 한 건강•영양교육 프로그램으로, 프로그램 참여 후 양육 스트레스 감소와 건강관리 행위 증가 등 긍정적인 변화가 보고되었다[40]. 근거통합 연구는 발달장애 가족을 대상으로 한 정신건강 증진 프로그램의 효과를 분석한 문헌고찰 연구로 구성되었다[27]. 전문가•교사를 단일 대상으로 한 연구는 총 2편으로, 모두 탐색적 질적연구에 해당하였다. 한 연구에서는 자폐학생의 식행동 특성에 대한 영양교사, 특수교사 및 의료전문인의 경험과 지원 요구를 심층적으로 탐색하여 식사 지도 과정에서 감각민감성, 섭식거부, 독특한 식행동 등으로 인한 실제적 어려움을 보고하였고[24], 다른 연구에서는 장애인 복지시설의 영양교육 프로그램 운영 경험을 주제로, 시설 영양사와 실무자 인터뷰를 통해 현장의 교육 요구와 한계를 탐색하였다. 해당 연구에서는 입소 장애인의 편식과 비만이 주요 문제로 지적되었으며, 편식 예방, 비만 관리 및 위생 교육에 대한 요구와 함께 평균 6–9세 아동 수준의 난이도, 시각적 자료 및 체험활동 중심 교육 매체의 필요성이 제시되었고, 거동이 불편한 장애인뿐 아니라 돌봄 종사자를 대상으로 한 영양교육 병행과 입소자–종사자 공동 교육 방식에 대한 의견도 함께 제시되었다[41]. 또한 일부 연구에서는 부모, 교사, 전문가 등 복합대상을 포함하여 가정∙학교∙시설 등 여러 환경에서의 식생활 교육 요구와 경험을 함께 보고하였다.
3. 장애 유형별 연구 동향
본 연구에 포함된 36편의 논문은 장애유형에 따라 네 가지 범주로 분류되었으며, 그 분포는 Table 5에 제시하였다. 분석 결과, 연구는 발달장애(통합) 22편(61.1%), 자폐성장애 8편(22.2%), 지적장애 2편(5.6%), 혼합(자폐+지적+정신장애 등) 4편(11.1%)으로 분류되었다. 가장 많은 비중을 차지한 발달장애 통합 연구는 근거통합 연구 8편, 개입 기반 실험연구 6편, 관찰 기반 양적연구 6편, 탐색적 질적연구 2편으로 구성되었으며, 연구 주제가 가장 다양하게 분포하였다. 근거통합 연구는 발달장애인을 대상으로 한 건강 및 식생활 관련 주제를 종합적으로 분석한 문헌고찰 연구로 구성되었다. 개입 기반 실험연구의 대표적 사례로, 발달장애 아동 어머니를 대상으로 한 건강교육 프로그램에서는 영양, 수면, 개인위생 등을 포함한 신체적 건강교육과 사회심리 교육을 병행한 결과, 실험군에서 자녀의 건강관리행위가 유의하게 증가(F = 9.21, P < 0.001)되고 양육 스트레스가 유의하게 감소(F = 15.32, P < 0.001)한 결과가 보고되었다[40]. 관찰 기반 양적연구에서는 발달장애인의 건강상태, 생활만족도, 영양섭취 및 식생활 특성을 중심으로 분석이 이루어졌으며, 일부 연구에서는 삼킴장애와 장내미생물 등 생리적 요인을 중심으로 건강위험요인을 분석하거나[35] 의료 접근성, 건강권 인식, 보건의료 서비스 이용 만족도 등을 다루었다[23]. 탐색적 질적연구는 발달장애인의 건강관리 및 식생활과 관련한 경험과 지원 요구를 면담과 질적 분석을 통해 심층적으로 탐색한 연구로 구성되었다. 자폐성장애를 단일 대상으로 한 연구는 근거통합 연구 5편, 탐색적 질적연구 2편, 관찰 기반 양적연구 1편으로 이루어졌으며, 근거통합 연구에서는 자폐성장애를 대상으로 한 식행동 및 섭식 관련 연구를 종합적으로 분석한 문헌고찰 연구가 포함되었다. 탐색적 질적연구에서는 자폐성장애 아동을 대상으로 한 식행동 지도 경험을 중심으로, 감각 민감성, 섭식거부, 특이한 식사 패턴으로 인한 지도상의 어려움과 함께 교사•전문의 간 협력 및 맞춤형 지원의 필요성이 공통적으로 제시되었다[24, 39]. 관찰 기반 양적연구에서는 자폐아동의 연령에 따른 식행동, 음식 기호도 및 영양교육 요구도를 분석한 결과, 연령이 증가할수록 체질량지수와 과체중•비만 비율이 높아지고, 11–19세 아동이 10세 이하 아동보다 대부분의 식품군에서 기호도가 높게 나타났다는 점이 보고되었다[31]. 지적장애인을 대상으로 한 연구는 모두 2편으로, 두 연구 모두 개입 기반 실험연구에 해당하였으며, 한 연구에서는 운동 및 영양교육 프로그램을 적용 후 지적장애인의 체력과 신체 계측 변화를 분석한 결과, 신체계측에서는 유의한 변화가 없었으나 체력 중 유연성(P < 0.001), 근력(P = 0.045), 순발력(P = 0.013)에서 유의한 향상이 나타났고, 식습관 총점은 73.0점에서 76.1점으로 증가(P = 0.038)하였다[36]. 다른 연구에서는 실제 식사 상황을 기반으로 한 VR 음악치료 중재를 적용한 결과, 지적장애인의 식사태도 목표행동 수행이 중재 및 유지 단계까지 지속적으로 향상되는 효과가 보고되었다[37]. 혼합대상 연구는 총 4편으로, 관찰 기반 양적연구 3편과 탐색적 질적연구 1편으로 구성되었다. 관찰 기반 양적연구에서는 지적장애인과 자폐 청소년의 식행동 및 식습관, 식이섭취 실태, 장애유형 간 산과적 합병증 및 임상 특성 비교, 성인 지적장애인의 영양소 및 카로티노이드 섭취수준과 식습관 분석 등이 포함되었다[22, 32]. 이러한 연구는 장애유형 간 생리적•행동적 차이를 규명하였으며, 특히 지적장애인의 미량영양소 섭취 부족과 ASD인의 산과적 합병증 위험 증가를 보고하였다. 탐색적 질적연구에서는 발달장애 학생의 건강관리 및 교육에 대한 특수교사와 부모의 경험과 지원 요구를 탐색하였고, 코로나19 이후 위생•영양•정신건강 문제가 주요 쟁점으로 부각되면서 교사•부모 모두 학교–가정 연계형 건강 자기옹호 프로그램 구축과 맞춤형 교육자료•지원체계 마련의 필요성 요구가 보고되었다[25].
4. 주제별 연구 동향
발달장애인의 식생활 및 영양교육 관련 국내 연구는 네 가지 주제 범주로 분류되었으며, 해당 범주는 ‘식생활 실태 및 영양실태 조사 연구’, ‘영양, 식생활 교육 및 중재 연구’, ‘신체활동, 건강증진 관련 연구’, ‘의학, 보건, 임상관련연구’로 구성되었고, 이러한 분류 기준은 Table 6에 제시하였다. 각 연구주제별 연구분포 및 주요 내용은 Table 7에 정리하였다. ‘식생활 실태 및 영양실태 조사 연구’는 총 14편으로 관찰 기반 양적연구 9편과 근거통합연구 3편, 탐색적 질적연구 2편으로 구성되었다. 이 주제군은 발달장애인의 식습관, 식품섭취빈도, 영양섭취 수준, 건강행태 및 체중상태를 중심으로 실태를 파악하거나, 보호자•전문가의 인식과 경험을 탐색한 연구로 구성되었다. 관찰 기반 양적연구에서는 발달장애 청소년 및 성인을 대상으로 식행동과 식습관, 비만정도, 영양소 섭취수준, 건강행태의 차이를 분석하였으며, 국내 지적장애인과 자폐 청소년을 대상으로 한 식행동 및 식이섭취 실태조사에서는 채소와 유제품 섭취 부족, 미량영양소 섭취 부족이 공통적으로 보고되었다[22]. 또한 발달장애 성인의 생애주기 및 성별에 따른 건강행태를 분석한 연구에서는 노년기 발달장애인 여성에서 과체중이 관찰되었다[42]. 근거통합 연구로는 ASD 아동의 식행동 및 영양섭취 특성을 종합적으로 고찰한 문헌연구와 발달장애인의 식행동 및 영양섭취 관련 국내 연구동향을 분석한 문헌고찰 연구가 포함되어 개별 실태연구 결과를 종합적 관점에서 정리하였다[21, 43]. 탐색적 질적연구에서는 자폐성장애 자녀를 둔 어머니 면담을 통해 명확한 음식 선호와 특정 식행동, 식생활이 가족과 외식에 미치는 영향, 식생활 개선을 위한 환경 조성 노력, 그리고 정보 제공과 식생활 지도에 대한 지원 요구가 주요 주제로 도출되었고[39], ASD 학생의 식행동을 지도한 특수교사•영양교사•의료전문의 면담 연구에서는 감각민감성과 섭식거부, 특이한 식사행동으로 인해 지도에 어려움이 크며, 직종 간 협력과 맞춤형 지원체계가 필요하다고 보고하였다[24]. ‘영양, 식생활 교육 및 중재 연구’는 총 10편으로 개입 기반 실험연구 4편과 근거통합 연구 4편, 탐색적 질적연구 2편으로 구성되었다. 이 주제군은 발달장애인의 식생활 교육, 건강증진, 행동 변화 촉진을 위한 중재 및 프로그램 개발 연구로 구성되었다. 개입 기반 실험연구는 주로 학교•가정•시설 기반에서 이루어졌으며, 교육 프로그램, 운동•명상 등 다양한 접근을 통해 건강관리행동, 자기결정성, 식습관 개선 효과를 검증하였다. 발달장애 청년 대상 건강관리 교육 프로그램에서는 건강지식 향상이 보고되었으며[44], 학교–가정 연계형 건강 자기옹호 프로그램에서는 자기결정성 향상이 확인되었다[25]. 