Autism spectrum disorder is primarily defined by challenges in social and communication skills as well as the presence of restricted or repetitive behaviors. Furthermore, people with autism commonly experience co-occurring disorders like anxiety, depression, and various medical issues like gastrointestinal problems. In this blog, we’ll explore how autism is also linked to food related issues such as food selectivity and the consequences of an insufficient diet.
Food refusal or food selectivity is when the person only eats a limited variety of foods or they are especially resistant to specific foods or categories of foods. Research suggests that 51% to 89% of people with autism have eating disturbances such as food refusal.
Some research has found that children (and adults) with autism often consume fewer fruits and vegetables as compared to neurotypical children. Additionally, people with autism often have lower consumption of calcium and protein compared to the general population. Many people with autism prefer foods that are high in carbohydrates, such as white bread, pizza, cookies, or other types of fatty foods. People with autism often prefer sweet or sugary foods and reject foods that are bitter or sour.
The downside of food preference is that it can cause some negative consequences on a person’s health. For instance, a diet high in carbohydrates and low in protein, fruits, and vegetables can lead to higher blood glucose and triglyceride levels. This has the possibility of leading to malnutrition or above average weight. It might also lead to endocrine disturbances such as diabetes. This type of diet can also lead to higher rates of dental cavities, especially when in combination with poor dental hygiene. People with autism often have a low consumption of vitamin D, vitamin B12, vitamin C, calcium, zinc, and dairy as compared to the general population.
People with autism might go on specific diets, such as a casein or gluten-free diet, either by their own choosing or with the guidance of a parent or caregiver. However, there is little evidence to support many of these dietary approaches.
One of the core characteristics of autism spectrum disorder is having restricted or repetitive behaviors. Food selectivity can be considered a form of restricted behavior. Developing a fixation on particular foods can be seen as a manifestation of a symptom known as insistence on sameness, where individuals exhibit a rigid adherence to routines or ritualized patterns of behavior. People with autism who have higher rates of restricted and repetitive behaviors are more likely to experience food selectivity.
People with autism are often hypersensitive or hyposensitive to sensory stimulation. This means that some people with autism are overly sensitive while others are not as sensitive in comparison to the general population. This includes the consumption of food. Food selectivity can be related to the taste of the food, the texture of the food, and/or the presentation of the food or what the food looks like. Difficulties with sensory processing are correlated with feeding issues in people with autism.
As we mentioned, people with autism often have limited food selectivity. They might only eat certain foods. They may have a strong dislike for certain foods, as well. They may be sensitive to the taste, smell, texture, or presentation of certain foods. They might avoid entire food groups.
In addition to food selectivity, people with autism may not eat enough food. They might “graze” and snack on small portions of food throughout the day. On the other hand, some people with autism might overeat and find it difficult to eat a moderate amount of food.
Additionally, people with autism may struggle with constipation. This may be related to their food choices and food selectivity, or it could be another medical issue not related to their food consumption. If this is the case for you or your child, be sure to consult with a medical provider for further guidance on how to address this issue.
It is also important to consider whether a person’s medications are impacting their diet or their health in some way. Some medications can be associated with constipation or with having a lower appetite. Other medications are associated with weight gain and some medications can be related to poor bone health. Be sure to discuss the possible side effects of medication with a medical provider.
Food consumption is correlated with behavior, emotional regulation, and cognitive abilities. It is important to consider this when evaluating a person’s diet.
When helping someone with autism, keep in mind that food selectivity, or “picky eating,” is common. Many parents find this difficult to manage. With good intentions, parents want their child to eat a well-balanced diet to ensure they consume the nutrients that support good health. It is important not to pressure children to eat new foods too much. It’s okay to compassionately encourage your child to try new foods. You can also consult with a professional, such as a BCBA, to help you work with your child on expanding their diet.
It is recommended that you create daily routines for eating if possible. This will help your child know what to expect, and it will help regulate their digestive system so that they are hungry at regular intervals. This is not to say that children shouldn’t have an extra snack from time to time, especially if they were more active than usual that day or they are going through a growth spurt.
You might also help mealtimes be more enjoyable for your child by doing things like letting your child pick their favorite spot to sit at the table or making sure the lighting and the noise in the environment is suitable for your child.
People with autism can have dietary challenges. It is important to consider their overall health and well-being when supporting their food consumption. It’s okay for people to have food selectivity but it can be helpful to continue to monitor your child’s health and behaviors to ensure they are developing appropriately and functioning at their best.