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For decades, nutrition for autism has been a fraught topic. There are divergent opinions and findings about this across the internet, the academic press, and across providers – everything from nutrition for autism has no scientific basis, to nutrition for autism is all that matters. As a pediatric nutrition expert who has served children with autism in clinical practice for over twenty years, I can assure you that it matters – a lot. It’s a crucial piece of the autism puzzle, and overlooking it can mean missed opportunity for a happier, healthier, more functional child. I have witnessed significant reduction in autism features as well as complete reversals of autism spectrum diagnoses, with intensive professional nutrition intervention.

If you’re a parent navigating an autism diagnosis for your child, your head might be spinning about now. Where do you start? Medication? Behavior therapy? Speech therapy? Occupational therapy? Different classroom? Social skills group? What to eat or nutrition for autism is probably the last thing you want to think about… not to mention the fact that your child with autism may be an epically picky eater. While you know they should eat better, they just…. don’t. Ok so… Feeding therapy?

Autism is a chronic condition with unique medical and nutrition features. Kids with autism have higher rates of ear infections, respiratory infections, food allergies, asthma, gastrointestinal problems, inflammatory conditions, sleep disorders, seizures, and nutrient deficits. Gastrointestinal problems are among the most common co-morbidities for kids with autism. Nutrition deficits worsen all these problems. The right nutrition support can repair these, to dramatically improve your child’s functional status and well being. What I have observed across my decades of practice in nutrition for autism is that regardless of interventions being tapped, optimizing nutrition, growth pattern, and gut health improve the results of any intervention. Nutrition for autism can synergize other interventions, so children on the spectrum get more out of all their supports.

No matter what level of severity your child’s presentation is for autism, nutrition can make an impact. Nutrition for autism is a deep topic. After so many years in clinical practice, I am still learning every day, especially as we delve deeper into the gut microbiome and its role in brain and immune function. Here are five categories where nutrition and autism align. Leverage these to help your child thrive.

1 – Brain Development and Function Depends Entirely On Nutrition:  First and foremost, let’s remember this: Your child’s brain happened because you ate while pregnant. Severe malnutrition while pregnant can cause spontaneous abortion. For pregnancies carried through less severe malnutrition, the baby’s brain weight will be lower than normal, with fewer neurons and glial cells – a permanent change. For kids with developmental deficits, early and strong nutrition support – especially in the first one thousand days of life – can make or break long term outcomes for a child. Even being marginal or deficient for just one nutrient while pregnant – like iron – can permanently alter a baby’s brain structure and function, and cause low birth weight or low birth length.

Nutrition continues to be crucial after your baby is born. Weak nutrition in the first 1000 days can leave your baby’s brain with fewer glial cells, reduced myelination, and less synaptogenesis. In fact, there are five major processes that allow a human brain to grow and develop. All of them are vulnerable to nutrition deficits. None of them happen to potential without adequate food and nutrition. Impeding any one of these processes can lead to developmental features that can affect people with autism. Because kids on the spectrum have gastrointestinal and feeding problems more often, they are at higher risk for nutritional effects on the brain. While this all starts in utero, brains don’t stop developing until the end of adolescence. A young child’s brain uses almost twice the caloric fuel of an adult’s, just for starters! The evidence is rich, deep, and decades-long, when it comes to describing how nutrients and energy from food let the developing brain do its job.

It’s easy to forget all the things our brains master in our early years. We acquire mastery to sort, process, remember, learn, regulate, manage sensory inputs, and control motor functions. The brain also runs basal metabolic functions for us, like breathing, sleeping, filtering our blood and lymph, and digesting. Using nutrition for autism can optimize this so your child has a better life long outcome. You can assure the brain gets a steady and strong supply of fuel and nutrients, to protect against infections or toxins that can injure the brain.

2 – The Gut-Brain Axis Is Pivotal For Kids With Autism – It’s increasingly noted for its high impact on the features of autism. Kids with autism have distinctly different gut microbiomes than typically developing peers. That is, the array of microbes living in their intestines is different. Redirecting gut microbiome in persons with autism has shown promise in clinical trial for diminishing autism features. This and many other studies reveal that when GI features improve, so do autism features. They are significantly correlated with eachother. In my own pediatric nutrition practice, I witness this correlation time and time again: Autism features improve when GI issues are corrected. This means fixing gut dysbiosis, redirecting the microbiome to a healthier profile, and resolving problems like constipation with means other than laxatives that simply mask underlying cause.

Even children without outward suffering from obvious GI symptoms may harbor a disrupted gut microbiome that, once addressed, will yield benefits rather than impediments. Some research demonstrates that anxiety, inattention, tics, and obsessive-repetitive behaviors can be turned on and off, depending on status of certain microbes in the gut. Volatility, picky eating, constipation, encopresis, diarrhea, and irritable stools – features that afflict children with autism more often than typical peers – can shift with gut microbiome management as well.

At the very least, we depend on a healthy gut microbiome for immune function, for the production of short chain fatty acids that fuel our gut tissue, and for support in accessing and absorbing nutrients from food. More research is emerging about the far reaching impact these gut microbes have on the brain and the immune system. Nutrition directly impacts the gut microbiome, and maintaining a healthy balance of gut bacteria through proper nutrition can positively affect mood, behavior, and overall well-being in individuals with autism. In my pediatric nutrition practice, I use tools like GI-MAP to look more deeply into the array of microbes in a child’s gut. This helps me choose foods, probiotics, or other supports to build better digestion, absorption, and stooling – but I see the benefits expand into the child’s functional status, focus, mood, and behavior too.

