Nowadays, every 60-70 child has autism spectrum disorder and there are a lot of parents who have a fear of having a child with autism. Medical authorities state that unhealthy, unqualified industrial foods (nutritional value, vitamin, low mineral, refined) and environmental factors are the most important reasons for the increase in autism.
According to various researches, in the spread of autism spectrum disorder, the decrease of vitamins and minerals in the soil, vegetables, and fruits which are impoverished by using excessive chemical fertilizers and drugs, the reduction of Omega-3 consumption, the excessive exposure to heavy metals, antibiotics and toxins are some of the important factors.
Researches suggest that autism spectrum disorder is becoming widespread and that this is not only a genetic cause, and that negative environmental factors, such as water and environmental pollution, have much more important effects on the formation of autism. Autism is a neurodevelopmental disorder that starts in the digestive system and shows its results in the brain, according to experts.
Being refined and unnatural foods which are poorer from vitamins and minerals makes the detoxification reactions that have already slowed down lazier to do its job. Diets should be prepared without foods that are known to cause digestion and some kind of morphine since most children with autism have intestinal and gastric problems.
The care of a child with autism spectrum disorder can be difficult on many levels, and ensuring a healthy diet is no exception in this issue. However, for a child with autism, a healthy, balanced diet can create a world that changes the ability to learn, how they manage emotions and the way they process information.
Children with autism usually have limited eating habits as well as eating difficulties, so they may not take the nutrients they need, especially calcium and protein. Therefore, the importance of nutrition in autism should not be ignored.
Many parents see their child’s preference for taste, color, smell and texture as the biggest obstacles to a balanced diet. The fact that the child with autism begins to try new foods – especially those which are soft and slippery – may seem almost impossible. Parents can observe that the child may avoid certain foods or even whole foods.
Experts state that as one of the easiest ways to approach sensory problems of children with autism, to keep them away from the kitchen table. Also, they say that parents should take their kids to the supermarket and let them choose a new food to experiment. When they get home, research the Internet in order to find out how and where it grew up. Then they should decide together how to prepare. When they finish progress, parents should not worry if the child with autism does not want to eat. Experts suggest that parents should wait until the child want.
Relationship Between Nutrition and Autism Spectrum Disorder
Nutritional and dietary practices may help to reduce the symptoms of autism, even though it is not considered a treatment approach in autism alone. It is also very important for the ideal growth and development of children. There is also evidence that communication between the brain-intestinal tract can play a role in the development of autism.
Nutrition can reduce the symptoms of autism spectrum disorder, as well as autism symptoms, may adversely affect the child’s diet. Children with autism may be sensitive to the taste, smell, color, and texture of the food and therefore refuse to eat certain foods. Children with focusing problems cannot sit at the table for a long time and may have eating problems.
If children with autism do not consume enough nutrients and fluids, digestive problems such as constipation can be observed. Drug therapy may affect appetite and thus food consumption. Various dietary applications, which are suggested to reduce symptoms in children with autism, are also frequently discussed. However, there is no definitive and evidence-based data on this issue.
There are two most common dietary concerns in autism spectrum disorder which are restricted/obsessive diets and using diet as a treatment for autism, which is called biomedical interventions.
Restricted/ Obsessive Diets; Many children with autism have a selective eating preference that goes beyond the usual picky eating behaviors which are observed in most children at specific developmental stages. These kinds of self-limiting diets are usually a direct result of the disorder itself. The diet that they have may be limited to as few as 2 or 3 foods. There are common feeding concerns.
• They may have difficulties with transition to textures, especially during infancy.
• They may have problems with accepting and eating new foods.
• They may have restricted food intake due to color, texture, packaging and food temperature.
• They may have difficulties with mealtime preparation, for example, they may have a preference for specific plate and cutlery, positioning of food on a plate.
• They may prefer continually eating rather than having meal times.
So, dealing with these kinds of struggles and challenges, such as selective eating, there are some strategies. For example;
• Most children with autism can do best when meal times are at the same time, same place and same situation every day.
