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Autism
Dietary Intervention Recommendations
These
are general recommendations to clean up the diet. Often ASD children have
cravings to the very foods that they have sensitivities to. Once the diet has
been "cleaned up" and there is improvement in behaviour, other more subtle
food sensitivities become more obvious, and easier to identify. For example
after removing gluten and dairy, sensitivities to other foods like soy, corn,
apples or bananas may be more obvious to see.
As
a practitioner, convincing a parent to make changes to a child's diet is the
most difficult step in the child's recovery. There are many obstacles to
changing a child's diet.
-
The child often has a limited diet, surviving on a limited number of foods
-
Any change to the diet will be met with strong opposition from the child
-
Withdrawal symptoms can be quite severe, leading to major regression in
behaviour
-
Lack of support from the mother's partner, and extended family ("just a
little bit can't hurt")
-
Lack of support from the school
-
The child's pediatrician, behavioural specialist, speech pathologist, etc.
trying to convince you that there is no evidence that diet is of any use.
Worst case scenario, accusing you of child abuse if you attempt a
gluten/casein free diet. Best case scenario, when you return to the
specialist after being on the diet for a while and the change in the child
is obvious, it's not unusual for parents to be told at this point "Just
keep doing what you are doing, it seems to be working".
One
of the most respected doctors in America specialising in the treatment of ASD
children, Dr Jacqueline McCandless, refuses to see any child in her clinic,
unless they have been gluten and dairy free for at least 6 months! Unless this
is done any other treatment will not be as effective.
For those that say that there is no evidence that dietary
intervention is effective, I refer to
Supporting Research
That Dietary Modification Can Benefit The Majority Of Children on the
Autism Spectrum. No
more needs to be said, except to go ahead and do it!
Eliminate all artificial
colours and flavours from the child’s diet as they can often upset sensitive
children. I
would highly recommend a ‘low’ chemical diet for any child with behavioural
problems, for at least two weeks, based on the Failsafe food website www.fedupwithfoodadditives.info
and the Royal Prince Alfred Hospital – Allergy Unit www.cs.nsw.gov.au/rpa/allergy/default.htm recommendations. The
majority of children show a marked improvement in behaviour with the
elimination of artificial colours, flavours and preservatives. Natural food
chemicals (salicylates, amines, glutamates, phenols, oxalates, etc.) can also
present problems in these children.
Common
food additives that children are sensitive to:
Colours
Artificial:
102, 107, 110, 122-129, 132, 133, 142, 151, 155
Natural:
160B (annatto)
Preservatives
Sorbates:
200-203
Benzoates:
210-218
Sulphites:
220-228
Nitrates,
nitrites: 249-252
Propionates:
280-283
Antioxidants:
310-312, 319-321
Flavour
Enhancers
Glutamate
(e.g. MSG): 620-625
Other
flavour enhancers and modifiers: 627-637, 640-641
Hydrolysed
vegetable protein: HVP
Textures
vegetable protein: TVP
Food
Additives Code Lists
For
a full list of food
additive codes and what they mean click on the link to the Fed Up With Food
Additives website
Foods commonly
found to be a problem:
Consider
following a strict gluten free and casein free diet for a trial period of
at least 6 months.
Parents
consistently report improvement in their child’s symptoms when dairy and
gluten are removed from the child’s diet.
If you need evidence that a gluten and casein free diet may
be beneficial, it is highly recommended that you
read the dietary studies and anecdotal evidence (click
here). Especially if your health professional is still saying that there is
no scientific evidence, it is "quackery", and that it is not safe.
Please
read
the 10 Weeks to the
GF/CF Diet
FIRST
before going gluten and casein free.
Dairy
Substitutes
Pureharvest
Organic Rice Milk. Does not have added
phosphate.
Rice
Dream Rice Milk
So
Natural Rice Milk
Aussie
Rice Milk
Oat
Milk (not suitable if starting gluten free)
DariFree: a
potato based milk alternative that many ASD children tolerate very well.
Frutia
instead of icecream.
Turtle
Mountain Purely Decadent Ice Cream.
See website for retail outlets.
Breads
And Other Baked Goods
Laucke
Bakers Bread Mix -
Available at most Coles stores (in Victoria, Malvern and Brandon Park stores
carry a full range of gluten free foods, other stores may only stock a limited
range).
Naturis
buckwheat
and rice breads
Silly
Yaks Bakery Cafe in Northcote:
the
lady who runs the shop, has multiple allergies, making great tasting products
that are almost free of ingredients that may cause problems.
301
High St, Northcote, Vic. Ph. 9482 3999
Gluten
Free Gormet: Cakes,
nougat, muesli etc., special occasion cakes. Check ingredients on website for
dairy - not all products are CF. For opening times of factory outlets, stockists,
cafes and markets see website.
