By Deborah Jeanne Sergeant
If you have a child on the autism spectrum, it’s only natural to wonder why. Or wonder if something you do could help mitigate your child’s behavioral issues that are caused by autism.
Many parents scrutinize their children’s diet.
If the right foods can promote good health and prevent disease, could it also affect autism?
Physician Emily Knight, Ph.D., developmental behavioral pediatrician, assistant professor of pediatrics and neuroscience at URMC, says no.
“Autism is not caused by diet or food-related challenges or malnutrition,” she said. “The connection can go the other way around where children with autism have sensory and behavioral differences that cause feeding problems. They have higher rates of food refusals than typically developing children and can more limited range of food in their diets. When diets are very limited, they may not have the appropriate balance of nutrients.”
She added that studies indicate that children with autism tend to have less calcium and protein in their diet than typical children and that those gaps in nutrition can lead to long-term health risks — but not autism.
Knight said that families with children on the autism spectrum look at diet because they hope to find a natural intervention that can help their children’s challenging behaviors.
The anecdotal findings appear convincing.
However, “when you invest time and money in trying to help your child be his best self, you can see improvements that might have happened anyway with therapy,” Knight said. “Or it’s how we’re variable in behavior day to day. It’s easy to attribute it to diet. When we do a study where we challenge people with particular foods that families think they might be sensitive to and there’s also a placebo, we see there’s no difference between the two. It’s not the food or nutrient that’s causing the problem.”
Families generally view “natural” solutions as less risky and more healthful and beneficial. But Knight cautioned that highly restrictive diets and elimination diets should be only undertaken with the guidance of the child’s primary care provider.
“Research has not found a causal relationship between gut health and autism,” said Andy Shih, chief science officer at Autism Speaks in New York City. “However, ensuring a healthy and balanced diet is a key part of health and wellbeing in all children, including those with autism.”
He added that gastrointestinal issues are commonplace among those with autism, including constipation, diarrhea, irregular bowel movements, acid reflux and others, which can be caused by food sensitivities. The resulting stomach pain and discomfort can contribute to behavioral issues.
“We encourage families to consult with their child’s medical professionals to determine any food allergies and intolerances which might be contributing to GI distress,” Shih said. “A care team can help parents identify and implement treatment plans to relieve GI issues and reduce resulting behavioral symptoms.”
Anecdotally, some families choose to restrict gluten and casein (milk protein) intake and find it helps symptoms improve. However, Shish said that “rigorous clinical research to date does not support the effectiveness of gluten and casein free diets as an evidence-based treatment for autism.”
“While implementing a healthy diet in autistic children is important, some children may have food aversions and sensitivities that can make mealtime challenging for parents. Some children have sensory issues related to food, limiting the taste, texture and smells of foods they are willing to eat, which can lead to concerns about weight gain or malnutrition and may require the implementation of strategies to help children become comfortable with a variety of new foods.”
Food & Autism
Autism Speaks in New York City offers resources and guidance to address concerns around nutrition, including these:
• Tips for picky eaters:
www.autismspeaks.org/blog/autism-picky-eating-tips
• Parent’s Guide to Feeding Behavior in Autism:
www.autismspeaks.org/sites/default/files/2018-08/Exploring%20Feeding%20Behavior.pdf
• Parent’s Guide to Managing Constipation in Children with Autism:
www.autismspeaks.org/sites/default/files/2018-08/Constipation%20Guide.pdf