근거통합 연구로는 자폐성장애 학생의 식습관 개선 프로그램을 다룬 체계적 고찰과 섭식중재를 주제로 한 문헌고찰 연구들이 포함되어, 식생활 및 섭식행동 중재의 효과와 적용 가능성에 대한 근거를 종합적으로 제시하였다[29, 45-47]. 탐색적 질적연구는 교육 프로그램 운영 경험을 탐색하는 데 초점을 두었으며, 장애인 사회복지시설의 영양교육 프로그램 운영 모델을 분석한 연구에서는 현장 중심의 프로그램 설계와 실무자 교육 체계와 관련된 요구가 제시되었다[41]. ‘신체활동, 건강증진 관련 연구’는 총 5편으로, 개입 기반 실험연구 3편과 근거통합 연구 2편으로 구성되었다. 이 주제군은 운동, VR, 음악치료 등 신체활동 중심의 중재를 통해 발달장애인의 체력•건강행동•식사행동 변화를 검증한 연구들로 이루어져 있다. 개입 기반 실험연구에서는 지적장애인을 대상으로 한 운동 및 영양교육 프로그램을 적용한 결과, 유연성(P < 0.001), 근력(P = 0.045), 순발력(P = 0.013) 등 신체적 체력 지표를 유의하게 향상시켰고, 식습관 점수 또한 73.0점에서 76.1점으로 개선되었으며[36], VR을 활용한 음악치료 프로그램에서는 지적장애인의 식사행동 수정과 식습관 개선 효과가 보고되었다[37]. 비디오게임 기반 VR 운동 프로그램은 발달장애 성인을 대상으로 체력, 평형성, 근육량, 유연성의 유의한 향상을 보여주었다[26]. 근거통합 연구에서는 운동 중재와 발달장애인의 건강 및 신체활동 관련 연구를 종합적으로 분석하여 신체활동 기반 중재의 효과와 적용 가능성에 대한 근거를 제시하였다[48]. ‘의학, 보건, 임상관련연구’는 총 7편으로 근거통합 연구 4편, 개입 기반 실험연구 1편, 관찰 기반 양적연구 1편, 탐색적 질적연구 1편으로 구성되었다. 해당연구들은 발달장애인의 생리적 특성, 임상적 건강문제 및 의료서비스 접근 경험과 관련된 주제를 다루었다. 근거통합 연구로는 발달장애와 장내미생물의 관계를 주제로 한 문헌고찰 연구[35]와 발달장애인의 보건의료서비스 연구동향을 종합적으로 정리한 주제범위 문헌고찰이 포함되어 의료 접근성, 서비스 이용 경험 및 제도적 개선 필요성을 제시하였다[28]. 개입 기반 실험연구에서는 삼킴장애를 가진 발달장애 아동을 대상으로 한 ABA 기반 중재가 수행되어 음식 거부 행동이 감소하고 섭식시간 단축 및 섭취량 증가가 보고되었으며[33], 관찰 기반 양적연구에서는 ASD와 지적장애 간 산과적 합병증 및 임상적 특성 차이가 분석되어 ASD 아동에서 남아 비율이 높고(P < 0.01), 산후기 의학적 문제는 적으며(P < 0.01), 언어발달지수는 낮고 운동발달지수는 높게 나타났다[32]. 탐색적 질적연구에서는 발달장애인 당사자와 보호자를 대상으로 한 인터뷰를 통해 의료서비스 이용 과정에서의 의사표현 어려움과 자기결정의 제약, 그리고 의료서비스 개선에 대한 지원 요구가 주요 주제로 도출되었다[23].
5. 출판 시기별 연구 동향
연도별 연구유형의 분포는 Table 8에 제시하였다. 2015년부터 2023년까지는 관찰 기반 양적연구, 개입 기반 실험연구 및 탐색적 질적연구가 비교적 고르게 분포하였으며, 개별 식행동 및 영양섭취 실태를 분석한 연구나 단기 중재 프로그램을 중심으로 수행되었다. 반면 2024년 이후에는 근거통합 연구의 비중이 증가하여, 체계적 문헌고찰과 주제범위 문헌고찰을 중심으로 연구 결과를 종합•정리한 연구가 다수 발표되었다.
본 고찰은 주제범위 문헌고찰로서 국내 발달장애인의 식생활 및 영양교육 관련 연구 동향을 연구유형, 연구대상, 장애유형 및 연구주제별로 분류•정리하고, 각 연구 영역에서 나타난 연구 분포와 특성을 제시하는 데 목적이 있다. 이를 통해 향후 연구 설계와 현장 적용을 위한 과제를 도출하고자 하였다.
최근 10년간 발달장애인의 식생활 관련 연구는 관찰 기반 양적연구를 중심으로 한 실태 파악에서 출발하여, 개입 기반 실험연구, 탐색적 질적연구, 그리고 근거통합 연구가 병행되는 방향으로 점차 확장되어 왔다. 관찰 기반 양적연구는 발달장애인의 식습관과 영양섭취 문제를 체계적으로 파악하는 기초자료로 기능하였으며, 탐색적 질적연구는 식생활 관리 과정에서의 환경적•제도적 요인과 실제적 어려움을 드러내는 데 기여하였다.
개입 기반 실험연구는 영양교육, 운동 및 행동중재를 중심으로 수행되어 식습관 개선과 건강행동 변화의 가능성을 제시하였으나, 다수의 연구가 소규모 표본과 단기 중재 설계로 수행되어 중재 효과의 지속성을 검증한 연구는 제한적이었다. 한편 근거통합 연구는 개별 연구의 단편적 결과를 종합하여 연구 흐름과 공백을 체계적으로 정리하고, 향후 연구 방향 설정과 정책적•실무적 논의를 위한 근거를 제시하였다. 전반적으로 연구유형의 다양화와 함께 연구대상과 접근방법의 확장이 이루어졌으나, 중재 효과의 장기적 유지와 생애주기별 적용 가능성을 검증하는 연구는 여전히 부족한 실정이다.
연구대상별로 살펴보면, 국내 발달장애인의 식생활 관련 연구는 단순한 식습관이나 영양섭취 실태 분석을 넘어, 섭식장애, 감각민감성, 삼킴장애, 산과적 합병증 등 임상적 문제를 포괄하는 다층적 접근으로 확장되고 있다. 그러나 아동•청소년기 발달장애인을 대상으로 한 연구는 관찰 기반 양적연구와 이론적 고찰이 주를 이루었으며, 실제 현장 적용을 검증한 개입 기반 실험연구는 상대적으로 낮았다. 이러한 연구 분포를 고려할 때, 학교–가정 연계형 중재를 기반으로 감각 특성, 정서 요인, 자기결정성을 통합한 맞춤형 식생활 교육 프로그램의 개발과 효과 검증이 향후 연구 과제로 제시된다. 반면 발달장애 성인 대상 연구는 실태 중심 연구에서 벗어나 행동 변화와 자기관리 능력 향상을 검증하는 개입 기반 실험연구가 비교적 활발하게 수행되고 있었으며, 운동•영양교육을 통합한 다학제적 접근이 주요 특징으로 나타났다. 다만 장기추적 기반의 맞춤형 중재모델과 생활환경•심리요인을 반영한 지속가능한 건강관리체계를 다룬 연구는 제한적인 수준에 머물러 있었다. 한편 전문가•교사 대상 연구는 현장 실무자의 경험을 중심으로 식생활 교육이 직면한 현실적 제약과 개선 요구를 구체적으로 제시하였으며, 이는 향후 발달장애인의 식생활 교육이 단순한 영양정보 전달을 넘어, 실무자 전문성 강화와 다직종 협력체계를 기반으로 설계될 필요성이 제기되었다.
발달장애(통합) 대상 연구는 영양•행동•가족•임상•서비스를 포괄하는 다층적 구조로 구성되어 있으며, 생애주기별•생활환경별 요인을 함께 고려한 연구들이 다수 포함되어 있었다. 자폐성장애 대상 연구는 감각민감성 기반 섭식문제를 중심으로 수행되었으며, 섭식행동이 감각적•행동적 요인에 의해 복합적으로 영향을 받는 특성이 보고되었다. 또한 부모–교사–전문가 연계형 행동중재와 맞춤형 영양교육의 결합이 효과적인 접근으로 제시되고 있었다. 한편 지적장애 및 혼합대상 연구는 아직 소수에 그치나, 신체활동과 감각•정서 요인을 결합한 융합적 중재와 장애유형 간 비교 분석을 통해 발달장애인의 건강관리 문제를 통합적으로 다룬 초기 단계 연구로 분류할 수 있다.
식생활 및 영양실태 연구는 발달장애인의 식습관 문제를 기초적으로 규명함과 동시에 사회•심리적 맥락을 함께 제시해왔으나, 대부분 단면연구에 머물러 인과관계 및 장기 변화 분석에는 한계가 있다. 이에 따라 향후에서는 표준화된 영양평가 도구 개발, 생애주기별 실태 모형화, 보호자•전문가를 포함한 다층적 분석을 결합한 통합 연구로의 발전이 요구된다. 한편, 의학•보건•임상 연구는 삼킴장애, 장내미생물, 의료서비스 접근성 등 생리•의학적 특성을 중심으로 수행되었으며, 일부 연구에서는 장–뇌 축(gut–brain axis) 이론에 근거하여 발달장애인의 식이, 면역, 행동 간 상호작용을 설명하고자 하였다. 이러한 연구들은 향후 생리적 요인과 행동•심리적 요인을 함께 고려한 다학제적 임상 접근의 가능성을 제시하고 있었다. 아울러 근거통합 연구는 각 주제 영역에서 개별 연구 결과를 종합•정리함으로써 연구 흐름과 공백을 체계적으로 제시하는 역할을 수행하였다. 식생활 및 영양실태 영역에서는 발달장애 아동•청소년의 섭식 문제 특성과 식습관 형성 요인을 반복적으로 정리하였으며[29, 30], 자폐성장애를 대상으로 한 연구에서는 ABA 기반 접근과 행동중재 전략이 주요 연구 주제로 제시되고 있다[45-47]. 또한 발달장애 성인을 대상으로 한 근거통합 연구에서는 영양교육, 신체활동, 의료정보 제공, 심리•정서적 지원을 포함한 다요인적 건강증진 프로그램이 중심적으로 검토되고 있다[19, 27]. 이와 함께 보건의료서비스 및 임상 영역의 리뷰연구에서는 장내미생물, 삼킴장애 등 생리적 요인과 의료 접근성, 의사소통 지원 문제를 함께 다루는 경향이 나타나고 있다[23, 28, 35].
