Researchers studied 836 children in China to understand why kids with autism have more trouble with eating and nutrition. They found that autistic children eat fewer healthy foods like fruits and vegetables, get less important nutrients like protein and vitamins, and are exposed to more food additives. Interestingly, the study discovered that eating behaviors—like not enjoying food or being picky—act as a bridge between autism symptoms and nutrition problems. The findings suggest that helping autistic children develop better eating habits could improve their overall nutrition and health.

The Quick Take

  • What they studied: How autism symptoms connect to eating problems and poor nutrition in children, and whether eating behaviors explain this connection
  • Who participated: 469 children with autism and 367 children without autism in China, all around 8 years old. Parents answered detailed questions about their children’s eating habits and symptoms
  • Key finding: Children with autism eat lower-quality diets with fewer nutrients, more processed foods, and more food additives. Their eating behaviors—like not enjoying food or being very picky—help explain why autism symptoms lead to nutrition problems
  • What it means for you: If you care for a child with autism, understanding their specific eating challenges could help you make targeted improvements. Working on eating behaviors may be more effective than just telling them to eat healthier foods. However, this research was done in China, so results may differ in other countries

The Research Details

This was a case-control study, which means researchers compared two groups: children with autism and children without autism. Parents filled out detailed questionnaires about their children’s eating habits, food preferences, nutrition intake, and autism symptoms. The researchers then used statistical analysis to find connections between these factors.

The study measured several important things: how much protein, vitamins, and minerals children ate; how much processed food and additives they consumed; and the quality of their overall diet. They also looked at specific eating behaviors like food enjoyment, pickiness, and emotional eating patterns.

To understand how eating behaviors connect autism symptoms to nutrition problems, researchers used a special statistical technique called mediation analysis. This helps show whether eating behaviors are the reason why autism symptoms lead to poor nutrition.

Case-control studies are good for finding connections between conditions and outcomes. By comparing autistic and non-autistic children, researchers could see specific differences in eating and nutrition. The mediation analysis was particularly important because it didn’t just show that autism and poor nutrition go together—it revealed the eating behaviors that might explain why this happens. This helps doctors and parents understand what to actually change.

This study had a reasonably large sample size (836 children), which makes the findings more reliable. The researchers adjusted their analysis for age and sex to account for these factors. However, the study relied on parent reports rather than directly measuring what children ate, which could introduce bias. The study was conducted in China, so the results may not apply equally to children in other countries with different food cultures and healthcare systems.

What the Results Show

Children with autism showed significant nutritional differences compared to non-autistic children. They consumed less protein and had more deficiencies in important vitamins and minerals. They also ate fewer fruits and vegetables while consuming more animal-based fats and processed foods.

A striking finding was that 38.2% of autistic children exceeded the recommended daily calorie intake (eating too many calories), compared to only 22.9% of non-autistic children. This suggests autistic children prefer energy-dense, ultra-processed foods that are high in calories but low in nutrition.

The most important discovery was about eating behaviors acting as a bridge between autism symptoms and nutrition problems. Children with low social motivation (a core autism symptom) showed reduced food enjoyment and increased food pickiness, which then led to nutritional deficiencies and poorer diet quality. Similarly, children with more restricted and repetitive behaviors (another autism symptom) showed abnormal food responsiveness and emotional eating patterns, which led to higher exposure to food additives like emulsifiers and thickeners.

The study found that autistic children with more severe core symptoms were especially vulnerable to multiple dietary problems at once. Diet quality was consistently poorer in the autism group across multiple measures. The exposure to food additives was notably higher in autistic children, which is concerning because these additives’ long-term effects on developing children are still being studied.

Previous research has documented that autistic children have eating difficulties, but this study provides new insight into how autism symptoms specifically lead to nutrition problems through eating behaviors. The finding that eating behaviors mediate this relationship is relatively novel and suggests that previous studies may have missed an important explanation for why these problems occur.

The study relied on parent-reported information rather than direct observation or measurement of actual food intake, which could be inaccurate. The research was conducted only in China, so findings may not apply to children in other countries with different food systems and cultures. The study design (case-control) shows associations but cannot prove that autism symptoms directly cause eating problems. Additionally, the study didn’t measure whether children had other conditions that might affect eating, which could influence results.

The Bottom Line

For parents and caregivers of autistic children: Work with healthcare providers to identify your child’s specific eating challenges and behaviors. Rather than just pushing children to eat healthier foods, focus on improving eating behaviors like food enjoyment and reducing pickiness. Consider consulting a nutritionist familiar with autism to develop personalized strategies. Moderate confidence: These findings are based on solid research but come from one country and rely on parent reports.

Parents and caregivers of children with autism should pay special attention to these findings. Healthcare providers, nutritionists, and educators working with autistic children would benefit from understanding these connections. Children with autism who have severe symptoms may need extra nutritional support. This research is less directly applicable to autistic adults or children in countries with very different food systems.

Improving eating behaviors and nutrition is typically a gradual process. You might see small changes in food acceptance within weeks, but meaningful improvements in nutrition and diet quality usually take several months of consistent effort. Long-term benefits to overall health may take 6-12 months or longer to become apparent.

Want to Apply This Research?

  • Track daily food intake by meal, noting: (1) whether your child ate fruits or vegetables, (2) number of processed/ultra-processed foods consumed, (3) signs of food enjoyment or pickiness during meals. Rate each meal on a simple scale (1-5) for how well your child ate.
  • Start by identifying one eating behavior to improve—for example, increasing food enjoyment at meals or reducing pickiness around one food group. Use the app to set small, achievable goals like ‘Try one new fruit this week’ or ‘Eat vegetables at two meals today.’ Track progress daily to see patterns.
  • Use the app to create a weekly summary showing trends in eating behaviors and food variety. Set monthly check-ins to assess whether targeted behavior changes are leading to improved nutrition. Share data with your child’s healthcare provider to adjust strategies as needed. Monitor for any changes in energy levels, mood, or overall health as eating improves.

This research describes associations between autism symptoms and eating/nutrition problems in Chinese children and should not be used for self-diagnosis. If your child has autism or you’re concerned about their eating habits or nutrition, consult with a pediatrician, registered dietitian, or autism specialist. This study provides insights into eating behavior patterns but does not replace professional medical advice. Individual children may respond differently to interventions based on their unique circumstances.