Picky Eating Can Cause Severe Deficiencies – Reverse It


Fries and crackers.  Sausage and juice.  Cookies, pretzels, and chicken nuggets.

Believe it or not, in some cases this is all that a child with autism eats. I had one client that only eat crackers and fries. Another that ate only sausage and juice. And the third: cookies, pretzels and chicken nuggets.

As a nutritionist working with autism for many years, I’ve met plenty of children whose diet consisted of so few foods.

Such limited eating is common with ASD.  Up to 80% of children with developmental delays are picky eaters. There are many possible causes: sensory issues, anxiety, need for sameness and routine, biochemical and brain chemistry, opiates from foods (that cause addictions), and more.

Regardless of their cause, issues around food – and consequently nutrition – should not be ignored.  Children with autism routinely suffer underlying physiological issues and behavioral symptoms that are influenced by the foods they eat and the nutrition they do/do not receive. And when you consider that picky eating is also common with autism, it’s easy to imagine that nutritional deficiencies may result.

For ASD parents, the natural desire to “nourish” their child sometimes takes a back seat to the day-to-day realities of just getting their child to eat anything. Parents struggle just to get their child to eat enough daily food and calories, let alone make nutritious choices. With meltdowns and fights over food, parents routinely (and understandably) let their child eat anything, just to get food in.  And too often – because it’s autism – the child’s picky eating habits and possible nutrition consequences remain unchecked.

The experience of a boy hospitalized for heart issues has shed light on the need for nutritional evaluation in children with autism – something that the biomedical autism community and I have been shouting for years. The case study was written up by Dr. Melody Duvall in the prestigious medical journal, Pediatrics.

The boy in this case study ate only chicken nuggets, crackers, cookies and water – not uncommon for a child with autism.  He would not eat fruits, vegetables, juice, or vitamins.

This boy developed a limp and severe pain with walking, followed by cough, tachypnea, hypoxia, and tachycardia, he was admitted to the hospital and later diagnosed with pulmonary hypertension. His entire medical team was stumped; they could not identify a source to the varied ailments the boy suffered from.  His health declined and heart problems arose. Then, on a lark, the boy’s mother mentioned what she thought was an unrelated symptom – that her son had bleeding gums.

Alas, one doctor recognized that as a symptom of scurvy. She immediately called for a medical work up that identified severe nutritional deficiencies, including “undetectable” levels of vitamin C (cause of scurvy), as well as low vitamin B1, B6, B12, and vitamin D.  This boy with autism was suffering from severe malnutrition.

He was given a multivitamin/mineral formula to supply him the nutrients is diet was lacking. Once his nutrient levels were replenished, the metabolic bone disease and pulmonary hypertension were reversed – and a healthy boy restored.

This case study’s findings demonstrate that not getting essential nutrients in the diet can be seriously detrimental.  It is one example, but likely not uncommon.

No child should needlessly suffer because we do not routinely consider the importance of food and nutrition. And while feeding a child with autism with picky eating habits is difficult or seems “impossible,” this is not reason to let the issue go and ignore their nutrition intake.

I don’t want you to worry about this, but please DO understand the seriousness of nutrient deficiencies, the importance of guarding against it, and the need to give strategic attention to food and nutrition.

Work with your doctor, have proper testing done, and monitor diet and nutrition status.  Get support from a nutrition professional to improve nutrition intake and nutrient supplementation.  When necessary, seek out a feeding therapist that can help a child expand food and supplement options.

And the simplest thing for some immediate support is to start a high quality multivitamin/mineral formula. This is one of the first nutrition steps of my Nourishing Hope for Kids program (and you can download my free “12 Nutrition Steps to Better Health, Learning, and Behavior.”). Avoid a gummy or candy vitamin, instead choose one packed with important high quality forms of nutrients.

This case study is a stark example of what can happen when children get stuck in such narrow food choices.  Hopefully, this will open some eyes – that adequate nutrition and attention to diet is essential for children on the spectrum.  It demonstrates that nutrient deficiencies can cause physical symptoms in children (with autism or not), that there are underlying physiological matters in autism to be investigated and addressed – an insight that can help many children get the care they need.

Share what has helped your child.

Julie Matthews is a Certified Nutrition Consultant who received her master’s degree in medical nutrition with distinction from Arizona State University. She is also a published nutrition researcher and has specialized in complex neurological conditions, particularly autism spectrum disorders and ADHD for over 20 years. Julie is the award winning author of Nourishing Hope for Autism, co-author of a study proving the efficacy of nutrition and dietary intervention for autism published in the peer-reviewed journal, Nutrients, and also the founder of BioIndividualNutrition.com. Download her free guide, 12 Nutrition Steps to Better Health, Learning, and Behavior.

References for this article:

  1. Manikam, Ramasamy, and Jay A. Perman. “Pediatric feeding disorders.” Journal of clinical gastroenterology 30, no. 1 (2000): 34-46.
  2. Mayes, Susan Dickerson, and Hana Zickgraf. “Atypical eating behaviors in children and adolescents with autism, ADHD, other disorders, and typical development.” Research in Autism Spectrum Disorders 64 (2019): 76-83.
  3. Levine, A. S., J. E. Morley, B. A. Gosnell, C. J. Billington, and T. J. Bartness. “Opioids and consummatory behavior.” Brain research bulletin 14, no. 6 (1985): 663-672.
  4. Masic, Una, and Martin R. Yeomans. “Does monosodium glutamate interact with macronutrient composition to influence subsequent appetite?.” Physiology & behavior 116 (2013): 23-29.
  5. Goto, Tomoko, Michio Komai, Hitoshi Suzuki, and Yuji Furukawa. “Long-term zinc deficiency decreases taste sensitivity in rats.” The Journal of nutrition 131, no. 2 (2001): 305-310.
  6. DeJesus, J. M., Gelman, S. A., Herold, I., & Lumeng, J. C. (2019). Children eat more food when they prepare it themselves. Appetite, 133, 305-312.
  7. Heim, S., Stang, J., & Ireland, M. (2009). A garden pilot project enhances fruit and vegetable consumption among children. Journal of the American Dietetic Association, 109(7), 1220-1226.
  8. Ghanizadeh, A. “Parents reported oral sensory sensitivity processing and food preference in ADHD.” Journal of Psychiatric and Mental Health Nursing 20, no. 5 (2013): 426-432.


Submit a Comment

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.