Autism And Food: How Might Sensory Differences Stand In The Way Of Healthy Nutrition?

Yes, we know — when most people hear the word "autism", they immediately think of differences in social behavior and communication styles. Sensory challenges are, however, an integral part of the autism spectrum too. The fifth edition of the diagnostic and statistical manual of mental disorders lists "hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment" as one of the main features of autism. 

Those sensory challenges can apply to food, too — big time. Research has found, for instance, that:

• More than half, 53 percent, of autistic people in one survey were hesitant to try new foods.
• Many autistic people have repetitive diets, with 59 percent of the participants of one study eating fewer than 20 different foods. 
• Despite reporting that their children had healthy appetites, 67 percent of parents of autistic children described them as picky eaters in another study. 

Why might autistic people have a more limited diet compared to neurotypical folks? 

The strong preference or need for routine and sameness characteristic of autism can partially explain why autistic people may have a smaller culinary repertoire. Change can be difficult and distressing, and that includes changes around mealtime and food.

Nobody wants to eat foods that are repugnant to them; this obviously isn't unique to people on the autism spectrum. Autistic people are, however, more likely to find certain foods unpalatable, and for different reasons. 

One further issue to consider is that autistic people have a higher rate of gastrointestinal problems, with different bits of research placing the percentage anywhere between 23 and 70 percent. These problems can range from constipation to diarrhea, and from difficulty swallowing to gas, bloating, vomiting, and food sensitivities (such as gluten intolerance). It is, again, no surprise that someone would avoid foods that make them physically sick. 

What kinds of foods might autistic people stay away from?

Just a quick look at the posts #ActuallyAutistic people share on Twitter, for instance, reveals that some people struggle to eat vegetables and fruits, while others have trouble with meat for sensory reasons.

While some autistic people can't stomach raw veggies and prefer thoroughly cooked and even pureed ones, others can only handle raw vegetables and fruits. "Slimy" textures like those found in eggplant, zucchini, and mushrooms pose a problem for many. Some find it difficult to eat solid foods at all (especially when stressed) and rely on veg- and fruit-rich protein shakes. 

How should sensory challenges in relation to food be managed?

Parents of children on the spectrum should know that:

• Your child isn't a "picky eater" to spite you, because they're being difficult on purpose, or for any other reason that has anything to do with you. Eating the foods you might want them to eat that they consistently refuse to tackle makes them feel physically uncomfortable and even sick. As adults, we don't eat stuff we perceive as disgusting, either. Don't (try to) force your child to eat foods they can't handle.
• Instead, find out what textures, smells, temperatures, or other properties of food your child has difficulty with. Try to help them hit their nutritional targets (daily recommended intake of vitamins and minerals, fat, protein, and carbs) with foods they do feel comfortable eating. 
• If necessary, work with your child's doctor or a nutritionist to come up with a healthy eating plan that works. Ask them about nutritional supplements where relevant. Your child's doctor can also rule gastrointestinal conditions in or out.

If you're an adult on the spectrum, you can:

• Use one of the many nutrition-tracking apps out there to see if your diet is giving you the right nutrients. If not, you can try to make adjustments. These can include nutritional supplements. 
• Work with your doctor or a nutritionist to make sure you are getting the right nutrients to keep you healthy, and to see if you have underlying gastroinestinal conditions.
• Build a diet that doesn't present you with sensory challenges, trying to experiment with new foods if you feel up to it.