The incidence of autism, often referred to as autism spectrum disorder, or ASD, increased within a 20-year period from an estimated 5 to 6 per 10,000 children to 65 per 10,000 children. According to the "Journal of the American Dietetics Association," children with autism appear to have an increased risk of gastrointestinal disorders and food allergies, which can be difficult to diagnose due to communication issues. The impact of diet on autism should be taken into account when treating autism to ensure that poor nutrition does not further complicate the disorder.
Leaky Gut Syndrome
It is hypothesized that symptoms of autism may be due to leaky gut syndrome, which occurs when increased intestinal permeability allows small proteins or peptides that normally cannot cross the intestinal membrane to enter the bloodstream. These proteins may then enter the brain, impacting the nervous system, leading to behavior problems in autistic individuals. Gluten and casein are believed to be two such offending proteins. A gluten-free, casein-free diet has been recommended for treatment, but there is no clear evidence that it is beneficial or practical for all children and their families. If you choose to try a diet that eliminates whole food groups, be sure to work with a dietitian that specializes in autism to prevent nutrient deficiencies.
Gastrointestinal Disorders
Gastrointestinal problems are common in autistic children. According to Elizabeth Strickland, a dietitian specializing in autism and author of "Eating for Autism," three of the main contributors are gastroesophageal reflux disease, or GERD, eosinophilic gastrointestinal disorders, or EGID and chronic constipation. Symptoms include pain or burning in the abdomen, chest pain, nausea, vomiting, diarrhea or painful stools, bloating, difficulty swallowing and difficulty sleeping. If your child is experiencing any of these symptoms, have her examined by a physician.
Food Allergies and Sensitivities
Food allergies, intolerance and sensitivity can lead to intestinal symptoms, including bloating, vomiting, diarrhea, reflux, gas and constipation. If your child is experiencing these symptoms, have his doctor rule out allergies. If blood tests suggests no reaction but issues still persist, work with a dietitian to try a short-term challenge diet or elimination diet to identify food sensitivities or intolerance that did not show up in the blood test.
Medication Interactions
Medications are often prescribed to treat issues related to autism including depression, behavior problems, seizures, digestive problems, sleeping disorders and allergies. Side effects can increase feeding problems for these children as well as interact with nutrients in foods. Medication can decrease or increase appetite and weight, lead to abdominal pain, nausea, vomiting, diarrhea or constipation, or cause dry mouth and altered taste. If your child is taking medications, have a registered dietitian review the list to determine if feeding problems may be due to medication interaction with specific foods or side effects of the medicine.
Problem Feeders
Gastrointestinal problems due to medications, allergies or disorders can make eating extremely painful. The child eventually associates food with pain and refuses to eat. This can lead to malnutrition, poor growth and developmental issues. While picky eaters are common and part of childhood development, problem feeding is not. In "Eating for Autism," Strickland identifies problem feeders as those that: eat fewer than 20 foods and slowly decrease acceptance to only five to 10 foods; avoid all foods with a particular texture; and will not tolerate or even touch new foods. Problem feeders often require long-term, extensive feeding therapy from a multidisciplinary team to resolve these issues.
References
- "Journal of the American Dietetic Association"; What is the Current Status of Research Concerning use of a Gluten-free Casein-free Diet for Children Diagnosed with Autism?; W Marcason; March 2009
- "Eating for Autism"; Elizabeth Strickland, MS, RD, LDN; 2009
- "Pediatrics"; Evaluation, Diagnosis, and Treatment of Gastrointestinal Disorders in Individuals with ASDs: A Consensus Report; Timothy Buie, et al.; January 2010
- University of Florida Department of Pediatrics: Autism, Casein and Gluten Food Sensitivity, Diet
- "Cochrane Database of Systematic Reviews"; Gluten- and Casein Free Diets for Autism Spectrum Disorder; Claire Millward, et al.;
- American Dietetic Association: Autism and Diet
