Does nutrition fit in the same box for everyone?
Happy Neurodiversity Celebration Week!
Our minds work and therefore think, act, and react in different ways. Similarly, the ideal diet or eating behaviour for one person does not automatically work for everyone else. Evidence has repeatedly suggested that children and adults on the spectrum have problems maintaining a healthy diet and are conflicted with various aspects of eating. These can range from the sensory characteristics of foods to difficulties concentrating on planning and preparing meals to an increased incidence of food allergies to specific eating preferences.
Ultimately, this has been shown to lead to an elevated risk of various factors: vitamin- and mineral deficiencies, obesity, eating disorders, severe food selectivity and increased intake of ultra-processed snacking foods. Especially in children, a nutrient-deficient diet expands the risk of developmental- and growth deficiencies (Peretti et al., 2019; Hyman et al., 2012). Similarly, certain nutrient deficiencies were shown to elevate the symptoms of various spectrum disorders (Adam et al., 2011; Guo et al., 2019).
This means that adults on the spectrum and carers of children with a spectrum condition face an added challenge in preventing deficiencies and ensuring a balanced diet while also making mealtimes enjoyable and comfortable. And that can add a whole lot of stress to all parties!
Next to the various wonderful organisations, charities and blogs that provide tips and tricks on all sorts of scenarios, an important component is often overshadowed: observation and self-reflection. Observing the tiny reactions to foods or changes in your child or in yourself are important internal signals signposting us to the solutions that suit us best. As with any trial-and-error process, trying one thing at a time and observing the response can prevent both being overwhelmed and confused about the trigger of the response. Moreover, instead of a dreadful and lengthy process, it can be a fun and explorative task between the child and the carer or for yourself. Throughout the process, make sure to remember that communication or self-reflection is key here! Rigid, silent expectations can only trigger disappointment, frustration, and error without the right communication about what methods, foods and routines work.
Some tips
Sensory learning techniques such as naming, touching, chewing, picturing in different states or smelling foods have, for instance, been found to encourage children to eat foods with repetition (Dazeley and Houston-Price, 2015). In addition, up to 15 repeated exposures have been shown to increase the acceptance of initially refused foods (Dovey et al., 2008). However, there is no right or wrong approach - see what works for you and your child. The following blogpost by RDs for Neurodiversity is an interesting exploration of what this could look like: Article
Lastly, it should be emphasised that a diet does not need to 100% perfect, clean and rigidly planned to be healthy. Making sure your diet suits your lifestyle in a balanced, sustainable and comfortable way that will enable you or your child to want to keep doing it. Ultimately, nutrition is so much more than just meeting recommended macro- and micronutrient intakes. It is about satiety, community, learning, exploring and once again: trial and error. Taking small steps to build a sustainable diet for yourself and your familywith foods and routines you enjoy and that also nourish your body and mind may be the step into a whole new life.
Julia J. Rucklidge, PhD, Professor of Psychology at the University of Canterbury, Clinical Psychologist and Member of the Science Advisory Council at Think through Nutrition has built her work around this exact relationship between nutrition and mental health. In her 2021 book publication “The Better Brain: How Nutrition Will Help You Overcome Anxiety, Depression, ADHD and Stress”, she, along with Dr Bonnie Kaplan, explores how balanced and healthy eating can influence the emergence and treatment of spectrum disorders and other mental health conditions. Next to fascinating information on this relationship, the book also provides recipes and interactive templates to make your relationship with healthy food enjoyable.
When we build a healthy routine with health that we enjoy, that satiates and satisfies us and that is realistic and sustainable in our day-to-day life, it enables us to feel our best physically and mentally. As Julia stressed in a TEDx talk in 2014: “Nutrition matters. And if we’re really ready to get serious about mental health, we need to get serious about the critical role played by nutrition.”
References:
Adams, J. B., Audhya, T., McDonough-Means, S., Rubin, R. A., Quig, D., Geis, E., Gehn, E., Loresto, M., Mitchell, J., Atwood, S., Barnhouse, S. and Lee, W. (2011). ‘Nutritional and metabolic status of children with autism vs. neurotypical children, and the association with autism severity.’ Nutrition & metabolism, 8(1), p. 34. Available at: https://doi.org/10.1186/1743-7075-8-34
· Baird, J.S. and Ravindranath, T.M. (2015) ‘Vitamin B deficiencies in a critically ill autistic child with a restricted diet.’ Nutr Clin Pract, 30(1):100-3. Available at: https://doi.org/10.1177/0884533614541483
· Collings, S. (2021) Adapting Intuitive Eating for Neurodivergent People. Available at: https://www.rdsforneurodiversity.com/blog/adapting-intuitive-eating-for-neurodivergent-people (Accessed: 15/03/2023)
· Dazeley, P., and Houston-Price, C. (2015) ‘Exposure to foods' non-taste sensory properties. A nursery intervention to increase children's willingness to try fruit and vegetables.’ Appetite, 84, pp. 1–6. Available at: https://doi.org/10.1016/j.appet.2014.08.040
· Dovey, T. M., Staples, P. A., Gibson, E. L. and Halford, J. C. (2008) ‘Food neophobia and 'picky/fussy' eating in children: a review.’ Appetite, 50(2-3), pp. 181–193. Available at: https://doi.org/10.1016/j.appet.2007.09.009
· Guo, M., Zhu, J., Yang, T., Lai, X., Lei, Y., Chen, J. and Li, T. (2019) ‘Vitamin A and vitamin D deficiencies exacerbate symptoms in children with autism spectrum disorders.’, Nutritional neuroscience, 22(9), pp. 637–647. Available at: https://doi.org/10.1080/1028415X.2017.1423268
· Hyman, S. L., Stewart, P. A., Schmidt, B., Cain, U., Lemcke, N., Foley, J. T., Peck, R., Clemons, T., Reynolds, A., Johnson, C., Handen, B., James, S. J., Courtney, P. M., Molloy, C., and Ng, P. K. (2012) ‘Nutrient intake from food in children with autism.’ Pediatrics, 130, pp. S145–S153. Available at: https://doi.org/10.1542/peds.2012-0900L
· Peretti, S., Mariano, M., Mazzocchetti, C., Mazza, M., Pino, M. C., Verrotti Di Pianella, A. & Valenti, M. (2019) ‘Diet: the keystone of autism spectrum disorder?’, Nutritional Neuroscience, 22:12, pp. 825-839. Available at: https://doi.org/10.1080/1028415X.2018.1464819
· TEDx Talks (2014) The surprisingly dramatic role of nutrition in mental health | Julia Rucklidge | TEDxChristchurch. Available at: Youtube (Accessed: 15/03/2023)
· The Better Brain (2023) Julia J. Rucklidge, PhD. Available at: https://thebetterbrainbook.com/julia-j-rucklidge (Accessed 15/03/2023