3 – Your Care Team May Not Know What To Do About Nutrition. I’ve worked with children on the spectrum since 1999, providing nutrition assessment, support, and intervention. I’ve authored books on nutrition for autism, trained other professionals in it, blogged on it, and lectured on it. I’ve completed hundreds of nutrition assessments and care plans for kids with autism, from all over the US and in other countries.

Here’s the thing: I have truly actually never met a child on the spectrum free of a nutrition concern. The problem is that either nobody on the child’s care team did a nutrition assessment at all, or if it was done, it was cursory and missed a lot of important details. A deeper, functional-focused nutrition assessment lets me find the nutrition problems – and when we fix them, these children’s lives begin to improve dramatically.

This happens all the time. Why? Because your neurologist, speech therapist, pediatrician, occupational therapist, and neuropsychologist aren’t nutritionists or dietitians. It’s not their job to do this assessment, and they aren’t trained or expected to do it. It’s well known that autism and nutrition is a thing. It’s just not their thing. And often, in the rare circumstance where a child gets a nutrition referral with an autism diagnosis, a hospital-based dietitian may not be free to really investigate, or may not know how to do more than a cursory screening.

Common nutrition problems for children with autism go beyond low status for zinc or iron, picky eating, lacking brain-critical fats or oils, or having tantrums that exhaust you at mealtimes. Kids on the spectrum do often have those problems, and nutrition for autism supports can solve these to improve behavior and functioning. It may take deeper digging to sort out where to start; it may fall on you as a parent to lead the physician team and ask for help. Get my e book on the Five Essential Lab Tests For Kids With Autism. This is a fast and deep dive into nutrition screenings to do right away, and how to get them done with your current provider team. This e book can save you months of time, agony, and money by showing you the path to quickly sorting what nutrition support your child might need.

4 – Kids With Autism Have More Immune Dysregulation – Nutrition and immune status are intricately intertwined. They have a circular relationship: The immune system needs strong nutrition to function best, while in turn, nutrition affects the immune system’s ability to defend. At any age, but especially in young children, the Cycle of Malnutrition and Infection can be devastating or life threatening. Many children I have assessed in my pediatric nutrition practice met malnutrition criteria and their physician team was none the wiser (see Bullet 3 above). Even mild malnutrition can affect the brain, immune system, and more.

But it goes deeper when a child has autism. Kids with autism have higher levels of inflammatory cytokines. Cytokines are a type of immune system protein that controls inflammation. Higher cytokines meant more aberrant behavior and more impairment in children with autism, in this study. Mothers with a history of autoimmune conditions like celiac disease, rheumatoid arthritis, or Type 1 diabetes are at higher risk for having offspring with autism. Many other features of higher inflammation have been described in children with autism. Clearly, there is an immune system link. Finding root cause of inflammation – whether it’s old infection, heavy metals, other toxic exposures, or more – has potential to lessen or even reverse your child’s debilitating features or symptoms.

Many research efforts have described these immune shifts with autism, and have investigated ways to reduce inflammation, since doing so can improve features of autism. The nutrition part of this gets back to helping the immune system defend from viruses, infections, and toxins, so these don’t embed deep into tissue and cause chronic havoc. Children may not appear sick as these invaders become situated in the body. Invading agents can disarm the immune system in nutritionally vulnerable children and overwhelm it, creating a perfect permanent residence for themselves, where they disrupt functioning, communication, behavior, sleep, and more. Consider an immune work up for your child with autism. You can learn more about what testing may be useful in my e book Five Essential Lab Tests For Kids With Autism.

5 – Elimination Diets Mean Eating More Not Less.. What about special diets for autism? I never recommend any diet without a rationale based on labs, symptoms, history, and clinical signs. Whatever diet your child eats, it should be tailored to your child, through individualized assessment and care. Replace what you remove with equal or even better food.

Contrary to the story you may have heard that elimination diets are risky, I have only seen this in cases where families launch a diet without help and end up over-restricting the child. But when done correctly, elimination diets help kids with autism become healthier, happier, and more open to a broader palate. They eat more food, not less, and better food to boot. They grow, sleep, eat, learn, and socialize better. They settle down into their true selves.

What is risky is leaving a child in picky eater mode, unable to eat more than a few foods, or waiting years until all other interventions fail before providing good nutrition care.

I have also not found that children suffer socially when using dietary restrictions typical with an autism diagnosis. Instead I routinely witness that because behavior and social skills can improve with the right nutrition support, children with autism become more socially engaged, make more friends, and get more access to social landscapes as a result. Kids tend to choose to be with their new best friends, rather than their old favorite food.

New autism diagnosis? Put nutrition first. It’s just the tippy top of the iceberg of potential! All those other services you’re looking at right now, and wondering how to pay for, work far better when paired with the right nutrition platform. Your child will get more mileage out of each intervention, whichever one you choose. In fact, you may even find you need fewer services or less intensive services, once nutrition support is engaged. I have witnessed many instances of children graduating sooner that expected out of Applied Behavior Analysis, feeding clinics, or social skill groups because of a nutrition piece.

Get Autism Nutrition Help Now! Not sure where to start? Here are two books on autism and nutrition that I’ve written for parents to start with, here and here. Send me your questions or comments below – I look forward to hearing from you!