Pav's
Allergy Bakery:
have
a rice loaf, pizza bases and dinner rolls. They also supply a rice premix bread
flour.
Gluten
Free Favourites: Australian on line shop.
Snacks
Sakata
Plain Rice Crackers
and
various rice thins
Sungold rice thins or
rice cakes (watch
the labels, some have grains, but ones made of just rice are available)
Smith’s
plain chips as
a treat but some kids have been known to react to them (Deli
Rock chips are ok) Plain
corn chips (if corn
sensitivity is not an issue)
Chang's
Oriental Noodles for a
crunchy snack
There
are
sweet
biscuits
available
that are gluten and dairy free made by
Freedom
Foods
and other companies, check the health food section of the supermarket, but
they are high in sugar
Gluten
Free / Casein Free Sweets
Orgran
(in
health food aisle in Coles, Woolworth’s) also make these fruity type bars, BUT
be aware they are mostly soy, therefore not suitable for those that are soy
intolerant.
"Funstraps"
by Riverside organics. They are just organic fruit - nothing else -pressed into
a long flat strip and there are a few different flavours in each packet.
Available in health food stores.
VegeBuddies:
made from organic fruit and vegetables, nothing else. Available in health food
stores.
Other Foods
Use
only olive or rice bran oils for cooking or salads. Rice
bran oil is one of the most
hypoallergenic and beneficial of oils for autistic children.
Pears
are considered to be the safest fruit to give these
children as it contains the lowest concentration of natural chemicals that may
affect these children.
If apples are given,
Golden Delicious apples should
be chosen as children have been found to tolerate these apples best.
My
child only eats a few foods, what can I do?
If
a child craves specific foods, there is a high probability that they are
addicted to these foods. Unfortunately
the reason that the kids self limit to bread, pasta, cheese, etc is that they
are addicted to the gluten and casein and so they crave it to the exclusion of
all else. Their food choices will never open up until you clear out the gluten
and casein from their system and the cravings stop. And that is what makes it
incredibly hard when dealing with an older and more aware child. It is obviously
much easier to get a child on the diet when they are young and have no choice in
what they are given. Removing
these foods usually will cause severe withdrawal problems (similar to withdrawal
of a drug) and the child’s behaviour usually gets worse in the days
following.
Find
suitable alternatives to the preferred foods. For example make some chicken
nuggets with gluten free crumbs. Gradually swap wheat pasta with rice pasta,
i.e. add a few to a whole bowl of wheat pasta and then gradually add more and
more at each meal.
Any
foods that can't be substituted may just need to be cut out. Plan to work
out all the foods you can substitute and stock up on them. Then swap all the
foods and once he is eating them I would then just cut out the ones that cannot
be substituted all at once. At least they will have some foods to eat while they
are clearing out the gluten and casein. The worst of the withdrawals are usually
over in about 2 weeks. When the cravings stop parents have found it easier to
introduce more new foods.
One
study found that adding condiments
produced increased food acceptance for a
number of foods.
Zinc
supplementation in particular is helpful in broadening food tastes.
What
To Do If A Child Has A Food To Which They Are Sensitive
If
they do eat something that has gluten and/or casein give them slippery
elm, aloe vera juice and lots of water. This seems to minimise any gut damage,
although they still may have hyperactive behaviour,
it may not be as bad and does not last for days.
Digestive
enzymes may
be used to help breakdown the proteins that they are sensitive to.
In
Conclusion
I
cannot stress the importance of being aware of your child’s change in
behaviour as a result of eating certain foods. Sometimes behavioural changes are
evident when sufficient quantities of a particular food are eaten. Other times
it is a combination of foods that contain the same chemicals but in lower
amounts, however when all foods are taken into consideration, these levels of
chemicals are exceeded and the child’s behaviour deteriorates.
Be
aware that certain food sensitivities may affect the child hours later or the
following day. The best way to keep track the effect that foods have on
behaviour is to keep a Symptom Diary, listing the foods eaten and the child’s
behaviour.
Be
aware that children’s behaviour may change when:
Children
eat an offending food while being cared for by friends or relatives who do not
understand the importance of what you are doing with omitting foods that the
child reacts to.
Children
eat foods given by another child, teacher at school or after school care.
In
effect the parent becomes the ‘detective’ in helping to unravel possible
sensitivities to foods and chemicals that the child may react to. Often the
source of the problem may not be obvious, for example children with gluten
sensitivity may react to play dough, or chemicals used in processing foods may
not be listed on the packaging of foods. Also parents have reported that
manufacturers sometimes change the contents of processed foods, hence a food
that was once considered ‘safe’ is no longer suitable. Always read the
packet labels.
For
advice or to book a consultation for your child call (03) 8802 7687 or email
me.
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