Nutrients
The primary function of calories is to provide energy for the body. Children with ASD have been shown to either consume too many or too few calories/nutrients and therefore have been shown to be at an increased risk of becoming overweight/obese or malnourished.
Carbohydrates provide energy for our bodies and brains. Carbohydrate quality can vary between foods, so choosing the right carbohydrates can improve health in children with ASD.
Our brains are made up of 60% fat, making them our fattiest organ! Brain health is especially important in autism, and choosing the right type of fats can either promote or reduce inflammation.
Many children with ASD do not meet daily fiber needs. Increasing dietary fiber can help improve digestive health, promote a healthy weight, and control blood sugars.
Up to 60% of a child’s body is made up of water, including vital organs like the skin, heart, muscles, kidneys, and brain. Children who are not properly hydrated are at higher risk for constipation, fatigue, and dry skin.
Protein is vital for proper growth & development, as well as bone and muscle health. Due to texture preferences, selective eaters may avoid tender protein foods, like meat. Children with ASD may have a hard time digesting protein, which could potentially cause GI discomfort and behavioral issues.
Macronutrients
Omega Fatty Acids
Omega-3 fatty acids are essential nutrients that are anti-inflammatory and important for brain and heart health. They have the most research of all fatty acids in connection to autism. Certain studies show a variety of improvements including social interaction, repetitive and restricted interests, behaviors, stereotypy, lethargy, improved nonverbal intellectual ability, restlessness, agitation, irritability, and self-injurious behaviors.
Omega-6 is an essential fatty acid involved in cell membrane structure and activity, as well as brain development. Due to the fact that many foods contain both omega-6 and omega-3 together, it can be challenging to associate the effects of omega-6 alone in research studies. Focusing on the omega-6 ratio of the diet by emphasizing alternative fat sources is key.
Omega-9 fatty acids, while not technically termed “essential”, are beneficial fats frequently found in the Mediterranean diet. A diet high in omega-9s may reduce inflammation, promote brain health, and enhance mitochondrial function.
Children with autism consume less vitamin A and have more vitamin A deficiencies than typically developing children. Vitamin A is a fat-soluble vitamin that is vital for our vision, immune system, and gut microbiome.
Thiamin is a water-soluble vitamin more commonly known as Vitamin B1. Thiamin is important for most tissues and organs in our bodies. Individuals with autism may not consume enough, may have higher needs, or may not absorb it well due to gut issues. For these reasons, appropriate intake should be considered.
Riboflavin, or vitamin B2, is a member of the B-vitamin family and is water-soluble. Due to restrictive diets, gastrointestinal issues, or metabolic abnormalities, children with ASD may have low levels. It is important for proper growth & development, cell function, and important antioxidants like glutathione.
Niacin is a water-soluble vitamin and known as vitamin B3. Niacin is involved in more than 400 reactions in the human body, and is important for the metabolism, nervous system, and antioxidant protection. The research is slim on autism and niacin, though individuals with autism who are picky eaters may be at higher likelihood for deficiency.
Vitamin B5 is essential for producing red blood cells, which carry oxygen throughout the body, and helps produce energy by breaking down fats and carbohydrates. Research shows kids with autism are at risk for inadequate intake and low levels of vitamin B5. Adequate intake may benefit mood and help maintain metabolic processes.
Vitamin B6, or pyridoxine, is important for neurotransmitters, cognitive development, and methylation, which are all important factors in ASD.
Biotin is an essential nutrient that helps the body break down nutrients for energy production. Recent studies have found that children with autism are at risk of biotin deficiency, which may affect cognitive performance and immune function. Supplementation may improve these concerns.
Folate is one of the most studied vitamins in relation to autism. Research shows that folate levels are often abnormal and folate receptors may be faulty in those with ASD. The MTHFR gene mutation and the microbiome both play important roles in folate status.
Individuals with autism frequently have low levels of B12, which may be caused by methylation issues or low stomach acid. Supplementation of the correct form of B12 can help methylation and help maintain metabolic balance.
Vitamin C, or ascorbic acid, is important for immune function, neurotransmitter and collagen production, as well as antioxidant status. Vitamin C deficiency has been documented clinically in children with autism with severely selective diets.
Vitamin D deficiency occurs at a higher rate in individuals with ASD, and may correlate with ASD severity. Supplementation showed improvements in behavior, stereotypy, eye contact, and attention span.
Vitamin E is an antioxidant known for its role in protecting cells, tissues, and organs from damage and immune-enhancing activity. Studies suggest that children with autism are at risk for vitamin E depletion, and that recommended intake has the potential to protect brain function.
Vitamin K has long been recognized for its vital role in blood clotting and the building of bones. Research indicates risks for vitamin K deficiency in autism, and supplementation may potentially improve autism-related nutritional and metabolic processes.
Vitamins
Children with autism are more likely to have calcium deficiency than children without autism. Restrictive diets (such as the dairy-free diet) or picky eating may increase the risk of calcium deficiency, or in severe cases, even rickets.
