“Diet does not cure autism – that is a fact.“
I realize that diet restrictions can be viewed as controversial. But I have to include it here because it has made such a huge difference in my quality of life as an autistic adult and that of our neurodivergent kids. We used to suffer from chronic allergic bronchitis and asthma, caused by the dairy protein, casein. Once eliminated from our diet the symptoms miraculously vanished.
We also suffered from chronic IBS and my eldest was even diagnosed with autoimmune inflammatory bowel disease. But once wheat gluten was eliminated from our diet the symptoms miraculously vanished.
Coincidence? I think not.
Through many years of trial and error, lots & lots of prayer and my own research, we have actually implemented helpful dietary adaptations ourselves. Even before I knew we were autistic and before I knew that there is a link between these foods and autism.
We also struggle with sensory differences and with the texture, smell and taste of certain foods. Food sensitivities and intolerances, digestive and gastrointestinal issues, gut inflammation, autoimmune issues, high oxalates, high inflammation, nutritional deficiencies (e.g. vit B, vit D), blood sugar imbalance, sleep issues, misophonia, proprioception, and restrictive eating due to limited "safe foods".
There is increasing evidence that nutritional and lifestyle interventions can greatly benefit individuals with autism. For instance, many people with autism experience significant digestive issues, making gut balance a primary focus from a nutritional standpoint. The following nutritional and lifestyle factors are also important to consider:
maintaining balanced blood sugar levels
identifying food allergies, such as gluten and dairy
addressing nutrient deficiencies
ensuring an optimal intake of essential fats, particularly omega-3 fatty acids.
Before exploring popular dietary options for children with autism, it's crucial to recognize the role nutrition plays in autism. Although nutrition or specific diets do not cure autism, there are reports suggesting that a modified diet can have positive effects.
Autistic Eating Differences & Food Issues
Autistic children and adults may have heightened sensory sensitivity to light, touch, sound, and taste, which can affect the range of foods they consume. Autistic people have the same nutritional needs as others, and maintaining a balanced diet is crucial for health and development. Many autistics have a complex relationship with food and co-occurring conditions like ARFID or other eating disorders are quite common.
Some typical dietary considerations related to autism include:
A need for routine during meals, which might involve specific seating arrangements, particular cutlery and plates, or the desire to eat alone.
Sensitivity to smells, sights, and sounds during meals can influence eating habits.
Digestive issues, such as constipation, diarrhea, and bloating.
Food hypersensitivity, where the body adversely reacts to certain foods.
Consuming a limited diet, often consisting of foods similar in color and taste.
If your child is selective with food, you may discover that offering healthier options can be extremely challenging. An autistic child may not have many foods that they consider "safe foods" and they may be very restrictive or prefer the same foods and the predictability that if offer.
Autism and Gastrointestinal issues: What causes GI problems in autism?
In a study published in 2014, gastrointestinal dysfunction was present in 49 percent of 164 children with ASD. Additionally, 22 percent showed signs of diarrhea, and 26 percent had constipation.
The findings confirm what many parents of children with ASD have long suspected: autism and gastrointestinal issues are connected.
Gastrointestinal dysfunction or GID refers to diseases that occur in the gastrointestinal tract. Some of these conditions include:
Constipation – is a condition where there are difficulty and irregularity of bowel movements. Symptoms include a bloated or distended stomach and pain when experiencing a bowel movement.
Vomiting – throwing up can be a symptom of a bacterial or viral infection, but it can also be caused by food allergies, migraines, and other underlying medical conditions.
Diarrhea – is a condition that involves watery stools and the urgent need to go to the toilet. Beyond viral causes, diarrhea is a symptom of celiac and Crohn’s disease.
Crohn’s disease – is a chronic bowel disease that inflames the gastrointestinal tract anywhere between the mouth and the anus. The cause is unknown, but studies have suggested a link to the immune system.
Lactose intolerance – is the inability to digest lactose, a sugar found in animal milk (cow, goat, and sheep), and can be brought about by Crohn’s or celiac disease. People who are lactose intolerant experience bloating, stomach pain, nausea, or diarrhea within a few minutes of consuming lactose.
Irritable Bowel Syndrome (IBS) – defined as the “abdominal discomfort associated with altered bowel habits,” the symptoms are often sudden, persistent, and irregular bowel movements that can either be constipation-predominant or diarrhea-predominant.
Gastroesophageal Reflux Disease (GERD) – also known as heartburn or acid reflux, this condition is caused by a weak esophageal sphincter which makes partially digested food go back up the esophagus.
Celiac disease – is an autoimmune disorder triggered by the protein gluten. Many parents of children with ASD have found that excluding gluten from their child’s diet improved symptoms as a response to the protein can damage the villi (the small, finger-like projections in the small intestine), which interferes with absorption and can lead to other health problems.
Identifying the root causes of gastrointestinal symptoms and assessing if they can be managed or alleviated through dietary changes or specific diets is crucial. In the end, it is recommended that parents discuss with their child's doctor any diet, digestion, and bowel movement concerns that could cause dysregulation in autistic people.