• Caregivers can use visual timetables and visual schedules in order to arrange meal time. Written timetables or Picture symbol schedules detailing when and where they will eat, what will be eaten and what type of behavior expected at meal times makes those times more predictable. So, it will be a less anxious occasion for the child with autism.
• Whilst children with autism should not be restrained, seating that encourages staying at the table can be helpful and beneficial.
• As a calm and comfortable environment as possible should be established.
• Some children with autism eat more when there is a video or music on, on the other hand, this may be too distracting for other children with autism.
• Caregivers should work in order to broaden the variety of a child’s diet expanding on already accepted and eaten food groups, for example, it could be different types of bread.
• It should not be assumed that the child automatically refuses food in a new environment. For instance, the child may eat spinach at grandmother’s home but not at home.
• It should be set small goals in stages and it will allow the child with autism to reach a larger goal step by step. For example, before encouraging a child in order to eat vegetables, they need to accept a small amount on their plate first. The amount may be as small as possible like a pea, however, this allows the child in order to remain secure within the environment they are familiar with.
It will be a slow process to change in dietary intake and not all strategies will work for each child. As we all know, autism is a spectrum disorder and each individual’s needs are different from each other. That’s why behavior modification needs to be tailored according to each individual child and also a family situation.
Knowledge of the composition of different foods, alternative substitutes and supplementation is the expertise the dietitian can bring to ensure the child with autism has an adequate diet. Reassurance and advice during these critical periods of growth is a valuable and essential use of dietetic resources.
Nowadays, there is a huge amount of information available via the Internet, books, parent networks and other organizations to parents of children with autism. However, this information can be overwhelming and often contradictory. Interests in having diet and vitamins as a therapeutic with autism spectrum disorder are high.
Biomedical Interventions are often supported by parent of children on the spectrum. Although diets are a popular treatment for autism there is a lack of consistent and good quality scientific evidence to support their recommendation as a treatment for symptoms of autism.
Keeping children with autism spectrum disorder away from packaged foods, all cereal products except corn and rice, soybeans, heavy metal-containing objects are just a few of the things to do. As a result, they form part of a whole. In order to complete this whole, there are some necessities to do.
It is necessary to apply all the treatment steps such as a natural food diet, gluten-free and casein-free diet, removal of vitamin, mineral and amino acid deficiencies, correction of intestinal flora, supplementation of digestive enzymes, ingestion of natural foods, removal of heavy metals, cleaning of heavy metals, medicines, and education.
1. Gluten Free Casein Free (GFCF) Diet
It is the most popular and best know dietary intervention. In order to reduce the symptoms of autism, there are some people who apply gluten and casein removal from the diet. Gluten is a protein found in wheat, rye, and barley, and casein is a protein found in milk.
It has been suggested that intestinal permeability may increase in children with autism, as a result of which gluten and casein fragments may affect the brain and central nervous system with blood circulation. However, the removal of casein, from the diet leads to a deficiency of micronutrients such as calcium and phosphorus, while the removal of gluten from the diet may cause a deficiency in pulp intake with B-group vitamins.
There is a theory behind the treatment. It has been suggested that individuals with autism spectrum disorder have a gut which is abnormally leaky. The poorly digested casein and gluten leak into the bloodstream and affect mental function and behaviors. Therefore, it is proposed that by eliminating foods which are containing gluten and casein from the diet, autistic behaviors may be reduced.
According to reviews, gluten free casein free diet cannot be recommended as a standard treatment for autism spectrum disorder due to the limited data available. Although there is no definitive scientific evidence, if such a diet is to be applied, it should be accompanied by a nutritionist and the necessary vitamin-mineral supplements should be taken.
2. Yeast Free Diet
There is a theory behind the treatment which is that it is believed that a leaky gut in people with an autism spectrum disorder, may be caused by an overgrowth of yeasts in the gut, following treatment with antibiotics. And then in behavioral symptoms of autism, allergic reactions or increased susceptibility to allergies can happen as a result.
