Monday, July 19, 2010

Picky Eating and Autism

In TIME magazine, a small article discussed a connection between picky eating as a young child and autism.
The science involved in the article strikes me as particularly solid, and as I read on, I couldn't help but smile:

"But Emmett and her team say changes in feeding patterns, which can materialize as soon as several months after birth, could signal the presence of early autism. In some children with autism, their dietary choosiness is related to physical symptoms of the disorder — if they are unable to chew or swallow properly, eating becomes a frustrating challenge. For other children, the issue is sensory, which makes certain textures and smells of food unpleasant; some children eat only crunchy foods, for instance, while others will stick to a white-foods-only diet."

My dear sainted mother probably has many (un)fond memories of getting me to try new foods. Between the ages of 3 and... let's say very recently *cough* I was an obscenely picky eater. My favourite foods were pizza, pickles, frozen blueberries, and frozen peas, and I would often turn up my nose at the meals my mother cooked, and then, to her exasperation, I would switch my interest to raw flour or kool-aid powder. With that in mind, I think the only thing that this article missed the target on was a chance to mention that pica can also be a sign of autism at an early age. Pica and picky eating for me went hand-in-hand, so I believe it warrants a mention in an article about the connection between food, nourishment, and autism.
The article makes a note on how this can affect the overall health of autistic individuals. Of particular concern seems to be a possible lack of nutrients due to a picky eater's distaste for certain foods:

"Hyman is now conducting a more detailed study of the dietary habits of autistic children, and is planning to take the British study one step further in order to understand the longer term health effects of an unvaried diet in childhood in autistic adolescents and adults. Already there is evidence that children with autism tend to have thinner bones, and the current study confirms that kids with ASD consumed slightly less vitamin D than non-autistic children. "Taking in adequate energy doesn't mean you are taking in adequate nutrients," says Hyman."

The vitamin D consumption is new to me. I synthesized a lot of vitamin D as a child, being fortunate enough to live in a tropical climate where sunshine, and therefore vitamin D, was abundant. But I think consuming slightly less than non-autistic children isn't of much concern, because vitamin D is a fat soluble rather than water soluble vitamin, meaning it stays in your body rather than getting excreted out. A bit of sunshine a day during the sunny season, a bit of fortified milk in the winter...*
As for adequate nutrition, there are in fact several ways of working around my sensory issues with certain foods. Some of these are tricks I learned from my mother after I was an adult and she confessed how she got me to eat certain foods, others I picked up on my own trying to figure out how to make foods that were nutrient rich but tactile-displeasing to me palatable. People with autism of all ages, or, their parents/guardians, try these suggestions, or add your own in the comments. If anyone has a way of making tofu more palatable than dousing it with relatively large quantities of soy sauce, please, let me know!
Before we begin, I'd like to note that what displeasures I get from certain foods may not apply to all people with autism, and therefore my advice should be taken with a grain of salt. I'm not a doctor or a nutritionist, just an autistic girl concerned with eating healthy and not gagging.

+ In my personal case, foods that I cannot personally stand are foods with a moist, crumbly texture, like bananas. Bananas are an abundant source of potassium, vitamin B6, and vitamin C, so my mother was determined to get me to eat them. The way she accomplished this was by mashing the banana, and then putting it in the blender with ice cream, blueberries, and other sweet fruits I was fond of, so that I would not be bothered by the texture of the banana. Why not try and sneak the offending foods into a blender with some favourite foods, so the texture is eliminated and the taste subdued? This also, apparently, works with eggs, but I won't recommend that, because of salmonella concerns.

+ Another thing that really bothered me is temperature. I hated food that was room temperature and lukewarm, preferring frozen food, or food that was microwaved. If a food is refused at a certain temperature, try putting it in the freezer or the microwave to see if that elicits a more positive reaction to your taste buds?

