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How Good Nutrition Can Transform Lives: A Guide for Families of Individuals with Special Needs

Author: Sally Shi-po POON, Registered Dietitian

 

Caring for someone with special needs is both rewarding and challenging. Small successes—like introducing a new food, improving sleep, or alleviating digestive discomfort—can make a significant difference in daily life. Yet, many caregivers may overlook the profound impact that nutrition can have on these outcomes.

Having worked closely with individuals with Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), Down’s syndrome, and other developmental conditions, I’ve witnessed firsthand how tailored nutrition can improve physical health, enhance behaviour, and boost overall well-being.

Let’s explore the science and practical strategies that can help individuals with special needs thrive.

Common Nutritional Challenges and Solutions

  1. Digestive Issues

Many individuals with special needs experience digestive problems, such as constipation, bloating, or diarrhoea. These issues can affect mood, behaviour, sleep, and overall quality of life.

Practical Dietary Solutions:

  • Increase Fibre Gradually: Incorporate fruits, vegetables, legumes, and whole grains to support bowel regularity.
  • Add Probiotics: Include fermented foods like yogurt, natto, or kimchi to promote a balanced gut microbiome. Consult a healthcare provider before introducing supplements.
  • Stay Hydrated: Ensure sufficient water intake to prevent constipation and support digestion.

Addressing digestive problems can improve comfort, behaviour, and overall well-being.

  1. Picky Eating

Picky eating is particularly common among children with ASD or ADHD due to sensory sensitivities to textures, tastes, or smells. This can lead to prolonged, stressful mealtimes and a limited diet.

Strategies to Manage Picky Eating:

  • Set Time Limits: Keep meal durations to 20–30 minutes. Use a timer and explain to the child, “When the timer rings, mealtime is over.” Avoid offering snacks later to encourage timely eating.
  • Create a Routine: Designate an eating space and establish pre-meal routines, such as washing hands, to signal it’s time to eat.
  • Set Clear Expectations: Use simple rules like “Stay seated while eating” and “No toys or screens at the table.” Praise positive behaviour with specific feedback, e.g., “Great job trying a new food today!”
  • Minimise Distractions: Turn off background noise and remove unrelated items from the table to help the child focus on eating.
  • Align Caregiver Practices: Ensure all caregivers follow the same mealtime rules to avoid confusion and ensure consistency.

When to Seek Help: If picky eating persists, consult a dietitian, occupational therapist, or feeding therapist for specialised strategies.

  1. Misguided Dietary Restrictions

Some families eliminate foods such as eggs, dairy, gluten, or nuts based on unproven methods like IgG food sensitivity tests. However, such restrictions are often unnecessary unless recommended by a healthcare professional. Removing entire food groups without evidence can lead to nutrient deficiencies and increased stress during meal planning.

Steps to Take:

  • Consult a licensed allergist or healthcare provider if you suspect a food allergy or intolerance.
  • Focus on a well-balanced diet that includes a variety of nutrient-rich foods unless advised otherwise by a medical professional.

Reputable organisations, including the American Academy of Allergy, Asthma & Immunology, and Canadian Society of Allergy and Clinical Immunology, discourage the use of IgG testing to diagnose food allergies or sensitivities due to a lack of scientific evidence.

  1. Managing Side Effects of Psychiatric Medications

Medications prescribed for ADHD or behavioural challenges, such as stimulants or antipsychotics, can impact appetite, weight, and overall nutrition.

Common Side Effects:

  • Stimulants: May reduce appetite, leading to weight loss or nutrient deficiencies.
  • Antipsychotics: Often increase appetite, resulting in weight gain and raising the risk of obesity and related conditions.

What Families Can Do:

  • Monitor Appetite: Track eating patterns and consult a dietitian to adjust portion sizes or meal timing.
  • For Reduced Appetite: Offer nutrient-dense options like smoothies, nut butters, and full-fat dairy in small portions.
  • For Increased Appetite: Focus on low-calorie, high-fibre foods such as fruits, vegetables, and whole grains to manage weight.
  • Encourage Physical Activity: Regular exercise can promote a healthy weight, improve mood, and enhance overall well-being.
  1. Fast Eating Behaviours

Some individuals with neurodiverse conditions may eat too quickly because of sensory sensitivities or impulsivity. This can lead to overeating, poor digestion, or bloating.