2015년부터 2023년까지는 실태연구, 중재연구, 질적연구 및 리뷰연구가 비교적 고르게 분포하며, 개별 식행동과 영양섭취 실태를 파악하거나 단기 중재 효과를 검증하는 연구가 중심을 이루었다. 반면 2024년 이후에는 체계적 문헌고찰과 주제범위 문헌고찰 등 근거통합 연구의 비중이 증가하면서, 개별 사례 분석을 넘어 발달장애인의 건강, 영양 및 행동 전반을 통합적으로 조망하는 연구로 확장되는 양상을 보였다.
국내 발달장애인의 식생활 및 영양지원은 주로 특수학교와 복지시설 등 시설 기반 환경을 중심으로 이루어지고 있으며, 이로 인해 지역사회 및 재가 환경에서 생활하는 발달장애인을 포괄하는 체계적인 영양지원 서비스는 상대적으로 제한적으로 운영되고 있다. 또한 영양•식생활 교육은 단기적 프로그램이나 개인 대상 중재 중심으로 운영되어, 생애주기 전반을 고려한 지속적인 관리 체계로 확장되기에는 한계가 있는 것으로 나타났다.
반면 해외에서는 발달장애인의 식생활 및 영양지원을 공공 건강관리와 장애 서비스의 필수 구성요소로 인식하고 있다. 미국 영양 및 식단 학회(Academy of Nutrition and Dietetics)는 지적 및 발달 장애성인과 특별 건강 관리 요구가 있는 아동•청소년 발달장애인에게 영양사의 전문적 개입이 필수적임을 공식 입장문을 통해 명시하였다[56]. 이러한 접근은 탈시설화 이후 지역사회 기반 서비스로의 전환과 함께, 다학제적 건강관리 체계 내에서 영양서비스의 역할을 제도적으로 강화하는 방향으로 이어지고 있다. 해외의 체계적 문헌고찰에 따르면, 기존 영양 및 건강증진 중재는 개인 대상 교육에 편중되어 있으며, 물리적 환경이나 정책 수준의 개입은 제한적인 것으로 보고되었다[57]. 또한 발달장애 성인을 대상으로 한 중재 연구는 소규모•단기•비무작위 설계가 많아 장기적 효과와 정책적 확장 가능성을 검증하기에는 근거가 충분하지 않다는 한계가 지적되었다[58]. 그럼에도 불구하고 이들 연구는 개인 단위 중재를 넘어 공중보건 정책 및 기관 차원의 구조적 개입이 필요함을 공통적으로 제안하고 있다.
이러한 해외 연구 및 정책 동향과 비교할 때, 국내 발달장애인의 식생활•영양지원은 여전히 시설 중심 및 개인 단위 개입에 머무르는 경향이 강하다. 특히 현재 사회복지급식관리지원센터의 관리 대상은 주로 집단급식소를 운영하는 장애인 이용 시설에 한정되어 있어, 기관에 소속되지 않은 재가 발달장애인과 그 가족을 대상으로 한 식생활 및 영양관리 지원은 제도적으로 충분히 포함되지 못하고 있다. 이는 사회복지급식관리지원센터의 역할이 시설 관리 중심에서 나아가, 지역사회 내 재가 발달장애인과 보호자를 포괄하는 영양상담, 식생활 교육, 식사 지원 연계 기능으로 확장될 필요성을 시사한다. 따라서 향후 국내 연구는 개인 대상 중재 효과 검증을 넘어, 지역사회 및 재가 발달장애인을 포괄하는 영양지원 모델의 구조적 설계와 정책적 실행 가능성을 함께 검토하는 방향으로 확장되어야 한다. 나아가 발달장애인의 식생활 및 영양관리를 공공 서비스 영역으로 명확히 위치시키고, 다직종 협력체계를 기반으로 한 지속가능한 지원체계 구축이 요구된다.
Limitations
국내 발달장애인의 식생활 및 영양교육 관련 연구는 지난 10년간 양적•질적 성장을 이루었으나, 여전히 연구대상, 연구설계, 교육•지원체계의 미비 등 여러 측면에서 구조적인 한계를 지닌다. 이에 선행연구의 경향을 토대로 주요 문제점을 도출하고, 향후 연구 및 정책적 발전 방향을 제시하고자 한다.
대부분의 연구가 특수학교 재학생, 복지시설 이용자, 성인 소규모 집단을 중심으로 수행되어 발달장애인 전체 인구의 특성을 반영하지 못한다. 특히 노년층을 대상으로 한 연구는 극히 제한적이며, 실태조사 또한 지역적 편중이 심해 대도시 중심으로 이루어져 있다. 또한 보호자•전문가•의료인 등 다층적 참여자 간의 상호작용을 통합적으로 분석한 연구는 매우 드물다. 따라서 향후 연구에서는 대규모 표본과 전국 단위 데이터를 활용하고, 장애유형•연령•성별을 세분화하여 분석하는 접근이 필요하다.
기존 연구의 상당수는 단면조사(cross-sectional) 중심으로 이루어져, 장기적인 효과나 지속가능성을 검증하지 못했다. 특히 영양교육•운동•행동중재 연구는 중재 직후의 성취에 초점을 맞추어, 이후의 행동 유지나 자기결정성 변화, 재발 예방 등의 과정을 충분히 추적하지 못했다. 향후에는 장기추적(longitudinal) 연구와 혼합방법(mixed-methods) 접근을 도입하여, 양적 결과뿐 아니라 정서•환경적 요인까지 통합적으로 분석할 필요가 있다.
많은 프로그램 개발 연구가 높은 만족도와 교육 효과를 보고하였으나, 대부분 일회성 또는 단기적 연구 프로젝트로 그쳐 실제 현장 적용이 제한적이었다. 학교•가정•복지시설 간의 협력체계가 미비하여 교육 프로그램이 지속되거나 제도화되지 못하는 사례가 많았으며, 영양사•특수교사•보호자 등 교육자 대상의 역량 강화 연구도 부족하다. 이러한 한계는 프로그램의 실행력과 전문성 확보를 어렵게 하며, 중재의 지속가능성을 저해한다. 향후에는 ‘현장–연구–정책’을 연계하는 실천기반 연구(practice-based research)를 활성화하고, 교육자 훈련체계 및 표준화된 매뉴얼 개발이 병행되어야 한다.
정책•서비스 연구는 건강권 보장, 의료접근성, 사회참여를 논의하고 있으나, 아직 영양•식생활 중심의 국가정책이나 제도적 지원체계는 부재한 실정이다. 발달장애인은 여전히 정기 건강검진 미수검, 영양상담 서비스 미흡, 식사지원 인력 및 교육자료 부족 등의 문제를 겪고 있다. 특히 가족의 돌봄 부담이 장기적으로 누적되며, 성인기 이후의 건강관리 공백이 심각하다. 따라서 향후 연구는 단순한 프로그램 효과 검증을 넘어 정책•법제화 연구, 지역사회 기반 영양관리모델 구축으로 확장되어야 한다.
Conclusion
본 연구는 최근 10년간 국내 발달장애인의 식생활 및 영양교육 관련 연구 동향을 연구유형, 연구대상, 장애유형, 연구주제 및 연구시기별로 종합적으로 고찰함으로써, 연구의 흐름과 한계를 체계적으로 정리하고 향후 연구 및 실천 방향에 대한 시사점을 도출하고자 하였다. 분석 결과, 국내 연구는 실태조사와 단기 중재 중심에서 점차 질적연구, 통합•리뷰 연구 등으로 확장되고 있으나, 여전히 장기적 효과 검증과 생애주기별 연계, 지역사회 기반 적용에는 한계가 존재하는 것으로 나타났다.
향후 연구에서는 대규모•전국 단위 자료를 활용하여 연령, 성별, 장애유형별 특성을 보다 정밀하게 분석하고, 시설 이용 여부와 관계없이 학교–가정–지역사회를 포괄하는 대표성 있는 데이터 구축이 필요하다. 또한 단면 연구에 머무르기보다 종단적 연구와 혼합방법 연구를 통해 영양교육 및 중재 효과의 지속성과 생애주기 전반에 미치는 영향을 검증할 필요가 있다. 아울러 실천기반연구를 활성화하여 영양사, 교사, 보호자, 지원인력의 전문역량 강화를 도모하고, 표준화된 교육 및 중재 체계 개발이 병행되어야 할 것이다.
특히 해외에서는 발달장애인의 식생활 및 영양지원을 개인의 선택이나 단기 프로그램이 아닌, 지역사회 기반의 공공 서비스로 제도화하려는 정책적 논의가 지속되고 있는 반면, 국내는 여전히 시설 중심의 지원체계에 머무르는 경향이 강하다. 이에 향후 국내 정책은 해외 사례를 참고하여, 시설 소속 여부와 무관하게 모든 발달장애인을 포괄하는 지역사회 기반 영양지원 모델로 전환될 필요가 있다. 이는 사회복지급식관리지원센터를 포함한 기존 제도의 역할을 재정립하고, 발달장애인의 건강권 보장과 삶의 질 향상을 위한 공공 영양서비스 체계를 강화하는 방향으로 이어져야 할 것이다.
결론적으로, 국내 발달장애인의 식생활 및 영양교육 관련 연구는 개인 중심의 실태조사와 단기 중재를 넘어, 연구–실천–정책이 연계된 통합적 지원모델로 전환되어야 하며, 이는 발달장애인의 지속가능한 건강관리와 사회적 참여를 촉진하기 위한 핵심 과제로 제시된다.

