In the United States it is estimated that up to 95% of kids do not meet their daily recommended fiber intake.¹ Children with Autism Spectrum Disorder (ASD) are 4x more likely to deal with gastrointestinal issues such as constipation and heartburn, compared to children without autism.²

Studies have shown children with autism are often at higher risk of nutritional deficiencies, metabolic imbalances, and gut problems due to their unique eating patterns. This is additionally exacerbated in kids with sensory processing disorders, who may have a limited diet as a result of adverse reactions to certain smells, tastes, and textures.³

Amidst the multifaceted nature of autism, dietary habits emerge as a significant contributor to constipation. The good news is that it’s also one of the factors that parents can help control to provide their little ones with relief. Let’s review the strategies for nutrition interventions and practical tips for parents to bridge the nutrition and fiber gap and prevent constipation in kids on the spectrum.

Nutrient Deficiencies in Kids with Autism

There are several factors as to why autistic kids struggle with eating but sensory issues remain as one of the most common reasons. Selective eating occurs when a kid consumes a very limited number of foods due to individual preferences in food texture, taste, colors, or shapes.

While selective eating can look different in each kid, a limited diet can lead to a lower intake of nutrients. Studies⁴ analyzing components of autistic children’s blood and tissue reveals they have lower levels of important nutrients, such as:

Vitamins B3, B6, B12
Vitamin C
Vitamin D
Calcium
Iron
Magnesium
Zinc

Managing our little one’s diet to ensure our kiddos have the required amounts of each of these vitamins can go a long way in supporting overall development and preventing health deterioration.

Understanding the Fiber Gap in Autistic Children

Research indicates that kids with ASD tend to consume diets low in fiber, contributing to constipation issues.⁵ Fiber plays a crucial role in maintaining bowel regularity by promoting bulk formation and stool softening.⁶ Addressing the fiber gap through dietary modifications is essential for managing constipation in ASD kiddos. The following chart shows the daily recommended amount of fiber for kids:

4 Nutrition Tips for Constipation Support in ASD Kids

1. Increase Fiber Gradually

Starting with a gradual approach to fiber intake can help with not only the adjustment of taste preferences, but digestive tolerance. Begin with modest servings of fiber-rich foods and progressively amplify by increasing portions weekly over the span of two to three weeks. This can help your kid’s digestive system get adjusted to the increase in fiber consumption. Adding too much fiber too quickly can cause bloating, gas, or cramps. Kids should drink plenty of water as well through this process, which helps move fiber through the intestines. Aim for an increase of one to two cups of extra water on top of their usual fluid intake daily.

2. Incorporating Probiotic and Prebiotic-Rich Foods

Studies suggest that combining foods rich in prebiotics and probiotics can create a synergistic effect in promoting a balanced and flourishing gut microbiota. A healthy gut microbiota is the key to maintaining good digestion. Prebiotics are a type of plant fiber that acts as the nourishment for probiotics, the live good type of bacteria in the digestive system. This synergistic effect enhances probiotic survival and activity in the microbiome. Both probiotics and prebiotics help foster an environment helpful to the growth of beneficial gut bacteria such a bifidobacteria, supporting digestion and overall gut health.⁷ Natural sources of prebiotic fiber include:

Apples
Bananas
Carrots

Data from research also suggests that both prebiotics and probiotics may help alleviate common digestive issues such as constipation and diarrhea, creating a balanced environment in the gastrointestinal tract.⁸Sources of probiotics include:

Yogurt with live and active cultures
Kefir
Fermented foods such as kimchi, pickles or tofu

3. Sneak in Fiber

Fiber rich fruits and vegetables can be seamlessly integrated into your kid’s diets by blending into smoothies or soups to change the texture and tastes. Try pairing different fruits and vegetables with foods your little ones already know and love for them to get familiar with new choices.

For our extra picky eaters, a textureless and tasteless prebiotic fiber supplement such as Begin Health’s Growing Up Prebiotics can be a great option to add to their water or favorite beverage as an easy way to sneak in more fiber throughout the day. Studies show that prebiotic fiber such as chicory root fiber can help with softer and more frequent stooling within six weeks of daily use.⁹

4. Meet Daily Hydration Needs

Adequate water intake plays a pivotal role in bowel regularity. Data from multiple studies reveal an association between lower fluid intake, dehydration, and the increased risk for constipation.¹⁰ In addition to fluid intake, hydration can also come from water-rich fruits and vegetables such as cucumbers, berries, or melons. The amount of water a kid needs to drink every day can change based on activities and the food that they eat. It’s best to adjust based on your little one’s thirst cues.

Clear, pale yellow colored urine is a good sign that your little ones are drinking enough water. Darker, tea colored urine usually indicates the need to increase fluid consumption throughout the day.

Again, it is particularly important to increase your kid’s fluid intake when increasing fiber intake. Fluids will help soften the stool and make it easier to pass. While water is always the best option, certain juices (pear, apple or prune) can provide a natural laxative effect. Fluids that contain a lot of sugar or caffeine can make constipation worse - therefore it’s best to avoid or limit those options. A few more tips to help your kiddo increase fluid intake:

Provide water in-between meal times, so your kiddos will not feel full before eating.
Give water or water-rich fruits such as grapes, oranges or watermelon as a snack before physical activities.
Keep a designated bottle or cup of water handy for your little ones to take sips anytime. Adding a wedge of citrus fruit like lemon or oranges to water can help give it more flavor.
Model good behavior by setting the example. Kids are more likely to drink water when they see their parents and siblings drinking water too.

4 Lifestyle Tips for Kids with Constipation from an RD

1. Establish a Mealtime and Bathroom Routine.

Consistency through routine can help promote bowel regularity and establish healthy habits. Eating is a natural stimulant for the bowels, so developing a regular meal time daily can help kids develop consistent bowel movements.

2. Encourage Physical Activity.

Studies show that engaging in regular physical activity helps stimulate bowel movements to reduce the risk of constipation in kids.9 This can be as simple as playing catch outside, walking, or riding bikes. The American Heart Association recommends at least 60 minutes of moderate to vigorous physical activity daily for kids ages 6 years and up.

3. Create a Nurturing Mealtime Environment.

Studies show that stress can contribute to digestive problems due to the brain-gut connection.¹¹ A stressful environment can also impact the way kids feel about certain foods. It’s critical to assess the mealtime environment in your home and make choices that help cultivate a stress-free atmosphere during mealtimes. This helps foster a nurturing environment free of stressors that may promote food aversions or digestive distress.

4. Model Healthy Nutrition Behaviors through Family Participation.

Children with autism who interact by assisting with the preparation of a food item may be more likely to attempt to taste that item. Activities such as cutting an apple, washing grapes, or adding toast to the oven may encourage your kids to eventually sample one of these items. Create a sense of empowerment within your little ones by involving them in meal planning and preparation to help them learn healthy behaviors with you and the rest of the family.

Your kids may feel that cooking something with you is just a fun activity. However, getting your little one to read the recipe and follow it will also assist with developing their academic skills in a natural environment. Not only can it expand reading skills, but it can also enhance their math skills. They can use their abilities to count, and measure in an enjoyable, stress-free environment.

Final Thoughts

The journey to bridging the fiber gap for ASD children with constipation will require a multifaceted approach that incorporates nutrition and lifestyle changes along with patience and persistence. Dietary modifications require time and consistency. Celebrating small victories is crucial as your family takes on this nutrition journey to creating a foundation of good health in your little ones. Parents who are looking to support a healthier gut environment in their kids can first address the fiber gap through diet choices by prioritizing prebiotic-rich foods, which can help with digestive balance.

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