The theory is that these symptoms can be prevented by eliminating dietary yeasts. According to some scientific results, yeast overgrowth in the gut is usually treated by prescribed medications and there is no evidence that eating less dietary sources of yeasts helps.
Children with autism may be at risk of malnutrition due to a lack of focus on food, food selectivity, and digestive problems, and nutritional deficiencies may occur in these children. In order to prevent these circumstances, A, C, B6, folic acid, B12 vitamins and other minerals and omega-3 fatty acid supplements can be used based on doctor’s advice and under doctor control.
As the knowledge we have about autism, individuals with autism may have abnormal or impaired metabolic or biochemical processes and high doses of vitamin or minerals, such as vitamin A, vitamin C, vitamin BG, Magnesium, Zinc, may be needed to correct for this.
Supplements can be costly. Besides that, also it should be noted that sometimes the suggested doses exceed the safe upper limit for adults with autism and little is known about long term high doses in children with autism. Well respected, independent reviews of the evidence that supplementation with vitamins and minerals is beneficial, have found it to be inconclusive.
4. Fish Oils and Other Supplements Rich in Omega 3 Fats
As we all know, Omega-3 fats play a key role in brain development and function. So, it makes that important for people on the spectrum as well.
There is some evidence that omega 3 supplements improve other neurodevelopment disorders, such as learning difficulties, mood disorders and in children with developmental coordination. On the other hand, there is not enough and sufficient evidence available in the case of autism spectrum disorder.
Due to its effects on brain development and cognitive functions, the use of omega-3 fatty acids in autism is a topic that everyone is curious about. Insufficiency of essential fatty acids such as omega-3 fatty acids may increase the severity of learning disabilities and behavioral problems. Consumption of fatty fish twice a week supports the intake of omega-3 fatty acids. If there is not enough fish consumption, it should be consulted by the doctor about the use of omega-3 supplements.
Besides those, fish oil supplements can be quite costly and that’s why there is a need for more autism specific researches. More autism-specific research is required in order to add to our knowledge in the area since we do not know enough about their long term use and any associated health risks. And also we have to know that if the effects of supplements are greater than achieved by eating a healthy diet, as recommended for the general population.
5. Probiotics and Enzymes
There are numerous digestive enzyme products and probiotics aimed at individuals with autism. For example, Probiotics can be taken as powders or as yogurt drinks. On the other hand, there is no scientific research currently available in order to indicate that probiotics have any therapeutic benefit in autism. In addition, there is no evidence that enzyme preparations have a useful role in autism.
What Are the Opinions of Experts on the Importance of Nutrition in Autism?
As the parents know well, many individuals with autism have a sensitivity to swallowing food. In addition, many individuals with autism can create even more compelling behavioral problems during meal times than usual. A newly published meta-analysis of scientific studies confirms these parental concerns and provides insights into the most common nutritional deficiencies associated with an autism spectrum disorder.
The researchers say that children with autism are more than five times more likely to have eating problems, such as cooking on their own, excessive food selectivity, and ritual-eating behaviors. Malnutrition is more common among children with autism than normally developed children.
In particular, there is a lack of low calcium and protein intake in individuals with autism. Calcium is very important in order to form strong bones. Adequate protein is also important for growth, mental development, and overall health.
The researchers stated that if a child with autism has also chronic eating problems, it increases the risk of experiencing social difficulties and the risk of academic failure. This increases the risk of diet-related diseases such as obesity and cardiovascular disease during adulthood and adolescence period, so the importance of nutrition in autism spectrum disorder is significant and should not be underestimated.
How Can You Make and Provide Individuals with Autism’s Nutrition to Take Easier?
A kitchen with a lot of tools, bright lights and the way the furniture is arranged is at the top of potential stress sources for individuals with an autism spectrum disorder. It is very helpful to make the meals as predictable and routine as possible. Serving food at the same time every day is one of the simplest ways in order to reduce stress level.