CONFLICT OF INTEREST

The authors declare no financial or other issues that might lead to conflict of interest.

FUNDING

This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2025S1A5A2A03016997).

DATA AVAILABILITY

Data sharing is not applicable to this article as no new data were created or analyzed in this study.

Fig. 1.
Flow diagram of the literature selection process (adapted from the Joanna Briggs Institute scoping review methodology).
kjcn-2025-00374f1.jpg
Table 1.
Literature search strategy and keyword combinations
Category Content
Databases RISS, KISS, DBpia
Search period January 2015–September 2025
Population-related keywords developmental disabilities, intellectual disability, autism spectrum disorder
Diet and nutrition-related keywords dietary habits, nutrition, nutritional status, diet, dietary patterns, intake, eating behavior, food preference, obesity, chronic diseases, weight management, health promotion
Nutrition education and intervention-related keywords nutrition education programs, nutrition intervention, caregiver perception
Search strategy Population-related keywords were combined with diet and nutrition or nutrition education and intervention-related keywords using the AND operator
Example search formula (developmental disabilities OR intellectual disability OR autism spectrum disorder) AND (dietary habits OR nutritional status OR dietary patterns OR health promotion)
Table 2.
Characteristics of included studies
Study ID Reference Population Disability type Study design Main topic Key findings
S1 Kim et al. [19] (2025) Adults with developmental disabilities Developmental disabilities (overall) Evidence synthesis studies (systematic review) Physical activity and health promotion Included studies primarily targeted adults with mild to moderate intellectual disabilities and most frequently used single-group pre–post designs. Interventions reported overall positive changes in anthropometric measures, physical fitness, physical activity levels, dietary behaviors, health knowledge, self-efficacy, and quality of life. Few studies assessed maintenance/generalization, intervention fidelity, or social validity. Programs mainly focused on nutrition education, physical activity information, and exercise participation, frequently using visual supports and reinforcement strategies
S2 Kim [21] (2024) Mixed (overlapping) Developmental disabilities (overall) Evidence synthesis studies (systematic review) Dietary habits and nutritional status Domestic studies have increased since 2012, with most employing literature reviews or survey designs. Qualitative and intervention studies were relatively scarce, and study populations were concentrated on children and individuals with multiple disabilities. Common dietary behavior issues included food selectivity, texture sensitivity, fear of new foods, pica, and atypical eating patterns
S3 Ahn et al. [22] (2015) Adults with developmental disabilities Mixed disability groups Observational quantitative studies (cross-sectional survey) Dietary habits and nutritional status Mean BMI indicated overweight in the intellectual disability group and obesity in the mental disability group. Intake frequencies of vegetables and dairy products were generally low. Both groups showed vitamin B1, B2, and calcium intakes below recommended levels. Carotenoid intake, particularly lycopene, was lower than that of the general population, and cryptoxanthin intake was also low in the mental disability group
S4 Lee et al. [23] (2018) Mixed (overlapping) Developmental disabilities (overall) Exploratory qualitative studies (in-depth interviews and focus groups; constant comparative analysis) Medical, health and clinical topics Key findings included difficulties in expressing and recognizing illness and symptoms, practical challenges in health management, barriers in access and communication during medical encounters, and limited self-determination in healthcare. Individuals with developmental disabilities experienced restricted access to information and decision-making due to communication difficulties and reliance on caregivers, with lack of disability awareness, inadequate facilities, and financial burden identified as major barriers
S5 Kim et al. [24] (2021) Professionals and teachers Autism spectrum disorder Exploratory qualitative studies (in-depth interviews and focus groups; constant comparative analysis) Dietary habits and nutritional status Major themes included types of eating behaviors, eating-related problems, influencing factors (individual, environmental, medical), coping and instructional strategies, instructional difficulties, and support needs. Common eating behavior problems among students with ASD included food selectivity, texture sensitivity, food refusal, and pica, with gastrointestinal symptoms, sensory and behavioral characteristics, and home–school environments interacting to influence eating behaviors
S6 Lee et al. [25] (2022) Children and adolescents with developmental disabilities Developmental disabilities (overall) Intervention-based experimental studies (single-group pre–post) Nutrition and dietary education or interventions Following the health education intervention, students’ health knowledge and health-promoting behavior scores significantly increased compared with baseline. Ninety-three percent of participants achieved health management goals at or above the expected level. Self-determination significantly increased in student self-ratings, whereas no significant changes were observed in parent or teacher ratings
S7 Kang & Lee [26] (2015) Adults with developmental disabilities Developmental disabilities (overall) Intervention-based experimental studies (randomized controlled pre–post design) Physical activity and health promotion Muscle mass increased most in the APA + Wii group, whereas body fat mass decreased most in the APA group. Muscular endurance, strength, flexibility, and cardiorespiratory fitness improved more in groups including APA than in the Wii-only group, while balance improved most in the Wii group. Step counts and caloric expenditure increased in all intervention groups compared with controls
S8 Lee & Kim [27] (2024) Parents and caregivers Developmental disabilities (overall) Evidence synthesis studies (systematic review) Medical, health and clinical topics Depression intervention programs for families of individuals with developmental disabilities showed overall significant reductions in depressive symptoms. Most programs were short-term (fewer than 10 sessions) group-based interventions, with reported effect sizes in the moderate to large range
S9 Shin et al. [28] (2024) Mixed (overlapping) Developmental disabilities (overall) Evidence synthesis studies (scoping review) Medical, health and clinical topics Regular health checkups were identified as the most highly needed healthcare service. Across the life course, early diagnosis and early intervention were prioritized in infancy, whereas prevention of early aging and medical support were emphasized in middle and older adulthood. Individuals with developmental disabilities exhibited higher prevalence of chronic diseases, increased risk of premature mortality, and lower access to healthcare services, indicating substantial health vulnerability
S10 Kim & Song [29] (2018) Children and adolescents with developmental disabilities Autism spectrum disorder Evidence synthesis studies (meta-analysis) Nutrition and dietary education or interventions The overall intervention effect size was Tau-U = 0.876, indicating moderate to high effectiveness. Larger effects were observed at younger ages and during follow-up phases compared with intervention phases. Multicomponent interventions were more effective than single-technique approaches, with the greatest effects reported for interventions lasting less than 20 sessions and approximately 2 months (5–8 weeks)
S11 Min & Kim [30] (2024) Children and adolescents with developmental disabilities Autism spectrum disorder Evidence synthesis studies (narrative review) Dietary habits and nutritional status Feeding disorders in children with ASD were reported to be highly diverse, highlighting the need for comprehensive assessment. Available assessment tools were limited, and the inclusion of additional domains such as oral-motor and digestive function was recommended
S12 Park et al. [31] (2020) Mixed (overlapping) Autism spectrum disorder Observational quantitative studies (cross-sectional survey) Dietary habits and nutritional status BMI distribution differed by age, with higher rates of underweight among children aged ≤ 10 years and higher rates of overweight and obesity among adolescents aged 11–19 years. Most participants consumed snacks at least once daily. Food preferences differed across age groups for grains, vegetables, fruits, dairy products, fats, and sugars. Parents reported high needs and willingness to participate in nutrition education
S13 Lee et al. [32] (2016) Children and adolescents with developmental disabilities Autism spectrum disorder Observational quantitative studies (retrospective medical record review) Medical, health and clinical topics At the first visit, children with ASD had a higher proportion of males, fewer obstetric complications, and lower receptive and expressive language scores than children with intellectual disabilities. Children whose diagnosis changed from intellectual disability to ASD were all male, had more frequent family histories of developmental delay, and showed significantly lower initial receptive language scores. Sex, language characteristics, and obstetric information were associated with early ASD identification
S14 Jeon & Cho [33] (2018) Children and adolescents with developmental disabilities Developmental disabilities (overall) Intervention-based experimental studies (single-case design) Medical, health and clinical topics After intervention, meal intake increased to approximately 700–800 g, with reductions in frequent small meals and shorter mealtime duration. Feeding patterns shifted from predominantly formula-based intake (≥ 80%) to mixed feeding after one week and to 100% solid food intake after two weeks. Applied behavior analysis intervention was associated with reductions in food refusal behaviors
S15 Kim [34] (2022) Adults with developmental disabilities Developmental disabilities (overall) Observational quantitative studies (cross-sectional survey with mediated regression analysis) Dietary habits and nutritional status Higher levels of perceived obesity were associated with poorer dietary habits and lower life satisfaction. Regular meals and balanced nutrition were positively correlated with both dietary habit scores and life satisfaction. Dietary habits showed a significant mediating effect in the relationship between perceived obesity and life satisfaction
S16 Oh & Hong [35] (2025) Adults with developmental disabilities Developmental disabilities (overall) Evidence synthesis studies (narrative review) Medical, health and clinical topics Individuals with developmental disabilities showed reduced gut microbiota diversity, increased harmful bacteria, and decreased beneficial bacteria, which were associated with neurotransmitter dysregulation, immune and inflammatory responses, and metabolic imbalance. Dietary modification, probiotic supplementation, and physical activity interventions were reported to improve gut microbiota balance and related metabolic pathways
