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Exclusion of various food additives

There is little good quality research available on the effects of food additives on children with autism spectrum disorder. Food additives that have been suggested to affect these children include artificial food colourings, aspartame, monosodium glutamate (MSG) and benzoate additives.

If parents of children with autism spectrum disorder are keen to trial the exclusion of food additives, they can do so as there is little effect on the nutritional quality of the diet and is in line with general healthy eating guidelines. However, they should weigh the benefits of following such a diet against limiting their child’s range of food choices further, as children with autism spectrum disorder already tend to self-limit their ranges of food consumed.

Exclusion of phenolic compounds and salicylates

The exclusion of these compounds is based on the hypothesis that consumption of these foods can inhibit the body’s usual detoxification pathways leading to raised levels of neurotransmitters such as serotonin. 

Foods commonly excluded are: 
  • cheese
  • chocolates
  • yeast extract
  • some food colourings
  • fruits such as apples, avocados, blueberries, kiwi fruit, grapes, plums, strawberries, 
  • vegetables such as cauliflower, cucumber, mushrooms, radish, eggplant, spinach, tomato, broccoli 
  • nuts such as peanuts, pistachios, almonds

What is the impact of excluding phenolic compounds and salicylates on autism spectrum disorder? 

More research is required on the effectiveness of the diet. Without suitable alternatives to replace foods high in phenolic compounds and salicylates, children with autism spectrum disorder may compromise on energy or nutrient intake.  Moreover, salicylates are found naturally in fruits and vegetables, and restricting these can lead to constipation. Hence, these exclusions are not recommended.  


Supplements

Proponents of using high doses of individual vitamins and minerals hypothesise that this is necessary due to metabolic and biochemical abnormalities. Most recommended dosages exceed the safe upper limit for children and even adults, and little is known about the long-term effects of high doses of supplements in children. 
  • Multivitamin and mineral supplementation: Vitamins and minerals which are popularly advocated include vitamins A, B and C, folate, magnesium and zinc. There is insufficient evidence to support the recommendation of specific vitamins and minerals for the treatment of autism spectrum disorder.  However, usage is appropriate when dietary intake is insufficient to meet recommended dietary intakes.

  • Fish oil and other fat supplements: It has been suggested that omega-3 deficits or imbalances in omega 3 to omega 6 fat ratio is linked to the difficulties associated with autism spectrum disorder. There is little evidence to support the use of omega-3 supplementation to improve the symptoms of autism spectrum disorder.
If parents are keen to supplement omega-3 intake due to fussy eating behaviour, refer to Brain Foods for Children: Fish and DHA for details. 

Ref: N18