In addition, parents should try to put themselves in the position of their child, it means they should develop empathy, and consider what privileges they can make for easier meals. For instance, if the child is light sensitive, they may try to eat under candlelight. In order to have participated in the child with autism in each meal, parents can choose the child’s favorite food or allow the child to choose the favorite chair of the table.
What Is the Importance of Breast Milk in Autism?
As it is known, breast milk is the best food that can provide all the nutrients that babies need for the first 6 months of life. Breast milk and the first yellow milk after birth are very important for the baby because it is the first vaccination of the baby and it protects the baby against diseases. Breast milk is vital for babies.
In addition, the best way to communicate with the mother is to breastfeed her baby. Furthermore, breast milk contributes to babies being more intelligent than other babies who are fed with other foods in their later years. In this sense, breastfeeding of individuals with autism spectrum disorder is more important than normally developed children, both physically and psychologically.
Breast milk is the ideal food source that contains all kinds of nutritional values such as protein, fat, iron, vitamins that the baby needs in the first six months. It protects the baby from infections due to the preservatives in it. Breast milk is easy to digest and there is no need to boil.
What Are the Types of Diet Used in the Treatment of Autism?
Children with autism spectrum disorder are at risk for malnutrition and any kind of nutrition. It was found that being overweight and obesity was higher in children with autism between the ages of 2 and 5 years and being overweight was more frequent in 5-11 years of age.
Limited social interactions, limited or repetitive behavior, acceptance of only certain foods, rejection of new or unusual foods, increased high sensitivities such as tissue, temperature, color, and odor affect the food intake and eating behavior of children with autism. They often reject fruits and vegetables. Other than that, most of the time, they have a specific preference for 2 or 3 food and eat them all the time.
There was a study which is done with 53 children with autism spectrum disorder and 58 normally developed children. It was found that children with autism aged between 3 and 11 years rejected more food and consumed less food than normally developed children did.
It has been reported that nutrient deficiencies in children with autism are observed at a higher rate. And also it has been reported that the rate of consuming a single type of food is 4 times more in children with autism compared to normally developed children.
Eating disorders, gastrointestinal disorders, epilepsy, and obesity are the most common disorders which are observed in individuals with autism. It is known that children with autism suffer from many vitamins and minerals insufficiencies as a result of having very permeable intestines and being highly selective in nutrition. Various approaches to nutritional therapy are being tried.
- Gluten-free Cazeine-free diet: Gluten-free diet, which is used as a limitation of consumption of wheat, rye, barley, and oat products, is also used in individuals with autism. In addition, removing milk and milk products (cheese, yogurt, buttermilk, etc.) are also considered to be effective in children with autism’s diet, as a casein-free diet.
- Ketogenic Diet: Autistic behaviors are thought to be related to a deficit in glucose metabolism. Therefore, it is thought that the ketogenic diet, in which carbohydrates are severely limited, may be effective.
- Special Carbohydrate Diet: This diet takes into consideration the absorption of both simple carbohydrates and complex carbohydrates. Consequently, simple carbohydrates are completely removed while the complex carbohydrates in the diet are restricted. The diet prohibits starches and consists mainly of meat, chicken, fish, eggs, vegetables, fresh fruit, nuts, and oilseeds. It starts with a limited amount of food intake and the number of nutrients is gradually increased as the intestinal tract improves.
- Feingold Diet: With this diet, coloring, it is recommended that flavoring, preservatives, and sweeteners containing nutrients should be removed from the diet. Almonds, apples, apricots, strawberries, cucumbers, spices such as curry, and also foods that are common reactive salicylate-containing foods such as grapes, raisins, oranges, honey, peaches, peppers, and tomatoes should be restricted.