S17 Kim [36] (2018) Adults with developmental disabilities Intellectual disability Evidence synthesis studies (single-group pre–post) Physical activity and health promotion After 16 weeks of intervention, no significant changes were observed in body composition indicators (BMI, body fat percentage). However, flexibility, muscular strength, and power significantly improved. Dietary habit scores increased, with higher intake frequencies of protein, green-yellow vegetables, and seaweed, and reduced intake of salty foods, sweets, and late-night snacks
S18 Choi & Kang [37] (2019) Adults with developmental disabilities Intellectual disability Intervention-based experimental studies (multiple-baseline single-subject design) Physical activity and health promotion All participants showed increased numbers of appropriate eating behaviors during intervention and maintenance phases compared with baseline. Mean performance increased from 3.2 of 13 behaviors at baseline to 7 during intervention and 11 during maintenance. VR-based social story music therapy was associated with improvements in eating behavior performance and social skill acquisition
S19 Kang & Kim [38] (2020) Parents and caregivers Developmental disabilities (overall) Observational quantitative studies (cross-sectional survey with hierarchical multiple regression) Dietary habits and nutritional status Poorer health status and higher levels of challenging behaviors in adults with developmental disabilities were significantly associated with increased caregiver burden. Health status and challenging behaviors were identified as significant predictors of caregiver burden
S20 Kim et al. [39] (2020) Parents and caregivers Autism spectrum disorder Exploratory qualitative studies (thematic analysis of in-depth interviews) Dietary habits and nutritional status Mothers’ experiences were categorized into themes related to children’s eating characteristics (clear food preferences, atypical eating behaviors, influence of past experiences), family interactions, efforts to improve dietary behaviors, and support needs. Children’s eating behavior problems imposed burdens on family meals, dining out, and mealtime atmosphere, with coping strategies involving environmental modification, consistent guidance, and program participation
S21 Kim [40] (2016) Parents and caregivers Developmental disabilities (overall) Intervention-based experimental studies (non-equivalent control group pre–post–follow-up design) Nutrition and dietary education or interventions Compared with the control group, the intervention group showed significantly greater improvements in children’s health management behaviors over time. Parenting stress scores in the intervention group significantly decreased at post-test and follow-up, with larger reductions than those observed in the control group
S22 Kim & Jeon [41] (2024) Professionals and teachers Developmental disabilities (overall) Exploratory qualitative studies (one-on-one in-depth interviews) Nutrition and dietary education or interventions The most frequently requested nutrition education topics were diet education for obesity prevention and management and basic nutrition knowledge. Education at kindergarten to lower elementary school level was considered appropriate given cognitive functioning. Activity-based, face-to-face education using real foods, cooking activities, and visual materials, delivered in sessions of approximately 30 minutes, was perceived as effective
S23 Ham & Sohn [42] (2023) Mixed (overlapping) Developmental disabilities (overall) Observational quantitative studies (secondary data analysis with two-way ANOVA) Dietary habits and nutritional status Smoking, alcohol consumption, and stress showed significant main effects across both life stage and sex. Overweight showed a significant main effect by life stage, whereas sexual health issues differed by sex. Significant interaction effects between life stage and sex were observed for all five health behaviors, with higher levels reported for specific subgroups such as adolescent males’ sexual health issues and older adults’ alcohol use or overweight
S24 Park et al. [43] (2019) Children and adolescents with developmental disabilities Autism spectrum disorder Evidence synthesis studies (narrative review) Dietary habits and nutritional status Many studies reported that children with ASD exhibited atypical eating behaviors such as food selectivity, binge eating, and pica compared with typically developing children. Data collection relied mainly on parent reports and observations. Associations between eating behaviors and individual characteristics were frequently reported, whereas evidence regarding family factors and nutritional intake or status was limited and inconsistent
S25 Choi & Lee [44] (2020) Adults with developmental disabilities Developmental disabilities (overall) Intervention-based experimental studies (single-group pre–post quasi-experimental design) Nutrition and dietary education or interventions Following the health management education program, participants showed significant increases in overall health knowledge and all subdomain scores. Total health-promoting behavior scores also increased significantly, although changes in specific subdomains were not statistically significant
S26 Cho & Park [45] (2025) Children and adolescents with developmental disabilities Autism spectrum disorder Evidence synthesis studies (systematic review) Nutrition and dietary education or interventions Common intervention techniques included high-probability request sequences, simultaneous or sequential presentation of preferred and non-preferred foods, peer modeling, and differential reinforcement. Most studies reported significant increases in food intake along with reductions in problem behaviors, although effect sizes and maintenance patterns varied by intervention setting
S27 Ha & Yoo [46] (2022) Children and adolescents with developmental disabilities Autism spectrum disorder Evidence synthesis studies (systematic review) Nutrition and dietary education or interventions Gradual, repetitive, and systematic food exposure interventions for children with ASD were associated with overall improvements in food intake, food variety, food acceptance, amount consumed, and food contact behaviors. Included studies summarized clinically applicable exposure strategies and assessment tools
S28 Hong & Hong [47] (2025) Mixed (overlapping) Developmental disabilities (overall) Evidence synthesis studies (systematic review) Nutrition and dietary education or interventions Most included studies focused on mental health–oriented programs for family caregivers. Interventions were associated with significant reductions in depression, anxiety, and stress, and improvements in quality of life and psychological well-being. Some studies also reported improvements in physical health behaviors such as exercise, self-care, and dietary behaviors
S29 Park et al. [48] (2023) Mixed (overlapping) Developmental disabilities (overall) Evidence synthesis studies (narrative review) Physical activity and health promotion Individuals with developmental disabilities demonstrated lower levels of physical activity and exercise participation than those without disabilities, along with poorer physical fitness and cardiovascular health indicators. Moderate-intensity aerobic and resistance exercise, as well as high-intensity interval training following prolonged aerobic exercise, were associated with improvements in fitness and arterial stiffness
S30 Kim et al. [49] (2015) Children and adolescents with developmental disabilities Mixed disability groups Observational quantitative studies (cross-sectional comparative study) Dietary habits and nutritional status Rates of overweight and obesity were higher in the ASD group (44%) than in the intellectual disability group (26%), and the use of appetite-stimulating medications was also more frequent in the ASD group. Functional eating difficulties such as opening beverage containers were more common in the intellectual disability group, whereas color-based food selectivity was more prevalent in the ASD group. Adolescents with intellectual disabilities consumed meat, seaweed, fats, and sugars more frequently and in larger amounts than those with ASD
S31 Lee et al. [50] (2021) Mixed (overlapping) Mixed disability groups Exploratory qualitative studies (focus groups and in-depth interviews; constant comparative analysis) Nutrition and dietary education or interventions Key themes included experiences with health problems and coping, practices of health management and education, support needs related to health management and education, and needs for school–home linked health self-advocacy programs. Teachers and parents perceived students with developmental disabilities as having physical and mental health problems, low health knowledge, and difficulties accessing healthcare services
S32 Lee et al. [51] (2021) Mixed (overlapping) Developmental disabilities (overall) Evidence synthesis studies (systematic review) Medical, health and clinical topics Research topics were categorized into health status and related factors, health education and dual diagnosis issues and support, and effectiveness of exercise-centered health promotion programs. Studies were most frequently conducted in 2014, with experimental designs predominating. Most studies targeted individuals with developmental disabilities, and intervention studies primarily focused on physical activity programs
S33 Cho [52] (2018) Adults with developmental disabilities Developmental disabilities (overall) Observational quantitative studies (cross-sectional SEM analysis) Dietary habits and nutritional status A greater number of health problems in adulthood was significantly associated with lower mental functioning and activities of daily living. Medical, community, and informal support services contributed to higher activity levels and social participation. Community services moderated the negative relationship between adult health problems and social participation
S34 Whang et al. [53] (2023) Children and adolescents with developmental disabilities Developmental disabilities (overall) Observational quantitative studies (cross-sectional comparative and logistic regression analysis) Dietary habits and nutritional status Infants from multicultural families were significantly more likely than those from Korean families to receive abnormal results on initial developmental screening and to be diagnosed with developmental disabilities. After controlling for sex, income, and residential area, multicultural family background (foreign-born mother) remained significantly associated with developmental disability risk
S35 Choi [54] (2025) Mixed (overlapping) Developmental disabilities (overall) Observational quantitative studies (cross-sectional SEM analysis) Dietary habits and nutritional status Family healthiness showed significant positive effects on both disability acceptance and life satisfaction. Disability acceptance was positively associated with life satisfaction and partially mediated the relationship between family healthiness and life satisfaction. Among control variables, age showed a negative association, whereas sex, disability type, education level, and presence of multiple disabilities were not significant
S36 Yang et al. [55] (2019) Mixed (overlapping) Developmental disabilities (overall) Intervention-based experimental studies (small-sample single-group program development and implementation) Nutrition and dietary education or interventions Participants demonstrated relatively high basic nutrition knowledge regarding major nutrient groups and healthy food choices. The intervention, using photo records and food models, was associated with enhanced ability to independently compose healthy meals. The program was implemented through a living-lab–based community network involving local residents, university students, and independent living support centers

