Diet and Autism
An interview with Brian Udell, MD.
Should parents try diets that eliminate certain foods to see whether their kids improve?
Although a recent report in the Journal of Pediatrics suggests no
need for dietary intervention, every parent needs to take a hard look at their
child's diet. And if eliminating a few substances can put an end to the chronic
diarrhea or make kids more communicative, most parents are willing to give it a
The first step for parents to try is an elimination diet for about a month
to see if the omission of casein and gluten or other highly allergic foods,
such as eggs, fish, seafood, tree nuts, peanuts, soy, and eggs, can improve
symptoms. If the child is drinking lots of milk, I suggest starting with the
elimination of dairy and replacing it with calcium-fortified soy or almond
Elimination is a better barometer than testing for these allergic foods,
since allergy testing may not be as effective.
After the elimination period, slowly introduce one new food at a time every
few days. Keep a symptom diary throughout the elimination and reintroduction
periods to determine which foods are tolerated.
These dietary changes may not be easy to implement, but they are
non-invasive, no-harm approaches that are worth trying to see if your child
Are there other diet strategies that may work?
Autistic kids who also have a seizure disorder may find relief from a
high-fat, low-carbohydrate ketogenic diet. This diet often leads to poor
growth, poor weight gain, and increased
cholesterol levels, so it is imperative to use this approach under the
supervision of a registered dietitian and physician.
Some children are successful when they follow a yeast- and sugar-free
Most parents would benefit from tips and mealtime strategies to encourage
their children to accept new foods. Parents need to serve as role models by
eating the new foods that are introduced along with familiar foods.
Do you recommend vitamins or mineral supplements?
Absolutely. Most kids with ASDs (or, for that matter, most kids) are picky
eaters, go on food jags, and don't eat a well-balanced diet. Parents need to
make sure their children are meeting their nutritional needs and a once-daily
multivitamin with minerals is great insurance. Stay within accepted guidelines
for all nutrients and make sure they are getting an adequate amount of all
vitamins and minerals.
What other nutritional advice do you give to your patients?
A healthy diet is essential for all kids, but even more so with kids with
ASDs because there is concern their GI issues may lead to poor absorption of
key nutrients for growth and development. One of our primary goals is to get
kids eating a nutritionally complete diet and to reestablish a healthy GI
I recommend a healthy, natural, varied diet as close to the earth a
possible. Avoiding pesticides, preservatives, artificial ingredients, fast
foods, monosodium glutamate, or processed foods is ideal, but not always
practical. Diets that are less processed and more natural, like an organic
diet, are easier to digest and absorb because they contain fewer toxins that
need to be eliminated.
Many of the kids with ASDs tend to be deficient in essential fatty acids,
fiber, and protein. We turn to registered dietitians to evaluate diets and help
parents understand where the nutrient gaps are and how to fill them.