Tips to Slow Down Eating:

  • Encourage thorough chewing and sipping water between bites.
  • Use smaller utensils or serve smaller portions to naturally slow the pace of eating.
  • Create a calm, distraction-free environment to promote mindful eating.
  • Model slow eating behaviours by eating together as a family.

Slowing down during meals enhances digestion, helps individuals recognise fullness, and makes mealtimes more enjoyable.

  1. Food Additives and Hyperactivity

Research, such as the Southampton Study (2007), suggests that certain artificial food additives may contribute to hyperactivity in sensitive children. The effects, however, are small and not universal.

Problematic Additives:

  • Sunset Yellow (E110)
  • Quinoline Yellow (E104)
  • Carmoisine (E122)
  • Allura Red (E129)
  • Tartrazine (E102)
  • Ponceau 4R (E124)

Practical Steps:

  • Keep a food diary to track patterns between diet and behaviour.
  • Focus on whole foods like fresh fruits, vegetables, lean proteins, and whole grains.
  • Read labels and avoid products containing the identified additives if sensitivity is suspected.
  1. The Gut-Brain Axis

The gut-brain axis is a two-way communication system between the digestive system and the brain. A healthy gut microbiome has been linked to several benefits for individuals with special needs, including:

  • Improved digestion and reduced discomfort.
  • Better mood regulation via serotonin production.
  • Enhanced sleep quality through melatonin regulation.
  • Potential reductions in challenging behaviours like irritability or aggression.

Gut Health and Immunity:

Around 70% of the immune system resides in the gut, where it helps regulate inflammation and strengthen the body’s defences. A healthy gut microbiome can also lower the risk of allergic conditions like eczema and hay fever in children.

Final Thoughts

Good nutrition is a cornerstone of improved health and well-being for individuals with special needs. By addressing specific challenges—whether related to digestion, eating habits, or medication side effects—families can create meaningful changes in daily life.

Early intervention is key. Building healthy habits during childhood lays the foundation for lifelong physical and emotional well-being. With patience, creativity, and professional support, families can empower their loved ones to thrive.

Together, we can build a brighter, healthier future—one meal at a time.

 

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Thinking Of Going Gluten-free? Read This First

Sally Shi-po POON (Registered Dietitian)

Gluten-free diet has gained considerable popularity in the general population over the past decade. Many celebrities and athletes have acclaimed it as an effective way to better health, weight control and athletic performance. There is, however, a lack of scientific evidence to support these claims. On the contrary, there are studies suggesting that gluten avoidance in diet may not be as “healthy” as it claims.

What is gluten-free diet?

Gluten-free diet is a diet that doesn’t contain any gluten. Gluten is a protein that is found in wheat, barley, rye, malt, and oats (unless they are labelled gluten-free). These ingredients are commonly found in bread products, pasta, breakfast cereals, cakes, cookies, batter-fried foods, beer and ale. There are a number of gluten-free grains and plant foods that are suitable for those on gluten-free diet. They include amaranth, arrowroot, buckwheat, cassava, corn, flax, legumes, millet, nuts, oats labelled gluten-free, potato, quinoa, rice, sago, seeds, sorghum, soy, tapioca, and teff.

Who should follow gluten-free diet?

People who have coeliac disease should follow gluten-free diet strictly. Coeliac disease is a serious, genetic, autoimmune illness where the consumption of gluten induces damage to the small intestine and causes nutrient malabsorption. Symptoms include bloating, diarrhoea, nausea, gas, constipation, fatigue, mouth ulcers, unexpected weight loss, hair loss and anaemia. The only treatment for celiac disease is strict avoidance of gluten for life. If you think you have coeliac disease, do not remove gluten from your diet until your doctor makes a diagnosis. If you remove gluten from your diet too early, it will cause an inaccurate result for both blood test and gut biopsy.