+ Another offender could be the way foods sometimes merge, or "touch" on the plate. I refused to eat foods that touched each other and had to have separate plates for everything. It could have just been my Jewish ancestry asserting itself, but my real reason for doing it was my aesthetic displeasure, which elicited an undesirable reaction on my taste buds. Separate plates and silverware may seem like a chore, but it does make a difference. It also encourages more colourful, and therefore nutrient-rich, eating if you have multiple plates with multiple dishes. Take the chance of not having to deal with food bleeding into each other and looking disgusting to see if you can find an arrangement of colours that pleases you. I personally, after living in Japan, like to abide by the "five colours" rule, eating five foods of different colours at every meal. If you have some distaste for foods of certain colours, like yellow, or blue (My own personal colours of dislike in food) this rule can help you get creative in finding foods that do not violate your own sensory disgust, but are nutritionally dense.

+ Smell and sound can often spoil a meal for me. Not even the smell of my meal, which is inoffensive enough, but the smells of other people's meals at the table. That's why restaurants used to be a huge problem for me, I would get sickened by the smell of someone's quivering, disgusting scrambled eggs, the -squirt- of a ketchup or mustard bottle (I hate almost all condiments) or the smell and squeak of someone eating a rubbery fish. Try to avoid offending sounds from the table; If the sound of ketchup or mustard excreting from the tube or bottle poses a problem, serve them in dishes on the table. If you are cooking fish, then put some cinnamon in the oven on a cookie sheet, which cancels out the odour.

+ And finally, when dining out to eat, I recommend earplugs, earplugs, a favourite blanket, a handkerchief to cover the nose, and a favourite book. It will make the setting more comfortable, and make issues with anxiety less likely. Don't be afraid to ask for special modifications to a meal, including switching meats, asking for sauces on the side, or other custom instructions. Just make your request polite, and leave an excellent tip if you are at an institution where tipping is expected, in a country where tipping is the custom.

I'm certainly no expert on the eating habits of every autistic on the planet. But I hope my own experience sharing proves helpful.

Edited to add: As for the issue of pica (this is more directed towards parents of younger children) as long as the stuff is close to foodstuffs, like flour, or kool-aid powder, it shouldn't be a problem. If it is something that has potential to cause illness, like play-doh, sand, or grass, then try and find out what is pleasing about the texture of the object consumed, and try and replicate it through foodstuffs that are edible. Instead of sand, try making crumbly dough made of flour, sugars, and cubes of butter chopped finely. It will mimic the pleasing texture, but there won't be any issues related to consumption of nonedibles.
* However, some people with autism, the most notable being Donna Williams, have reported that as children, they had difficulty synthesizing enough vitamin D, even with the aid of sunshine, fish oil tablets, D-fortified milk, and vitamin therapy. If this is the case, talk to a doctor, becuase difficulty absorbing vitamin D can lead to weak, brittle bones, and if you are like me and stim a lot, weak, brittle bones can get broken during a calming session of stimming, or even just from day to day activities and movement. It's of top priority that you get enough vitamins and minerals, and that you are synthesizing them properly. A blood test at the doctor can determine if you are getting enough vitamin D.


  1. For the no touching foods thing: a divided plate might also offer a solution. My brother didn't like his foods touching when he was little so we had, in our clean dish rotation, three divided plates that had three sections each and high walls.

    I can't stand bananas either, because of their texture. Now I just put them in smoothies with a bunch of other fruits I like and I can stand them a little bit better that way.

  2. Bento boxes can be great for multiple dishes and divided meals.

    And that was a good idea you had about eating crumbly bread instead of sand.

    (I don't always like hot food either!)

  3. I love bento boxes and also loathe bananas. It's not just the texture but the taste, for me, which makes smoothies difficult. It also makes avocados difficult--I like the taste, but still not the texture. Alas.

    Thanks for the link to the article. Very interesting.

  4. Tofu is nice stir-fried with whatever herbs and/or spices you like, and it also marinades beautifully. (Hi. I'm a Fat Acceptance blogger who might have ASD, found your site from a link on FWD/Forward)

  5. That's a good idea zaftigzeitgeist. I'll have to try it next time I have tofu around.
    And I must say, I love your name.