BMI, body mass index; ASD, autism spectrum disorder; APA, adapted physical activity; VR, virtual reality; ANOVA, analysis of variance.

Table 3.
Distribution of study types (2015–2025)
Research type Number (n) Percentage (%) Key characteristics
Observational quantitative studies 10 27.8 Assessment of dietary habits, nutrient intake, obesity status, and nutritional imbalances based on cross-sectional or comparative data
Exploratory qualitative studies 5 13.9 In-depth exploration of dietary experiences, self-determination, and perceived support needs of individuals with developmental disabilities and caregivers
Intervention-based experimental studies 8 22.2 Education-, exercise-, and behavior-based short-term participatory programs evaluating changes in health behaviors and dietary outcomes
Evidence synthesis studies 13 36.1 Systematic reviews, scoping reviews, and meta-analyses synthesizing intervention effects, research trends, and policy or service accessibility
Total 36 100.0
Table 4.
Distribution and key characteristics of study participants
Research subject Number (n) Main study types Key characteristics Research focus
Children and adolescents 10 Observational quantitative, intervention-based experimental, evidence synthesis Multidimensional approaches addressing feeding problems and sensory sensitivity School- and family-based dietary education and interventions integrating sensory and emotional factors
Adults 9 Intervention-based experimental, observational quantitative, evidence synthesis Integrated approaches combining exercise and nutrition education Development of behavior-change–focused and context-sensitive intervention models
Parents and caregivers 4 Observational quantitative, intervention-based experimental, evidence synthesis Care burden, parenting stress, and parent-focused education Family-based health promotion and nutrition education programs
Professionals and teachers 2 Exploratory qualitative Exploration of field experiences and educational needs Practice-based insights and needs for multidisciplinary collaboration
Mixed or multiple groups 11 Observational quantitative, exploratory qualitative, evidence synthesis Collaborative approaches involving parents, teachers, and professionals Expansion of coordinated and integrated nutrition and health education models
Table 5.
Study types and key topic trends by disability category
Disability category Number of studies [n (%)] Composition of study types Main research topics Summary of findings
Developmental disabilities (overall) 22 (61.1) Observational quantitative (6), intervention-based experimental (6), exploratory qualitative (2), evidence synthesis (8) Eating behaviors and nutrient intake; health management and health promotion programs; obesity, physical activity, and quality of life; caregiver health education; dysphagia, gut microbiota, and healthcare services Studies addressed a wide range of health-related topics, with intervention studies focusing on health behaviors and quality of life outcomes
Autism spectrum disorder 8 (22.2) Exploratory qualitative (2), observational quantitative (1), evidence synthesis (5) Sensory sensitivity; food refusal; feeding guidance; experiences of parents and teachers; age-related eating behaviors and food preferences; exposure-based and applied behavior analysis-informed feeding approaches Research primarily focused on feeding-related problems and behavioral characteristics
Intellectual disability 2 (5.6) Intervention-based experimental (2) Exercise and nutrition education programs; virtual reality- or music-based interventions Limited number of intervention studies addressing physical fitness and lifestyle-related outcomes
Mixed disability groups 4 (11.1) Observational quantitative (3), exploratory qualitative (1) Health management and educational experiences of students with disabilities; dietary intake patterns; obstetric complications; nutrient and carotenoid intake Studies examined diverse health and nutrition issues across heterogeneous disability groups
Table 6.
Topic-based study trend classification criteria
Category Examples of subtopics Corresponding research methods
Dietary habits and nutritional status Dietary patterns, food frequency, nutrient intake, obesity and weight status, eating behaviors, meal attitudes Observational quantitative studies; qualitative studies (exploration of caregiver, student, or professional perspectives); evidence synthesis studies (review of dietary and nutritional status)
Nutrition and dietary education or interventions Nutrition education programs, dietary behavior interventions, feeding interventions, family- and teacher-involved programs Intervention-based experimental studies; quasi-experimental designs; qualitative studies (program implementation and participation experiences); evidence synthesis studies (systematic or narrative reviews of interventions)
Physical activity and health promotion Exercise interventions, physical fitness, cardiovascular health, physical activity levels, obesity prevention, health management behaviors Intervention-based experimental studies (exercise-based or combined approaches); evidence synthesis studies (reviews of physical activity and health promotion programs)
Medical, physiological, and clinical topics Gut microbiota, feeding disorders, nutritional metabolism, physiological indicators, health screening, disease-related factors, healthcare access Clinical and observational studies; comparative studies; qualitative studies (healthcare experiences); evidence synthesis studies (scoping or systematic reviews of medical and healthcare topics)
Table 7.
Distribution and key contents by study topic (2015–2025)
Research topic category Number of studies (n) Main study populations Predominant study types Examples of subtopics Summary of research focus
Dietary habits and nutritional status 14 Children/adolescents, adults Primarily observational quantitative; some qualitative Dietary patterns, food frequency, nutrient intake, obesity and weight status, eating behaviors, meal attitudes Studies examined imbalances in nutrient intake (e.g., calcium and B vitamins), selective eating, and obesity patterns, as well as caregiver and professional perspectives on dietary practices
Nutrition and dietary education or interventions 10 Adults, children, parents, teachers Predominantly intervention-based; some qualitative and evidence synthesis Nutrition education, dietary behavior interventions, feeding interventions, family- and teacher-involved programs Research focused on changes in dietary behaviors, self-determination, meal-related attitudes, and caregiver practices following educational or behavioral interventions
Physical activity and health promotion 5 Mainly adults Predominantly intervention-based; some evidence synthesis Exercise interventions, physical fitness, cardiovascular health, physical activity levels, obesity prevention, health management behaviors Studies investigated physical health outcomes, body composition, and fitness improvements associated with structured physical activity or combined intervention programs
Medical, physiological, and clinical topics 7 Adults, children, older adult women with developmental disabilities Clinical, observational, and evidence synthesis Gut microbiota, dysphagia, nutritional metabolism, physiological indicators, health screening, healthcare access Research explored medical and physiological characteristics, feeding and swallowing disorders, and healthcare access issues related to nutrition and health among individuals with developmental disabilities
Table 8.
Distribution of study types by year (2015–2025)
Research type 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Total
Intervention-based experimental studies 1 1 2 2 1 1 8
Exploratory qualitative studies 1 1 1 1 1 5
Observational quantitative studies 2 1 1 2 1 2 1 10
Evidence synthesis studies 1 1 1 1 1 4 4 13
Total 3 2 0 5 3 4 2 4 3 5 5 36

n.

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        Research trends in dietary behaviors and nutrition education among individuals with developmental disabilities in Korea: a scoping review (2015–2025)
        Korean J Community Nutr. 2026;31(1):1-20.   Published online February 28, 2026
        DOI: https://doi.org/10.5720/kjcn.2025.00374
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      Research trends in dietary behaviors and nutrition education among individuals with developmental disabilities in Korea: a scoping review (2015–2025)
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      Fig. 1. Flow diagram of the literature selection process (adapted from the Joanna Briggs Institute scoping review methodology).

