Tips for ASD Individuals

Written by: Martha Junestita

Have you heard about Autism Spectrum Disorder??
Autism Spectrum Disorder (ASD) is a neurological and developmental disorder that normally begins in early childhood. Individuals with ASD often have difficulties with social interaction and communication and also exhibit restrictive, repetitive and unusual behaviours or reactions.

Atypical eating behaviours such as restrictive food intake and hypersensitivity to the textures, look and smell of food are also common for autistic people. Studies have shown that autistic people have a significant relationship between atypical oral sensory sensitivity and food selectivity which results in individuals with ASD often refusing many different types of food and leading to a decrease in overall consumption.

How does nutrition affect ASD?
People with ASD are more likely to suffer from malnutrition and gastrointestinal disorders as they might not get all the nutrients they need. Someone who grows up with poor diets has a high chance of being overweight and obese and that could lead to several chronic illnesses like heart disease, diabetes and stroke. 

What nutrition considerations do someone with autism need??
A rich, balanced and varied diet should be the primary focus. However, some studies from 2013 and 2020 published in the National Library of Medicine indicate that individuals with ASD often have inadequate intake of protein, calcium, vitamin D, vitamin C and vitamin B12. They also consume fewer fruits and vegetables and prefer high-carbohydrate foods, processed foods, sweets and snacks. This diet could be a concern for a long-term window period as this may lead to nutritional deficiency.

Let’s talk about those nutrition considerations!
– Calcium
Calcium is a macro-mineral that our body needs to develop and maintain bones and teeth health. Low intakes of calcium could lead to a condition called osteoporosis, this condition is when the mass, structure and strength of bone change and increase the risk of fractures. The adequate amount of calcium you need to take is different depending on the age and sex (around 1000-1300 mg per day). Many foods like dairy products, leafy green vegetables, nuts and seeds normally contain calcium.

– Vitamin D
Vitamin D is a fat-soluble vitamin that can occur in two forms. One is from sun exposure when ultraviolet (UV) rays strike the skin, and the other is from foods. The main function of vitamin D is to help the body absorb calcium and phosphorus. Other than that, vitamin D also plays a role in maintaining the immune system and healthy skin. Lack of vitamin D can lead to rickets in infants and children, causing bowed legs and knocked knees, and causing osteoporosis and osteomalacia in adults. The recommendation for vitamin D intake is about 10-15 mcg per day.

Few foods naturally contain vitamin D. However, fish like salmon, tuna, mackerel and eggs naturally contain vitamin D. It can also be found in fortified foods like dairy and plant-based milk, fortified margarine, fortified orange juice and fortified cereals.

– Vitamin B12
Also known as Cobalamin, vitamin B12 is a water-soluble vitamin that is essential for the development and healthy functioning of the neurological system and red blood cells, and for the production of DNA. Vitamin B12 deficiency can lead to haematologic symptoms like megaloblastic anemia that can cause fatigue, skin pallor and shortness of breath. Neurological complications like memory problems or even dementia and mood changes also can occur in individuals with a severe vitamin B12 deficiency.

Adequate intake of vitamin B12 is about 2-2.4 mcg per day for adults. Vitamin B12 is naturally present in animal-based foods such as meats, fish, poultry, seafood and dairy products. It also can be found in fortified foods like nutritional yeast and plant-based milk.

How can we help to improve the quality of life of those with ASD?
1. Encourage and include individuals in picking new foods
Focus on getting them familiar with new food by doing the research together, going to groceries and preparing it together, that might help them become a flexible eater. Don’t forget to be patient and supportive and not put the pressure on them.

2. Close monitoring of eating habits
Start by closely examining their diet to identify what kind of food they are comfortable with and what kind of food they need to have more to meet nutritional needs. Introduce them to foods that have different textures and smells to expand their diet. Also, pay attention to the surrounding environment, check if the table and chair are comfortable enough for individuals to have a meal, as well as cutleries and other stuff to help individuals have a better mealtime experience.

3. Supplementation
Multivitamin supplement will help people with ASD to get some extra nutrients that missing from their diet and improve the overall quality of life. Omega 3 and B12 supplement is also very important for metabolism and brain development since fats are essential to brain function, it could be used as a treatment to improve symptoms.

While supplements can be beneficial, they should not be a substitute for whole and nutrient-dense foods. 

4. Physical Activity
Physical activity is very important for maintaining health in general. Individuals with ASD normally have no desire to participate in any physical activity since they have restricted interest and have no social interaction but the lack of physical activity can lead to overweight and obesity.

Studies have shown that physical activity for ASD individuals will improve social behaviour, communication skills, academic performance and physical fitness. Try to have an easy to moderate physical activity depending on the individual’s ability for 30 minutes each day.

5. Have a consultation with a dietitian
Getting support from professionals might help a lot, Dietitian can provide individualised nutritional assessment and nutritional plans like gluten-free and casein-free diets for example. As well as monitoring the progress and providing on-going support to make sure individuals with ASD can meet their nutritional needs and improve their quality of life.

References:
1. Narzisi, A., Masi, G. & Grossi, E. (2021). Nutrition and Autism Spectrum Disorder: Between False Myths and Real Research-Based Opportunities. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234602/
2. Parletta, N., Niyonsenga, T. & Duff, J. (2016). Omega-3 and Omega-6 Polyunsaturated Fatty Acid Levels and Correlations with Symptoms in Children with Attention Deficit Hyperactivity Disorder, Autistic Spectrum Disorder and Typically Developing Controls. https://pubmed.ncbi.nlm.nih.gov/27232999/
3. Wang, Z., Ding, R. & Wang, J. (2020). The Association between Vitamin D Status and Autism Spectrum Disorder (ASD): A Systematic Review and Meta-Analysis. Nutrients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7824115/
4. Sharp, W., Berry, R., McCracken, C., Nuhu, N., Marvel, E., Saulnier, C., Klin, A., Jones, W. & Jaquess, D. (2013). Feeding problems and nutrient intake in children with autism spectrum disorders: a meta-analysis and comprehensive review of the literature. https://pubmed.ncbi.nlm.nih.gov/23371510/
5. Curtin, C., Hubbard, K., Anderson, S., Mick, E., Must, A. & Bandini, L.  (2015). Food selectivity, mealtime behaviour problems, spousal stress, and family food choices in children with and without autism spectrum disorder. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573255/
6. Sefen, J., Al-Salmi, S., Shaikh, Z., AlMulhem, J., Rajab, E. & Fredericks, S. (2020). Beneficial Use and Potential Effectiveness of Physical Activity in Managing Autism Spectrum Disorder. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7642468/
7. https://www.eatforhealth.gov.au/
8. https://dietitiansaustralia.org.au/diet-and-nutrition-health-advice