Chromium is a trace mineral that is found in a wide variety of foods such as whole grains, meats, and vegetables and is responsible for maintaining healthy blood sugar levels. While the research on chromium and autism is extremely limited, two studies found that children with ASD typically excrete high amounts of chromium in their urine and low amounts in their hair.
Copper may play a role as an antioxidant, protect against neurological conditions, and act as a treatment for some ASD symptoms. Some research has shown a significant alteration of trace elements in the gut microbiome of individuals diagnosed with ASD, but other research shows there is no difference in copper levels for children with autism.
Fluoride is a mineral that helps protect our teeth from dental caries and supports healthy bone mineralization. The most concentrated sources of fluoride are drinking water and toothpaste. Some studies have shown that fluoride and aluminum can exacerbate symptoms of ASD by worsening excitotoxicity and inflammation, and excess fluoride may affect cognitive development in children.
Iodine is an element found in food and supplements that the body uses to make thyroid hormones. These hormones have many functions including controlling the body’s metabolism. Children who are on a dairy-free diet, are selective eaters, and/or do not use iodized salt may be at increased risk of iodine deficiency.
Iron deficiency anemia, one of the most common nutrient deficiencies in the world, can cause symptoms such as fatigue, slow growth, or pica (eating non-food items). Iron should be a concern for those not consuming meat.
Magnesium can be a great way to naturally treat many comorbid conditions in autism such as anxiety, hyperactivity, and constipation. Magnesium can also be used topically or as Epsom salt baths.
Manganese is a trace element involved in bone formation, reproduction, immune responses, and the metabolism of amino acids, cholesterol, and glucose. Some studies have shown low levels of manganese and high levels of lead to be associated with more incidences of ASD and/or ADHD.
Molybdenum is a trace mineral found in foods like grains, legumes, nuts, leafy vegetables, organ meats, and dairy. Optimal molybdenum levels can help prevent toxins from building up in the body. While the research on molybdenum and autism is limited, one study showed elevated hair levels of molybdenum were inversely correlated with cognitive levels.
Phosphorus is the second most plentiful mineral found in the body. Phosphorus helps maintain strong bones and teeth, assists in energizing us, and makes up our DNA. Studies have shown that children with ASD consume significantly less phosphorus than typically developing children.
Potassium is an essential dietary mineral and electrolyte that is crucial for the normal functioning of cells, including nerves. Recent studies reveal that children with autism have lower intakes of dietary potassium, and that an increased consumption of high potassium foods may improve bone health.
Selenium plays a role in DNA synthesis, thyroid function, reproduction, and helps protect us from infection. Research has shown that individuals with ASD tend to have lower levels of selenium in their hair and blood, as do individuals classified as overweight/obese.
Trace minerals, also called trace elements or trace metals, are minerals found in small amounts in living tissues. Children with autism have been found to have lower levels of certain trace minerals which may impact growth, brain function, and inflammation.
Dietary zinc and zinc supplementation has been identified to have a therapeutic effect for individuals with ASD. Pica is associated with low levels of zinc and/or iron, which can cause children to crave non-food items.
Minerals
Other Nutrients
Amino acids are the building blocks of protein. There are 20 amino acids, falling into essential and nonessential categories, each with their own functions to keep the body healthy. Extreme picky eaters may be at risk for amino acid deficiency.
Antioxidants are naturally occurring molecules that help fight free radicals that are produced when the body breaks down food and reacts to the environment. Children with autism are known to have an imbalance in free radical production and antioxidants, called oxidative stress. Eating a diet high in antioxidant-rich fruits and vegetables can help neutralize this free radical imbalance.
Carnitine is an amino acid produced by the body and available in certain foods and nutrition supplements. Carnitine is vital for brain and mitochondrial function, both important for those with ASD. Some people with autism (10-20%) seem to have L-carnitine metabolism disorders and for these patients, a diet high in carnitine and dietary supplementation with L-carnitine is beneficial.
Choline is an essential dietary nutrient that is important for normal brain, nervous system and cellular function. Evidence suggests that children with autism have higher levels of choline deficiency, and supplementation may improve their receptive language skills.
Coenzyme Q10 (CoQ10) is an antioxidant that assists in energy production in our cells, heart health, and mitochondrial disease. In relation to autism, research has shown that supplementation with CoQ10 can improve symptoms of mitochondrial dysfunction.
Curcumin has been studied for its potential effects in a wide range of conditions from cancer to joint pain. However, curcumin’s ability to promote healthy gut bacteria, regulate neurobehavioral symptoms, and fight inflammation may be most notable for individuals with autism.
Individuals with ASD may have lower levels of the antioxidant glutathione, which may contribute to overall oxidative stress, immune dysfunction, and may lead to neurodevelopmental abnormalities.
Inositol is sometimes referred to as vitamin B8 and it is important for the integrity of cell membranes, mental health and blood sugar regulation.
Quercetin is a powerful antioxidant found in fruits and vegetables that shows promise in its ability to reduce inflammation. It is commonly isolated and used as a supplement.
Sulforaphane is found in the cruciferous family of vegetables, especially broccoli sprouts. Sulforaphane has been used with success in children with autism to improve detoxification and decrease oxidative stress and inflammation. Improvements in awareness, communication, irritability, and motivation have been reported.