Healthy Eating Habits in Individuals with Autism

You know the basics of healthy eating, but you also know it’s not always easy to apply them to daily life. Food refusals, decreased variety and restricted intake to a few (high carb, low protein) foods make it even more difficult to apply the basics of healthy eating to individuals with autism. Levels of physical activity are lower for many individuals with autism than for their typically developing age matched peers making the calories in and calories out formula challenging to apply. Add medication side effects, gastrointestinal distress and sensory sensitivity to the mix and you have the recipe for poor eating habits and potential health risks.

For the more severe cases, parents and teachers will have to work closely with medical professionals, dieticians and behavior analysts to design behavior intervention plans based on the function of the food related issues. But, in many cases, proactive strategies can be effective in increasing healthy eating habits for individuals with autism.

Here’s a reminder of some of the strategies for you to consider:

“Grandma’s Rule” is a way to remind your child that their actions are linked to outcomes. For example, “First eat your vegetables and then you can have dessert”. Remember this strategy will be most effective if you don’t give in. You must be prepared to withhold the dessert if your child does not eat the veggies. To start, keep the portion of the veggies much smaller than the portion of the dessert, and over time make adjustments to the ratios.

The “no thank you bite”. For picky eaters, you may be able to avoid a big battle, by setting an expectation that they have to try a novel or non-preferred food, but then can simply say “no thank you” after the first bite and be excused. In some cases, if children keep trying new foods, they may start to like some of them. At the very least, saying “no thank you” is a more appropriate response than protesting and refusing.

MyPlate ( is a colorful visual that can be an effective tool in shaping healthy eating behavior over time. The focus here is on variety, amount, nutrition and choices. This strategy may be a good choice if you are looking to shape the eating habits of everyone in your home or classroom.

Create settings where healthy choices are available. A great example of this is The NSSA Salad Shoppe. The creation of this enterprise has resulted in many positive outcomes related to healthy eating. Here’s a transcript of a conversation I had with the teachers in the Salad Shoppe:

Q: How has the Salad Shoppe impacted the nutrition and overall healthy eating habits of the students at NSSA?

A: The Salad Shoppe has given us a functional way to work on non-preferred food goals. Our students are sampling new foods, and the exposure over time has led to more willingness to try new foods. Parents have reported that food preparation and tasks related to making salad have transferred to home. The Salad Shoppe has opened up healthy lunch options for staff and students.

Q: Can you describe skill acquisition or behavior reduction programs related to healthy eating in your classroom’s Salad Shoppe?

A: In addition to trying new foods we work on:

–          Safe handling of food (e.g., wearing gloves and washing produce)

–          Food preparation (e.g., slicing, peeling, cutting etc.)

–          Issues related to sensory sensitivity (e.g., touching and tasting artichoke hearts, avocado, etc.)

–          Discrimination skills (e.g., fresh vs. rotten or expired etc.)

–          Safe handling of utensils (e.g., how to hold and work a knife)

–          Descriptive vocabulary (e.g., spicy, bland, bruised etc.)

In summary, promoting healthy eating habits doesn’t have to mean making huge sacrifices. Being proactive and planning in advance are key ingredients in promoting positive outcomes in individuals with autism. Meal prep is just another example. Finding the time can be very challenging. So, here’s one final tip: consider an online solution. Programs such as FreshDirect and Peapod take care of the planning process, including creating weekly menus, and supplying healthy recipes. This strategy can save time for you and your family to do other important things – like exercise!!

Written by Randy Horowitz, M.S.E.d., S.A.S.
Associate Executive Director of Program Development, Nassau Suffolk Services for Autism

Published July 2018