Autism Spectrum Disorders (ASD) and Diet

By Karen Ansel, MS, RDN, CDN
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Autism Spectrum Disorder, or ASD, is a complex developmental and neurological condition that typically appears during the first three years of life. It affects brain function, particularly in the areas of social interaction and communication skills. Classic symptoms include delayed talking, lack of interest in playing with other children, not wanting to be held or cuddled and poor eye contact. There is no known cause for ASD, but both genetics and environment are believed to play a role.

The Centers for Disease Control and Prevention estimates 1 in every 68 American children has been identified with ASD. It is about five times more common in boys than in girls.

People with ASD often repeat behaviors and have narrow, obsessive interests. These types of behavior can affect eating habits and food choices, which can lead to the following health concerns.

  • Limited food selection or strong food dislikes. Someone with autism may be sensitive to the taste, smell, color and texture of foods. They may limit or totally avoid some foods and even whole food groups. Common dislikes include fruits, vegetables and slippery, soft foods.
  • Not eating enough food. Kids with autism may have difficulty focusing on one task for an extended period of time. It may be hard for a child to sit down and eat a meal from start to finish.
  • Constipation. This problem usually is caused by a child's limited food choices. It typically can be remedied through a high-fiber diet, plenty of fluids and regular physical activity.
  • Medication interactions. Some stimulant medications used with autism, such as Ritalin, lower appetite. This can reduce the amount of food a child eats, which can affect growth. Other medications may increase appetite or affect the absorption of certain vitamins and minerals. If your child takes medication, ask your healthcare provider about possible side effects.

Caring for a child with ASD can be challenging on many levels, and healthful eating is no exception. For children with ASD, a nutritious, balanced diet can make a world of difference in their ability to learn, how they manage their emotions and how they process information. Because children with ASD often have restricted diets as well as difficulty sitting through meal times, they may not be getting all the nutrients they need, particularly calcium and protein.

If you have a child with ASD, try these nutrition strategies.

Be Prepared for Pickiness

Many parents find their child's sensitivity to tastes, colors, smells and textures the biggest barriers to a balanced diet. Getting your child to try new foods — especially those that are soft and slippery — may seem nearly impossible. You may find that your child avoids certain foods or even entire food groups. One of the easiest ways to approach sensory issues is to tackle them outside of the kitchen. Have your child visit the supermarket with you to choose a new food. When you get home, research it together on the Internet to learn about where it grows. Then, decide together how to prepare it. When you are done, don't worry if your child doesn't want to eat it. Simply becoming familiar with new foods in a low-pressure, positive way eventually can help your child become a more flexible eater.

Make Mealtimes Routine

A child with ASD will have to work harder at mealtimes because a busy kitchen, bright lights and even the way the furniture is arranged all are potential stressors. Making meals as predictable and routine as possible can help. Serving meals at the same time every day is one of the simplest ways to reduce stress. In addition, think about what concessions you can make for easier mealtimes. If your child is sensitive to lights, try dining by candlelight. Let your child pick a favorite food to include at every meal. Or, let your child choose a favorite seat at the table.

Seek Guidance for Special Diets

You may have heard that a gluten- or casein-free diet can improve symptoms of ASD. Gluten is a type of protein found in wheat, rye and barley. Casein is a protein found in milk. Proponents of the diet believe people with autism have a "leaky gut," or intestine, which allows parts of gluten and casein to seep into the bloodstream and affect the brain and central nervous system. The belief is that this may lead to autism or magnify its symptoms. While some studies indicate that these diets may be effective for certain children, controlled scientific studies have not proven this to be true so more research is needed. Keep in mind that restrictive diets require careful planning to make sure your child's nutrition needs are being met. Consult with a registered dietitian nutritionist before making any drastic changes to your child's diet as there can be side effects and potential nutrient shortfalls when a gluten- or casein-free diet is self-prescribed.

Working With a Registered Dietitian Nutritionist

Most children, with or without autism, can be choosy and particular about the foods they eat. A registered dietitian nutritionist can identify any nutritional risks based on how your child eats, answer your questions about diet therapies and supplements advertised as helpful for autism and help guide your child on how to eat well and live healthfully.

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