- Candida Body Ecology Diet (B.E.D) : Candida albicans is a yeast-like fungus that can cause infections in immunocompromised individuals. The excessive increase in Candida albicans has been associated with problems such as concentration disorder, aggression and hyperactive behaviors in children with autism. This diet includes many fermented foods such as raw sauerkraut, other cultured vegetables, kefir made with non-animal milk and yogurt. In addition to being gluten-free, it is a rice-free, corn-free and bean-free diet. Only a few foods such as quinoa, millet, whole wheat, and amaranth are allowed to consume in this diet.
- Eliminated Allergy Diets: Most children with autism have nutrient sensitivity due to abnormalities in the digestive system and immune system. Nondigestible carbohydrates or amino acids cause beneficial bacteria to react to these components in the intestine. The removal of allergic foods from the diet may lead to improvements in some children, including the improvement of behavior and attention in the gastrointestinal tract. Milk, wheat, soy, eggs, peanuts, nuts, fish, and shellfish are the products among the foods to be removed from the diet.
- Nutritional supplements: Children with autism have chronic diarrhea or constipation, gastrointestinal inflammation, and limited nutritional preference. For this reason, it is recommended to take the nutrient as deficient in the form of supplements based on the idea that they cannot be fed sufficiently.
Nutritional treatments were found to relieve the symptoms of autism. In addition to that, it has been found that sugar, additives, starch-containing foods and foods that cause an allergic reaction in children are aggravated.
However, it is not possible to say that any diet therapy applied is effective because it does not provide full efficacy in the treatment. There are always individual privileges in diets which are applied. Therefore, it is important to carefully follow a person’s illness and to draw a proper road map for that individual.
What Kind of Nutrition Should Be Consumed by Individuals with Autism?
Meat: It should be not fat-free, not overcooked.
Offal: It is very healthy but should be careful not to be diseased.
White Meat: Preferably poultry.
Seafood: It is forbidden due to heavy metal poisoning. Also, the ones that raised in the pool are forbidden because there are toxins present in the pool. Seaweeds and samphire are free to eat because they contain high chlorophyll.
Egg: It is the best quality protein source. Village eggs should be preferred. From 1 to 4 amount is edible per day. If it is possible, it should not be eaten as frying and if there is no way besides frying, it should be cooked in olive oil, nut oil or butter.
Vegetables: All kinds of are edible. They should be consumed as raw. Dark green leaves are rich in vitamin K, calcium and magnesium, and also contain Omega-3 fatty acids. Because they grow naturally, weeds such as hibiscus, sorrel, stinging nettle, purslane, labada are excellent.
French fries: It should not be eaten at all. A small number of potatoes can be placed in vegetable dishes because it is high sugar content.
Garlic: It is one of the most important foods that protect the cells. Since it contains sulfurous compounds, it also helps in heavy metal discharge. Sulfuric amino acids are generally low in autism. At least two pieces should be eaten every day. Onion is also as valuable as garlic with high sulfur content.
Olive: It should be consumed as much salt as possible free. Green olives should be preferred.
Fruits: Fruits which contains phenol such as apples, grapes, and strawberries should not be consumed. Fruits with high sugar content such as apricots, grapes, and bananas should also be eaten in a limited amount. Low sugar fruits can be consumed more. It must be careful about dry fruits are not moldy.
Milk and Dairy Products: Cow and sheep milk and products, such as yoğurt and cheese, should not be consumed. Kefir or yogurt juice made with these milk can be eaten. Goat milk and products, such as yogurt, cheese, and kefir, are free to consume.
Legumes: Chickpeas, beans, lentils, peas or cowpea should not be eaten more than 2-3 times a week.
Shelled Nuts: Walnuts, hazelnuts, peanuts, sunflowers, pumpkin seeds, and almonds could be eaten. Up to 25-50 grams per day are quite healthy. Raw and less salty should be preferred.
Oils: Oil restriction is harmful to the body.
Margarine: Absolutely prohibited!
Tea: All of them are very healthy.
Coffee: It is absolutely forbidden.
Chocolate: Chocolate consumption should be reduced. Once a week, medium, bitter and high-quality chocolate can be eaten.