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      Research trends in dietary behaviors and nutrition education among individuals with developmental disabilities in Korea: a scoping review (2015–2025)
      Category Content
      Databases RISS, KISS, DBpia
      Search period January 2015–September 2025
      Population-related keywords developmental disabilities, intellectual disability, autism spectrum disorder
      Diet and nutrition-related keywords dietary habits, nutrition, nutritional status, diet, dietary patterns, intake, eating behavior, food preference, obesity, chronic diseases, weight management, health promotion
      Nutrition education and intervention-related keywords nutrition education programs, nutrition intervention, caregiver perception
      Search strategy Population-related keywords were combined with diet and nutrition or nutrition education and intervention-related keywords using the AND operator
      Example search formula (developmental disabilities OR intellectual disability OR autism spectrum disorder) AND (dietary habits OR nutritional status OR dietary patterns OR health promotion)
      Study ID Reference Population Disability type Study design Main topic Key findings
      S1 Kim et al. [19] (2025) Adults with developmental disabilities Developmental disabilities (overall) Evidence synthesis studies (systematic review) Physical activity and health promotion Included studies primarily targeted adults with mild to moderate intellectual disabilities and most frequently used single-group pre–post designs. Interventions reported overall positive changes in anthropometric measures, physical fitness, physical activity levels, dietary behaviors, health knowledge, self-efficacy, and quality of life. Few studies assessed maintenance/generalization, intervention fidelity, or social validity. Programs mainly focused on nutrition education, physical activity information, and exercise participation, frequently using visual supports and reinforcement strategies
      S2 Kim [21] (2024) Mixed (overlapping) Developmental disabilities (overall) Evidence synthesis studies (systematic review) Dietary habits and nutritional status Domestic studies have increased since 2012, with most employing literature reviews or survey designs. Qualitative and intervention studies were relatively scarce, and study populations were concentrated on children and individuals with multiple disabilities. Common dietary behavior issues included food selectivity, texture sensitivity, fear of new foods, pica, and atypical eating patterns
      S3 Ahn et al. [22] (2015) Adults with developmental disabilities Mixed disability groups Observational quantitative studies (cross-sectional survey) Dietary habits and nutritional status Mean BMI indicated overweight in the intellectual disability group and obesity in the mental disability group. Intake frequencies of vegetables and dairy products were generally low. Both groups showed vitamin B1, B2, and calcium intakes below recommended levels. Carotenoid intake, particularly lycopene, was lower than that of the general population, and cryptoxanthin intake was also low in the mental disability group
      S4 Lee et al. [23] (2018) Mixed (overlapping) Developmental disabilities (overall) Exploratory qualitative studies (in-depth interviews and focus groups; constant comparative analysis) Medical, health and clinical topics Key findings included difficulties in expressing and recognizing illness and symptoms, practical challenges in health management, barriers in access and communication during medical encounters, and limited self-determination in healthcare. Individuals with developmental disabilities experienced restricted access to information and decision-making due to communication difficulties and reliance on caregivers, with lack of disability awareness, inadequate facilities, and financial burden identified as major barriers
      S5 Kim et al. [24] (2021) Professionals and teachers Autism spectrum disorder Exploratory qualitative studies (in-depth interviews and focus groups; constant comparative analysis) Dietary habits and nutritional status Major themes included types of eating behaviors, eating-related problems, influencing factors (individual, environmental, medical), coping and instructional strategies, instructional difficulties, and support needs. Common eating behavior problems among students with ASD included food selectivity, texture sensitivity, food refusal, and pica, with gastrointestinal symptoms, sensory and behavioral characteristics, and home–school environments interacting to influence eating behaviors
      S6 Lee et al. [25] (2022) Children and adolescents with developmental disabilities Developmental disabilities (overall) Intervention-based experimental studies (single-group pre–post) Nutrition and dietary education or interventions Following the health education intervention, students’ health knowledge and health-promoting behavior scores significantly increased compared with baseline. Ninety-three percent of participants achieved health management goals at or above the expected level. Self-determination significantly increased in student self-ratings, whereas no significant changes were observed in parent or teacher ratings
      S7 Kang & Lee [26] (2015) Adults with developmental disabilities Developmental disabilities (overall) Intervention-based experimental studies (randomized controlled pre–post design) Physical activity and health promotion Muscle mass increased most in the APA + Wii group, whereas body fat mass decreased most in the APA group. Muscular endurance, strength, flexibility, and cardiorespiratory fitness improved more in groups including APA than in the Wii-only group, while balance improved most in the Wii group. Step counts and caloric expenditure increased in all intervention groups compared with controls
      S8 Lee & Kim [27] (2024) Parents and caregivers Developmental disabilities (overall) Evidence synthesis studies (systematic review) Medical, health and clinical topics Depression intervention programs for families of individuals with developmental disabilities showed overall significant reductions in depressive symptoms. Most programs were short-term (fewer than 10 sessions) group-based interventions, with reported effect sizes in the moderate to large range
      S9 Shin et al. [28] (2024) Mixed (overlapping) Developmental disabilities (overall) Evidence synthesis studies (scoping review) Medical, health and clinical topics Regular health checkups were identified as the most highly needed healthcare service. Across the life course, early diagnosis and early intervention were prioritized in infancy, whereas prevention of early aging and medical support were emphasized in middle and older adulthood. Individuals with developmental disabilities exhibited higher prevalence of chronic diseases, increased risk of premature mortality, and lower access to healthcare services, indicating substantial health vulnerability
      S10 Kim & Song [29] (2018) Children and adolescents with developmental disabilities Autism spectrum disorder Evidence synthesis studies (meta-analysis) Nutrition and dietary education or interventions The overall intervention effect size was Tau-U = 0.876, indicating moderate to high effectiveness. Larger effects were observed at younger ages and during follow-up phases compared with intervention phases. Multicomponent interventions were more effective than single-technique approaches, with the greatest effects reported for interventions lasting less than 20 sessions and approximately 2 months (5–8 weeks)
      S11 Min & Kim [30] (2024) Children and adolescents with developmental disabilities Autism spectrum disorder Evidence synthesis studies (narrative review) Dietary habits and nutritional status Feeding disorders in children with ASD were reported to be highly diverse, highlighting the need for comprehensive assessment. Available assessment tools were limited, and the inclusion of additional domains such as oral-motor and digestive function was recommended
      S12 Park et al. [31] (2020) Mixed (overlapping) Autism spectrum disorder Observational quantitative studies (cross-sectional survey) Dietary habits and nutritional status BMI distribution differed by age, with higher rates of underweight among children aged ≤ 10 years and higher rates of overweight and obesity among adolescents aged 11–19 years. Most participants consumed snacks at least once daily. Food preferences differed across age groups for grains, vegetables, fruits, dairy products, fats, and sugars. Parents reported high needs and willingness to participate in nutrition education
      S13 Lee et al. [32] (2016) Children and adolescents with developmental disabilities Autism spectrum disorder Observational quantitative studies (retrospective medical record review) Medical, health and clinical topics At the first visit, children with ASD had a higher proportion of males, fewer obstetric complications, and lower receptive and expressive language scores than children with intellectual disabilities. Children whose diagnosis changed from intellectual disability to ASD were all male, had more frequent family histories of developmental delay, and showed significantly lower initial receptive language scores. Sex, language characteristics, and obstetric information were associated with early ASD identification
      S14 Jeon & Cho [33] (2018) Children and adolescents with developmental disabilities Developmental disabilities (overall) Intervention-based experimental studies (single-case design) Medical, health and clinical topics After intervention, meal intake increased to approximately 700–800 g, with reductions in frequent small meals and shorter mealtime duration. Feeding patterns shifted from predominantly formula-based intake (≥ 80%) to mixed feeding after one week and to 100% solid food intake after two weeks. Applied behavior analysis intervention was associated with reductions in food refusal behaviors
      S15 Kim [34] (2022) Adults with developmental disabilities Developmental disabilities (overall) Observational quantitative studies (cross-sectional survey with mediated regression analysis) Dietary habits and nutritional status Higher levels of perceived obesity were associated with poorer dietary habits and lower life satisfaction. Regular meals and balanced nutrition were positively correlated with both dietary habit scores and life satisfaction. Dietary habits showed a significant mediating effect in the relationship between perceived obesity and life satisfaction
      S16 Oh & Hong [35] (2025) Adults with developmental disabilities Developmental disabilities (overall) Evidence synthesis studies (narrative review) Medical, health and clinical topics Individuals with developmental disabilities showed reduced gut microbiota diversity, increased harmful bacteria, and decreased beneficial bacteria, which were associated with neurotransmitter dysregulation, immune and inflammatory responses, and metabolic imbalance. Dietary modification, probiotic supplementation, and physical activity interventions were reported to improve gut microbiota balance and related metabolic pathways
      S17 Kim [36] (2018) Adults with developmental disabilities Intellectual disability Evidence synthesis studies (single-group pre–post) Physical activity and health promotion After 16 weeks of intervention, no significant changes were observed in body composition indicators (BMI, body fat percentage). However, flexibility, muscular strength, and power significantly improved. Dietary habit scores increased, with higher intake frequencies of protein, green-yellow vegetables, and seaweed, and reduced intake of salty foods, sweets, and late-night snacks
      S18 Choi & Kang [37] (2019) Adults with developmental disabilities Intellectual disability Intervention-based experimental studies (multiple-baseline single-subject design) Physical activity and health promotion All participants showed increased numbers of appropriate eating behaviors during intervention and maintenance phases compared with baseline. Mean performance increased from 3.2 of 13 behaviors at baseline to 7 during intervention and 11 during maintenance. VR-based social story music therapy was associated with improvements in eating behavior performance and social skill acquisition
      S19 Kang & Kim [38] (2020) Parents and caregivers Developmental disabilities (overall) Observational quantitative studies (cross-sectional survey with hierarchical multiple regression) Dietary habits and nutritional status Poorer health status and higher levels of challenging behaviors in adults with developmental disabilities were significantly associated with increased caregiver burden. Health status and challenging behaviors were identified as significant predictors of caregiver burden
      S20 Kim et al. [39] (2020) Parents and caregivers Autism spectrum disorder Exploratory qualitative studies (thematic analysis of in-depth interviews) Dietary habits and nutritional status Mothers’ experiences were categorized into themes related to children’s eating characteristics (clear food preferences, atypical eating behaviors, influence of past experiences), family interactions, efforts to improve dietary behaviors, and support needs. Children’s eating behavior problems imposed burdens on family meals, dining out, and mealtime atmosphere, with coping strategies involving environmental modification, consistent guidance, and program participation
      S21 Kim [40] (2016) Parents and caregivers Developmental disabilities (overall) Intervention-based experimental studies (non-equivalent control group pre–post–follow-up design) Nutrition and dietary education or interventions Compared with the control group, the intervention group showed significantly greater improvements in children’s health management behaviors over time. Parenting stress scores in the intervention group significantly decreased at post-test and follow-up, with larger reductions than those observed in the control group
      S22 Kim & Jeon [41] (2024) Professionals and teachers Developmental disabilities (overall) Exploratory qualitative studies (one-on-one in-depth interviews) Nutrition and dietary education or interventions The most frequently requested nutrition education topics were diet education for obesity prevention and management and basic nutrition knowledge. Education at kindergarten to lower elementary school level was considered appropriate given cognitive functioning. Activity-based, face-to-face education using real foods, cooking activities, and visual materials, delivered in sessions of approximately 30 minutes, was perceived as effective
      S23 Ham & Sohn [42] (2023) Mixed (overlapping) Developmental disabilities (overall) Observational quantitative studies (secondary data analysis with two-way ANOVA) Dietary habits and nutritional status Smoking, alcohol consumption, and stress showed significant main effects across both life stage and sex. Overweight showed a significant main effect by life stage, whereas sexual health issues differed by sex. Significant interaction effects between life stage and sex were observed for all five health behaviors, with higher levels reported for specific subgroups such as adolescent males’ sexual health issues and older adults’ alcohol use or overweight
      S24 Park et al. [43] (2019) Children and adolescents with developmental disabilities Autism spectrum disorder Evidence synthesis studies (narrative review) Dietary habits and nutritional status Many studies reported that children with ASD exhibited atypical eating behaviors such as food selectivity, binge eating, and pica compared with typically developing children. Data collection relied mainly on parent reports and observations. Associations between eating behaviors and individual characteristics were frequently reported, whereas evidence regarding family factors and nutritional intake or status was limited and inconsistent
