The complexity of nutrition in Autism |31 March 2023

Sixteen years ago, the United Nations declared April 2 as World Autism Awareness day and since then it is celebrated on this day around the world every year.

Despite the fact that there is still space for improvement, we have made a lot of progress in terms of raising awareness about this health condition.The embracing of neurodiversity by professionals and academics has created greater acceptance of autism in many societies.

For parents living with a child with autism there are many challenges that is faced daily from simple tasks such as teeth brushing, combing or getting dressed for school. Many would agree that an autistic child’s diet is very complex but also quite limited in terms of diversity of food options eaten. This is of course related to the overall challenges they face in their daily lives.

What is Autism Spectrum Disorder (ASD)?

Autism Spectrum Disorder (ASD) is a complex developmental disorder that affects how people interact with others, communicate, learn, and behave. They generally have restricted or repetitive behaviours or interests.

There is not one autism but many subtypes (spectrum), most influenced by a combination of genetic and environmental factors. Because autism is a spectrum disorder, each person with this condition has a distinct set of strengths, challenges as well as type and severity of symptoms they experience. The degree of impairment in functioning because of these challenges varies between individuals with autism, and some may need more support than others.

Anyone can be diagnosed with autism regardless of their race, gender, ethnicity or socio-economic background. Although autism can be diagnosed at any age, symptoms generally appear in the first two years of life.

There is no cure for autism. Once a person is diagnosed with the condition, it is lifelong. However, early interventions can improve an individual’s daily functioning. The type and combination of interventions or treatment that a person with autism needs will vary.

Challenges with diet

Unfortunately, there is no ‘one-size fits all’ approach in the dietary management of autism. The general guidelines recommended for the whole population may not necessarily be applicable for this population group because of the many challenges they face.

Younger children with autism usually have very restrictive eating patterns, limited food intake and may have challenges with how a meal is presented, smells, looks (the colour and shape), the texture of the food or the eating environment itself.

They are therefore vulnerable to deficiencies of certain nutrients in particular B vitamins, vitamin C and D, calcium, iron, zinc and iodine.  In severe cases, an oral nutritional supplement like Pediasure is usually recommended alongside strategies to help improve food intake.

Older children on the other hand often have issues of overeating and are predisposed to becoming overweight. This is due to the high intake of refined carbohydrates (think white rice, white bread, sugar-coated cereals) as well as sugary and fatty foods like chips, processed meats, sweets, juices and low intake of fish, fruits, vegetables, beans, lentils, dairy products and wholegrains.

In such cases the parent should cut down on these highly processed foods and try swapping with a healthier alternative of a fairly similar appearance for greater acceptance.

Despite an autistic child having very selective food choices, if the child is otherwise growing well and has no overt symptoms of a nutritional deficiency then try not to become too worried.

Focus on continuously trying to diversify their diet and incorporating foods from all food groups keeping in mind any sensory issues or other challenges they may have with specific foods or around mealtimes.

Improving food intake

Strategies that work for one person may not work for another. Remember, autism is a spectrum so each person will have their own set of challenges when it comes to eating.

However, some useful tips that parents can try are outlined below bearing in mind that finding something that will only work for your child requires a one-to-one intervention with a more thorough and detailed nutritional assessment.

In summary to account for the diversity that exists in autism there are many aspects of the diet that have to be considered beyond just the food itself. This includes understanding why the child refuses certain foods, the role of the environment at mealtimes, how the child feels about eating (any anxiety or fears) and above all else the support system that exists be it family members, close friends or professionals and the coherence that exists. In the end, an individualised approach which focuses on the specific child and their needs is key in improving their dietary outcomes.

Celebrating World Autism Awareness Day

The observance for this year’s World Autism Awareness day focuses on the contribution of autistic people at home, at work, in the arts and in policymaking.

For this occasion, the United Nations are organising a virtual event on Sunday April 2 entitled ‘transformation: towards a neuro-inclusive world for all’ from 10am to 1pm EST (Eastern Standard Time). If you are interested, please copy the link https://www.un.org/en/observances/autism-day to register for the event.

Thank you for joining us this week on our Eat for Our Health page. Look us up on social media - eat for our health Seychelles on Facebook.

Please get in touch by emailing eat4ourhealth@gmail.com and let us know how you’re doing with these ideas, or better still, let us know how we can help you.

Yours in health

The E4OH team