Autism Spectrum Disorder (ASD) is characterized by challenges with social interaction and communication. For parents of children with autism, learning to manage this condition requires a multidimensional approach, including consideration of food and nutrition. A personalized, nutritious diet can help manage behavioral problems, health risks and quality of life for kids with autism. 

Beth Lambert, executive director of Epidemic Answers, says, “Once you come to understand autism as a whole-body condition, rather than just a brain-based or genetic condition, you start to understand the importance of nutrition in treatment and symptom management.” Not only does a nutritious diet help maintain brain balance, it also helps address many of the nutrition-related concerns that children with autism face, such as food sensitivities and allergies, digestive disruptions, sensory issues with textures and nutrient deficiencies. Each of these issues can impact a child’s behavior.

An essential piece of the autism and diet connection is gut health. Gaby McPherson, MS, RDN, LDN, at Fruitful Nutrition says, “Because a child's gut health is linked to their brain health, it's crucial to boost their gut function to reduce these symptoms that can impact their behaviors. Who wants to go around with a tummy ache and constipation every day?”

Yaffi Lvova, RDN, author of Beyond a Bite: Playful Sensory Food Exploration for ASD and Neurodivergent Kids, advises that individual abilities also should be considered when developing a nutrition plan. “Autistic children often have sensory sensitivities that make it difficult to eat certain (sometimes many) foods,” she says.

Therapeutic Diets

Many therapeutic diets have been evaluated for children with autism. Most involve the elimination of one or more foods, which can be challenging for a child that already has difficulty getting a wide variety of nutrients.

A popular option is the gluten- and casein-free diet. Gluten is the protein found in wheat, barley and rye. Casein is a protein found in milk and other dairy products. While some children with autism may be sensitive to gluten or dairy, this is not a one-size-fits-all approach, and there is mixed data in support of this regimen.

Another choice is the specific carbohydrate diet (SCD), which involves limiting certain carbohydrates, processed foods, most dairy, sugar and more, with the goal of reducing food sensitivities and improving the gut microbiome. Mixed outcomes have been reported with this diet due in part to its elimination of high-fiber foods that may be beneficial for brain health. McPherson explains, “Gut bacteria digest (or ferment) fiber in the large intestines to produce short-chain fatty acids, which are known to improve brain health significantly.”

The Feingold diet is another approach that eliminates artificial flavors, sweeteners, preservatives and salicylates. Salicylates are compounds found in certain fruits and vegetables. While there is some evidence that food dyes may play a role in children’s behavior, most studies on this diet have not demonstrated a significant impact on ASD symptoms. 

Personalized Nutrition 

Instead of following a specific therapeutic diet, most experts now understand that a diet for ASD needs to be personalized to each child. It is ideal to work with a registered dietitian that can address nutrient and feeding concerns and is trained to make individualized recommendations. A primary area to focus on, according to Lambert, is correcting vitamin deficiencies, which may play a role in improving behavioral and digestive challenges. Nutrients of concern include zinc, vitamin D, calcium, magnesium and essential fatty acids.

McPherson also relates that fiber should be at the forefront of any diet to address digestive concerns. “While many children on the spectrum may strongly prefer foods like chips, crackers, bread or white pastas, these foods tend to be lacking in fiber,” she says. “Good sources of fiber are split peas, multigrain breads and pears.”

A registered dietitian can also help families evaluate whether a diet is working. Lvova says, “It can be challenging to see whether a specific diet is working or not. When a change is made, the parents and caregivers often pay more attention in order to see if there is a difference, and the child responds positively to the change in attention. By keeping expectations realistic and ensuring a relaxed mealtime atmosphere, your child will have the best chance to meet their nutritional needs.” Ultimately, the goal is to make meals a positive experience for the child, with less emotional investment on which foods they can or cannot eat.

Ana Reisdorf is a registered dietitian, freelance writer and marketing consultant with more than 15 years of experience in the fields of nutrition and dietetics.