      S25 Choi & Lee [44] (2020) Adults with developmental disabilities Developmental disabilities (overall) Intervention-based experimental studies (single-group pre–post quasi-experimental design) Nutrition and dietary education or interventions Following the health management education program, participants showed significant increases in overall health knowledge and all subdomain scores. Total health-promoting behavior scores also increased significantly, although changes in specific subdomains were not statistically significant
      S26 Cho & Park [45] (2025) Children and adolescents with developmental disabilities Autism spectrum disorder Evidence synthesis studies (systematic review) Nutrition and dietary education or interventions Common intervention techniques included high-probability request sequences, simultaneous or sequential presentation of preferred and non-preferred foods, peer modeling, and differential reinforcement. Most studies reported significant increases in food intake along with reductions in problem behaviors, although effect sizes and maintenance patterns varied by intervention setting
      S27 Ha & Yoo [46] (2022) Children and adolescents with developmental disabilities Autism spectrum disorder Evidence synthesis studies (systematic review) Nutrition and dietary education or interventions Gradual, repetitive, and systematic food exposure interventions for children with ASD were associated with overall improvements in food intake, food variety, food acceptance, amount consumed, and food contact behaviors. Included studies summarized clinically applicable exposure strategies and assessment tools
      S28 Hong & Hong [47] (2025) Mixed (overlapping) Developmental disabilities (overall) Evidence synthesis studies (systematic review) Nutrition and dietary education or interventions Most included studies focused on mental health–oriented programs for family caregivers. Interventions were associated with significant reductions in depression, anxiety, and stress, and improvements in quality of life and psychological well-being. Some studies also reported improvements in physical health behaviors such as exercise, self-care, and dietary behaviors
      S29 Park et al. [48] (2023) Mixed (overlapping) Developmental disabilities (overall) Evidence synthesis studies (narrative review) Physical activity and health promotion Individuals with developmental disabilities demonstrated lower levels of physical activity and exercise participation than those without disabilities, along with poorer physical fitness and cardiovascular health indicators. Moderate-intensity aerobic and resistance exercise, as well as high-intensity interval training following prolonged aerobic exercise, were associated with improvements in fitness and arterial stiffness
      S30 Kim et al. [49] (2015) Children and adolescents with developmental disabilities Mixed disability groups Observational quantitative studies (cross-sectional comparative study) Dietary habits and nutritional status Rates of overweight and obesity were higher in the ASD group (44%) than in the intellectual disability group (26%), and the use of appetite-stimulating medications was also more frequent in the ASD group. Functional eating difficulties such as opening beverage containers were more common in the intellectual disability group, whereas color-based food selectivity was more prevalent in the ASD group. Adolescents with intellectual disabilities consumed meat, seaweed, fats, and sugars more frequently and in larger amounts than those with ASD
      S31 Lee et al. [50] (2021) Mixed (overlapping) Mixed disability groups Exploratory qualitative studies (focus groups and in-depth interviews; constant comparative analysis) Nutrition and dietary education or interventions Key themes included experiences with health problems and coping, practices of health management and education, support needs related to health management and education, and needs for school–home linked health self-advocacy programs. Teachers and parents perceived students with developmental disabilities as having physical and mental health problems, low health knowledge, and difficulties accessing healthcare services
      S32 Lee et al. [51] (2021) Mixed (overlapping) Developmental disabilities (overall) Evidence synthesis studies (systematic review) Medical, health and clinical topics Research topics were categorized into health status and related factors, health education and dual diagnosis issues and support, and effectiveness of exercise-centered health promotion programs. Studies were most frequently conducted in 2014, with experimental designs predominating. Most studies targeted individuals with developmental disabilities, and intervention studies primarily focused on physical activity programs
      S33 Cho [52] (2018) Adults with developmental disabilities Developmental disabilities (overall) Observational quantitative studies (cross-sectional SEM analysis) Dietary habits and nutritional status A greater number of health problems in adulthood was significantly associated with lower mental functioning and activities of daily living. Medical, community, and informal support services contributed to higher activity levels and social participation. Community services moderated the negative relationship between adult health problems and social participation
      S34 Whang et al. [53] (2023) Children and adolescents with developmental disabilities Developmental disabilities (overall) Observational quantitative studies (cross-sectional comparative and logistic regression analysis) Dietary habits and nutritional status Infants from multicultural families were significantly more likely than those from Korean families to receive abnormal results on initial developmental screening and to be diagnosed with developmental disabilities. After controlling for sex, income, and residential area, multicultural family background (foreign-born mother) remained significantly associated with developmental disability risk
      S35 Choi [54] (2025) Mixed (overlapping) Developmental disabilities (overall) Observational quantitative studies (cross-sectional SEM analysis) Dietary habits and nutritional status Family healthiness showed significant positive effects on both disability acceptance and life satisfaction. Disability acceptance was positively associated with life satisfaction and partially mediated the relationship between family healthiness and life satisfaction. Among control variables, age showed a negative association, whereas sex, disability type, education level, and presence of multiple disabilities were not significant
      S36 Yang et al. [55] (2019) Mixed (overlapping) Developmental disabilities (overall) Intervention-based experimental studies (small-sample single-group program development and implementation) Nutrition and dietary education or interventions Participants demonstrated relatively high basic nutrition knowledge regarding major nutrient groups and healthy food choices. The intervention, using photo records and food models, was associated with enhanced ability to independently compose healthy meals. The program was implemented through a living-lab–based community network involving local residents, university students, and independent living support centers
      Research type Number (n) Percentage (%) Key characteristics
      Observational quantitative studies 10 27.8 Assessment of dietary habits, nutrient intake, obesity status, and nutritional imbalances based on cross-sectional or comparative data
      Exploratory qualitative studies 5 13.9 In-depth exploration of dietary experiences, self-determination, and perceived support needs of individuals with developmental disabilities and caregivers
      Intervention-based experimental studies 8 22.2 Education-, exercise-, and behavior-based short-term participatory programs evaluating changes in health behaviors and dietary outcomes
      Evidence synthesis studies 13 36.1 Systematic reviews, scoping reviews, and meta-analyses synthesizing intervention effects, research trends, and policy or service accessibility
      Total 36 100.0
      Research subject Number (n) Main study types Key characteristics Research focus
      Children and adolescents 10 Observational quantitative, intervention-based experimental, evidence synthesis Multidimensional approaches addressing feeding problems and sensory sensitivity School- and family-based dietary education and interventions integrating sensory and emotional factors
      Adults 9 Intervention-based experimental, observational quantitative, evidence synthesis Integrated approaches combining exercise and nutrition education Development of behavior-change–focused and context-sensitive intervention models
      Parents and caregivers 4 Observational quantitative, intervention-based experimental, evidence synthesis Care burden, parenting stress, and parent-focused education Family-based health promotion and nutrition education programs
      Professionals and teachers 2 Exploratory qualitative Exploration of field experiences and educational needs Practice-based insights and needs for multidisciplinary collaboration
      Mixed or multiple groups 11 Observational quantitative, exploratory qualitative, evidence synthesis Collaborative approaches involving parents, teachers, and professionals Expansion of coordinated and integrated nutrition and health education models
      Disability category Number of studies [n (%)] Composition of study types Main research topics Summary of findings
      Developmental disabilities (overall) 22 (61.1) Observational quantitative (6), intervention-based experimental (6), exploratory qualitative (2), evidence synthesis (8) Eating behaviors and nutrient intake; health management and health promotion programs; obesity, physical activity, and quality of life; caregiver health education; dysphagia, gut microbiota, and healthcare services Studies addressed a wide range of health-related topics, with intervention studies focusing on health behaviors and quality of life outcomes
      Autism spectrum disorder 8 (22.2) Exploratory qualitative (2), observational quantitative (1), evidence synthesis (5) Sensory sensitivity; food refusal; feeding guidance; experiences of parents and teachers; age-related eating behaviors and food preferences; exposure-based and applied behavior analysis-informed feeding approaches Research primarily focused on feeding-related problems and behavioral characteristics
      Intellectual disability 2 (5.6) Intervention-based experimental (2) Exercise and nutrition education programs; virtual reality- or music-based interventions Limited number of intervention studies addressing physical fitness and lifestyle-related outcomes
      Mixed disability groups 4 (11.1) Observational quantitative (3), exploratory qualitative (1) Health management and educational experiences of students with disabilities; dietary intake patterns; obstetric complications; nutrient and carotenoid intake Studies examined diverse health and nutrition issues across heterogeneous disability groups
      Category Examples of subtopics Corresponding research methods
      Dietary habits and nutritional status Dietary patterns, food frequency, nutrient intake, obesity and weight status, eating behaviors, meal attitudes Observational quantitative studies; qualitative studies (exploration of caregiver, student, or professional perspectives); evidence synthesis studies (review of dietary and nutritional status)
      Nutrition and dietary education or interventions Nutrition education programs, dietary behavior interventions, feeding interventions, family- and teacher-involved programs Intervention-based experimental studies; quasi-experimental designs; qualitative studies (program implementation and participation experiences); evidence synthesis studies (systematic or narrative reviews of interventions)
      Physical activity and health promotion Exercise interventions, physical fitness, cardiovascular health, physical activity levels, obesity prevention, health management behaviors Intervention-based experimental studies (exercise-based or combined approaches); evidence synthesis studies (reviews of physical activity and health promotion programs)
      Medical, physiological, and clinical topics Gut microbiota, feeding disorders, nutritional metabolism, physiological indicators, health screening, disease-related factors, healthcare access Clinical and observational studies; comparative studies; qualitative studies (healthcare experiences); evidence synthesis studies (scoping or systematic reviews of medical and healthcare topics)
      Research topic category Number of studies (n) Main study populations Predominant study types Examples of subtopics Summary of research focus
      Dietary habits and nutritional status 14 Children/adolescents, adults Primarily observational quantitative; some qualitative Dietary patterns, food frequency, nutrient intake, obesity and weight status, eating behaviors, meal attitudes Studies examined imbalances in nutrient intake (e.g., calcium and B vitamins), selective eating, and obesity patterns, as well as caregiver and professional perspectives on dietary practices
      Nutrition and dietary education or interventions 10 Adults, children, parents, teachers Predominantly intervention-based; some qualitative and evidence synthesis Nutrition education, dietary behavior interventions, feeding interventions, family- and teacher-involved programs Research focused on changes in dietary behaviors, self-determination, meal-related attitudes, and caregiver practices following educational or behavioral interventions
      Physical activity and health promotion 5 Mainly adults Predominantly intervention-based; some evidence synthesis Exercise interventions, physical fitness, cardiovascular health, physical activity levels, obesity prevention, health management behaviors Studies investigated physical health outcomes, body composition, and fitness improvements associated with structured physical activity or combined intervention programs
      Medical, physiological, and clinical topics 7 Adults, children, older adult women with developmental disabilities Clinical, observational, and evidence synthesis Gut microbiota, dysphagia, nutritional metabolism, physiological indicators, health screening, healthcare access Research explored medical and physiological characteristics, feeding and swallowing disorders, and healthcare access issues related to nutrition and health among individuals with developmental disabilities
      Research type 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Total
      Intervention-based experimental studies 1 1 2 2 1 1 8
      Exploratory qualitative studies 1 1 1 1 1 5
      Observational quantitative studies 2 1 1 2 1 2 1 10
      Evidence synthesis studies 1 1 1 1 1 4 4 13
      Total 3 2 0 5 3 4 2 4 3 5 5 36
      Table 1. Literature search strategy and keyword combinations

      Table 2. Characteristics of included studies

      BMI, body mass index; ASD, autism spectrum disorder; APA, adapted physical activity; VR, virtual reality; ANOVA, analysis of variance.

      Table 3. Distribution of study types (2015–2025)

      Table 4. Distribution and key characteristics of study participants

      Table 5. Study types and key topic trends by disability category

      Table 6. Topic-based study trend classification criteria

      Table 7. Distribution and key contents by study topic (2015–2025)

      Table 8. Distribution of study types by year (2015–2025)

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      Korean J Community Nutr : Korean Journal of Community Nutrition
      © The Korean Society of Community Nutrition.
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