Autistic Gut health: Studies on the Microbiome and its effects on Autism
A recent study found that a balanced gut microbiome, composed of various bacteria residing in the intestines, can influence an autistic person's functioning. The study indicates a connection between autism and gut health, suggesting that a nutritious diet can be advantageous for children with autism.
Sleep and Gastrointestinal problems in Autism
According to research, it is estimated that 44 to 86 percent of children with ASD have sleep disorders, a rate much higher than the 10 to 16 percent observed in the general population. On average, children with autism take 11 minutes longer to fall asleep than neurotypical children.
There is evidence suggesting a connection between sleep and gastrointestinal dysfunction in children with autism. Sleep disorders are prevalent among autistic children and can include bedtime resistance, insomnia, unusual breathing patterns during sleep, difficulties waking up, and trouble staying awake during the day.
To alleviate sleep difficulties connected with gastrointestinal issues, Sleephelp.org recommends the following:
Avoid food that irritates or upsets the child’s stomach a few hours before bedtime
Limit liquid intake before bed to avoid bedwetting
Avoid caffeine (this includes tea, chocolate, and soda)
Provide exercise or intense physical activities during the day
Melatonin supplements are known to promote sleep (ask your child’s physician first)
Helpful Diets for Children with Autism
Many parents of autistic children choose to experiment with particular food regimens they think might be beneficial. Despite the lack of scientific backing, the feedback from parents suggests a different perspective.
Elimination diets are common among parents who implement particular autism diets for their children. These diets entail decreasing or eliminating foods deemed detrimental to a person's health and especially if they have food allergies or intolerances.
Examples of elimination diets include:
It is a fact that diet does not cure autism. However, there are certain diets that has proven to support autistic health and relieve digestive issues that are common to a lot of autistic people. Remember, benefits are not assured for every autistic child.
Let's examine some popular diets designed for specific dietary requirements and conditions.
The Ketogenic Diet for Autism
A ketogenic diet is simply a diet, which causes your body to run on what are called ketones instead of sugar from carbohydrates like pasta, grains or sugary foods. Ketones are a type of acid formed when your body begins burning stored or dietary fat for fuel instead of carbs. They’re actually a very efficient fuel for your body. The most abundant, and beneficial, ketone is called beta-hydroxybutyrate or BHB.
On a traditional diet, your body is constantly converting sugar from carbs into energy. However, when you change to a high-fat diet and limit your net carbs, your body starts producing ketones for energy. As a result, on a low carb diet, your body automatically begins burning fat. In a keto diet, the goal is to switch your body from burning sugar fuel to fat fuel.
A limited study indicated that a modified ketogenic diet might be advantageous for individuals with autism. This study involved 15 children aged between two and 17 years over a period of three months. The children followed a modified ketogenic diet supplemented with MCT (medium chain triglycerides). MCT is a dietary supplement known to aid in weight loss and reduce inflammation.
The study concluded that: “Components of the KD are possibly beneficial in improving social effect in children with ASD. Additional studies are needed to understand how the KD improves behavior.”
To follow a ketogenic diet, you should steer clear of foods high in carbohydrates. There are different versions and variations, e.g. the Keto Diet, Banting, LCHF, Paleo (allows fruit, dates, honey, etc.) Atkins (Low Carb, High Fat, High Protein) or our own South African Tim Noakes', The Real Meal Revolution. One of my favorites sources is Dr. Berg for an abundance of info, resources, mini-courses, recipes, video tutorials and his Keto Food List.
Dr. Berg explains that "throughout your life, you've been told that carbohydrates are essential for energy or that your brain relies solely on glucose from carbs, a type of sugar. These are myths, as shown by the numerous healthy, content individuals on low-sugar or low-carbohydrate diets. Instead, your body can utilize other fuel sources like fatty acids and ketones derived from fat burning. Although your body requires a minimal amount of glucose (sugar) to function, it can produce all the glucose it needs internally from fat or protein, not carbohydrates.
The carbohydrates you do require come from vegetables, but only for the vitamins, minerals, antioxidants, and fiber they provide. Otherwise, your body does not need carbohydrates for good health. In fact, the opposite is true. Carbohydrates, especially refined ones, deplete your nutrients and negatively impact your health. Carbs also convert to fat in your body and hinder fat burning."
Gluten-free & Casein-free Diet for Autism
The gluten-free and casein-free diet, known as the GFCF diet, is becoming increasingly popular within the autistic community. The positive feedback from parents and advocates frequently sparks discussion and debate.
The GFCF diet involves removing gluten (found in wheat, barley, and rye) and casein (found in milk and dairy products) from a child’s daily diet. Some parents choose this diet due to food allergies, while others believe it helps support autistic functioning.
The theory behind this diet posits that peptides and proteins in gluten and casein contain opiate-like chemicals that might cause altered reactions and behaviors. This chemical reaction could worsen dysregulation for children with ASD.
Foods to avoid in a GFCF diet are:
Milk and dairy products (cheese, ice cream, yogurt, etc.)
