Autism and Nutrition

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Autism and Nutrition

• Elisabeth Ceysens, MS, RD
• October 16, 2008
• New Mexico Autism Society

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Common Nutrition and Feeding Concerns

• Picky eating behaviors
• Difficulty with transitioning to age-appropriate
  diet
• Increased sensory sensitivity
• Short attention span
• Limited variety in diet
• Need for routine

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Eating Preferences

• Preference for dry, crunchy foods
• Refusal of soft, smooth textures
• Dislike of fruits and vegetables
• Preference for finger foods
• Preference for certain brands and preparation
  methods
• Preference for food of particular color(s)

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Preferred Foods

• dry cereal
• crackers
• chicken nuggets
• pizza
• bread
• hot dogs
• pasta

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What about Growth?

• The majority of children with ASD are of average
  height and weight

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Bone Health

• A study of 75 boys with autism ages 4 to 8 showed
  that the bones of the boys with autism was
  significantly thinner than bones of boys of the
  same age without autism.
• Conclusion selective food preferences and
  dairy-free diets put children at risk for calcium
  and vitamin D deficiencies.

J. Autism Dev Disord (2008) 38848-856
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Other Nutrition Concerns

• Vitamin and mineral deficiencies
• Gastrointestinal concerns (reflux, constipation,
  diarrhea)
• Drug-nutrient interactions
• Food allergies and Celiac disease
• Alternative therapies (CAM)

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Drug-nutrient Interactions

• Medications may increase or decrease appetite and
  may affect vitamin/mineral absorption
• Ritalin decreases appetite and stunts growth
• Risperdal, a SSRI, may increase appetite
• Seizure meds affect calcium, vitamin D and folate
  metabolism and may need to be supplemented

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Diet Adequacy What Do We Know?

• Some studies show no difference in nutrient
  intake with typically developing children.
• Other studies show children with ASD eat less
  than the recommended amounts of vitamins C, D,
  several B vitamins, iron and calcium.
• A 2008 study showed lower intake of vitamin A
  and calcium than controls.

J Amer Dietetic Assoc (2008) 1081360-1363
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Alternative Therapies

• No evidence-based research to show effectiveness
  of alternative treatments
• Select alternative therapy with caution and be
  aware of possible toxicity

• Vitamin B6 and magnesium supplement
• DMG
• Antioxidants
• Zinc
• Coenzyme Q10
• Beta Glucan

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Gluten-Free, Casein-Free Diet

• Leaky gut hypothesis the gut allows peptide
  metabolites of casein and gluten to cross into
  the blood and then into the spinal fluid.
• These peptides act as opiates in the brain and
  interfere with CNS function.
• The implication is that this causes autism.

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GFCF Diet Studies

• A meta analysis in 2004 showed no evidence for
  efficacy of GFDF diet.
• A 2006 preliminary study of 15 children with
  autism, ages 2-16 years, showed no significant
  results although parents reported improvement of
  autism symptoms. This study shows how a clinical
  trial can be conducted.

J of Autism and Dev Disord (2006) 36413-420
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GFCF diet Impact on Families

• Extra time needed to buy and prepare foods/meals
• Diet makes child special or different
• Diet makes peer/social interactions more
  difficult
• High cost of alternative foods

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GFCF Diet Nutrition Implications

• Children on the GFCF diet eat more fruits and
  vegetables and less bread and cereals
• Risk of nutrient deficiencies
• Gluten-free diet Iron, zinc, B vitamins and
  folate
• Diary-free diet Calcium, vitamin D,
  vitamin B2 and protein

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GFCF DietWhat to Do?

• Weigh the pros and cons and decide if the diet
  may be an option for your child.
• Start slowly. Start with CF or GF diet first,
  making a few changes at a time watch your
  child!
• Supplement calcium and vitamin D.
• Give a childrens multivitamin with minerals.
• Talk to your pediatrician.
• Consider consultation with a registered dietitian.

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GF Diet Websites

• www.gfco.org
• www.gluten.net
• www.livingwithout.com
• www.glutenfreepantry.com
• www.allergygrocer.com
• www.foodallergynetwork.com
• www.missroben.com

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Supplements to ConsiderProbiotics

• Probiotics are live microorganisms (bacteria)
  that have beneficial effect on the gut flora.
• No link between probiotics and autism symptoms
• Used for general gastrointestinal health.
• Each probiotic strain has a different mechanism
  of action and different effect on the body.

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Supplements to ConsiderOmega-3 Fatty Acids

• Omega-3 Fatty Acids
• inhibit the bodys inflammatory response
• may help reduce childhood asthma, heart disease
  and rheumatoid arthritis
• important in infant brain development
• recent reports of altered FA metabolism in boys
  with ADHD
• Found in fatty fish, walnuts, flax seeds,
  soybeans, canola and flaxseed oils

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Omega-3 Fatty Acids Recommended Amounts DHA/EPA
Combined

• 1-3 years 700 mg
• 4-8 years 900 mg
• 9-13 years 1200 mg
• 14-18 years 1600 mg
• Adults 1600 mg
• Note Maximum amount for adults is 3000 mg or
• 3 grams per day.

Food and Nutrition Board, Institute of
Medicine, Adequate Amounts (AI), 2002.
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Elisabeth Ceysens, MS, RDVoice Mail
272-0285email eceysens_at_salud.unm.eduAddress
Center For Development and Disability 2300
Menaul Blvd, SE, Suite 201C Albuquerque NM 87107
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Questions ?