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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 try. 

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 milk. 

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 improves.

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 diet.

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 system.

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. 

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