Bread, pastries, and most cereals (not labeled gluten-free)
What you can eat in a gluten-free casein-free diet:
Chicken, fish, meat
Fruits, vegetables
Potatoes, rice, infant rice cereal
Cereal and pasta labeled “gluten-free”
To address the lack of milk products, parents frequently select alternative dairy options like plant-based milks (almond milk, rice milk, soy milk) for children who don't have nut and soy allergies. Regarding the absence of gluten, parents choose gluten-free alternatives, which are now commonly available in nearly all food products.
GAPS Diet for Autism
GAPS, an acronym for Gut and Psychology Syndrome, was introduced by nutritionist Dr. Natasha Campbell-McBride, who also developed the GAPS diet.
This diet involves removing grains, pasteurized dairy, starchy vegetables, and refined carbohydrates from one's daily meals. It is designed for individuals with neurological conditions, such as autism.
The GAPS diet is based on the concept of leaky gut syndrome. A leaky gut is a condition where undigested food particles enter the bloodstream due to a compromised small intestine lining. Dr. Campbell-McBride suggests that this impacts brain function and may lead to neurological conditions, including Autism, ADD, ADHD, dyslexia, depression, schizophrenia, and bipolar disorder.
Symptoms of a leaky gut include:
Chronic diarrhea, constipation, gas or bloating
Poor immune system
Headaches
Hazy memory and poor brain function
Tiredness
Skin problems (acne, rashes, rosacea)
Craving for sweets and carbohydrate-rich foods
Arthritis and joint pain
The GAPS diet features a detailed meal plan divided into two stages: the introduction phase and the full diet phase. This plan requires gradually adding new foods during the introductory phase until you are prepared to adopt the full GAPS diet.
The diet includes a substantial intake of bone broth, hormone-free and grass-fed meats, fish, shellfish, animal fats, eggs, fresh fruits and non-starchy vegetables, kefir, hard cheese, coconut milk, nuts, and white beans.
Foods to avoid in the GAPS diet include:
Sugar and artificial sweeteners
Syrups
Alcohol
Processed and packaged foods
Grains such as rice, corn, wheat, and oats
Starchy vegetables, such as potatoes and yams
Milk
Beans, except white and greens beans
Coffee
Strong tea
Soy
The GAPS website advocates for supplements to accompany the diet. It specifically endorses its brand of probiotics for autism, along with fish and cod liver oil.
Health experts criticize the diet for its extensive list of prohibited foods, which may be impractical for picky eaters. More importantly, the exclusion of certain food groups could lead to malnutrition in children. Some health professionals also perceive the GAPS diet as a marketing strategy to sell books, DVDs, and supplements rather than a genuine treatment for conditions like autism. Parents and caregivers are urged to exercise caution when considering this method.
Helpful Tips for Healthy Eating Habits
Maintain a regular schedule for activities and meals. This can provide reassurance and help alleviate anxiety related to mealtimes.
Some autistic individuals may have specific interests that can be utilized to engage them in dietary interventions.
Understanding sensory needs can contribute to a more peaceful mealtime environment. This involves minimizing noise and odors during meals.
Make changes gradually, one at a time. Introducing or offering similar foods can be beneficial in expanding dietary variety. Small, incremental changes are generally most effective.
Enhance the exposure to various foods. Greater familiarity with a food can lead to increased acceptance. If your child is autistic, involve them in activities like shopping or chopping vegetables if they are willing, even if they are not expected to eat them.
Practice patience. Progress involves taking small steps and may require time. When supporting an autistic individual, providing ample support and encouragement is beneficial.
You or your child may struggle to find the right balance when it comes to healthy eating, their sensory differences can make it difficult to eat certain foods due to the taste and texture and that can lead to eating a very limited diet. They may also experience physical discomfort due to digestive and gastrointestinal issues that may cause sensory and mood dysregulation. Some autistic children and adults may experience a lot of anxiety and find eating and meal times very stressful and triggering, due to restrictive and repetitive eating habits.
Some examples include:
A strong preference for specific textures, like crunchy or soft foods.
A preference for particular food brands.
A liking for "beige foods" such as crisps, biscuits, white bread, chicken nuggets.
A preference for food to be cut in a specific way, such as toast cut into squares rather than triangles.
Not wanting different foods to touch on a plate.
A preference for predictable foods, like a branded takeaway burger or a specific brand of crisps, which always look and taste the same. In contrast, one banana might be very ripe while another is underripe or bruised, making it unpredictable. Autistic individuals often prefer predictability to help reduce anxiety.
Most individuals will fulfill their nutritional requirements even with a lack of dietary variety, but some may not receive all necessary nutrients. Preferring foods high in sugar while consuming little to no fruits, vegetables, protein, or healthy fats can result in weight gain, constipation, and potential nutritional deficiencies.
A highly restricted diet (such as consuming fewer than 20 different foods) can be concerning. It may lead to nutritional deficiencies that could impact weight, growth, and overall health. Mealtimes often involve many people, noises, and smells, which can be very stressful for an autistic person, making the dining environment unpleasant.
Finding a neuro-affirming dietitian may be really helpful and they can provide advice on techniques to reduce mealtime anxiety. Other health professionals, like neuro-affirming occupational therapists, can also assist, particularly with sensory challenges with certain foods.
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