Non-coeliac gluten sensitivity

Some people have gut symptoms when eating gluten, even if they don’t have coeliac disease. This is called non-coeliac gluten sensitivity. Symptoms are similar to coeliac disease, such as abdominal pain, bloating, and diarrhoea. Most people with non-coeliac gluten sensitivity agree that there is an improvement of symptoms after following gluten-free diet. The exact trigger for the non-coeliac gluten sensitivity remains controversial thus far. There are reports suggesting that fermentable oligo-di-mono-saccharides and polyols (FODMAP) in wheat, rather than gluten, induce the gut symptoms. The exact cause is, however, yet to be identified.

Is gluten-free diet healthy for the general population?

Not really! Although some celebrities adopt gluten-free diet for weight loss, there is no data to support similar effectiveness among people without coeliac disease. It is important to note that gluten-free does not necessarily mean low-energy. In 2017, experts from the European Society for Paediatric Gastroenterology Hepatology and Nutrition warned that gluten-free products should not be considered a healthy substitute to regular foods because they usually contain higher levels of saturated fat and lower levels of protein.

In 2017, a study published in British Medical Journal found that gluten-free diet may increase cardiovascular risk as a result of reduced consumption of hearty wholegrains. Gluten-free cakes, cookies, muffins, crackers, bread and pizza are usually made with refined carbohydrates, which are high in glycaemic index, and low in B vitamins, iron, and dietary fibre.

In addition, people on gluten-free diet were found to have significantly higher levels of heavy metals such as arsenic, mercury, lead, and cadmium than those not avoiding gluten. More research is needed to determine whether this diet poses a significant health risk in the long run. In case if gluten-free diet is needed, the best way to avoid excessive exposure to these metals is to diversify the food menu.

Does gluten-free diet improve athletic performance?

Implementation of gluten-free diet among non-coeliac athletes has become increasingly popular because of perceived ergogenic and health benefits. In 2015, a carefully designed study published in Medicine & Science in Sports & Exercise concluded that a short-term gluten-free diet had no overall effect on exercise performance, gut symptoms, perceived well-being, intestinal injury, and inflammatory responses in non-coeliac athletes. Whether avoiding gluten for a longer period of time would lead to improvements in sports performance or well-being is yet to be identified. Nevertheless, current study suggests that gluten-free diet is not a panacea. Athletes should always remember that proper nutrient intake and timing are critical components of athletic success.

Before adopting gluten-free diet…

The significance of gluten-free diet in the general population remains controversial and more research is warranted. Before adopting gluten-free diet, you should consult a dietitian to ensure that you will get all the essential nutrients from a variety of foods, including gluten-free grains, fruits, vegetables, legumes, fish, lean meat, nuts, seeds, and dairy.

If you are suffering from any gut symptoms, such as abdominal pain, bloating, or diarrhoea, you should consult a doctor for medical advice. Self-treatment or delay in treatment is undesirable.

Sally’s Nutrition Blog @ Hong Kong Tatler: https://hk.asiatatler.com/life/everything-you-need-to-know-about-going-gluten-free

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5 Flat-belly Foods To Eat This Summer

By Sally Shi-Po Poon (Dietitian)

You’ve been exercising hard and eating clean for weeks to get a flat belly this summer. However, you may wake up some days feeling bloated and miserable. Whatever the reason is – it can be the menstrual cycle, eating too much salt or something else; here are foods and dietary tips that can reduce bloating!

 

  1. Yoghurt

Yoghurt is rich in protein, calcium and potassium. It also contains probiotics which help maintain a healthy digestive system. Among low-fat, fat-free, plain, flavoured and Greek — the choices can be overwhelming when you are doing the grocery shopping! In general, it is better to choose low-fat or fat-free yoghurts as they contain less saturated fat which can help improve blood cholesterol profiles. Added sugar is a common ingredient in fruited or flavoured yoghurt. Instead, choose plain yoghurt and add your own fruits or flavours such as vanilla, cinnamon or a drizzle of honey. Greek yoghurt is strained so its texture is thicker and creamier than regular yoghurt. Yoghurt contains less lactose than milk so is easier to digest for people who are lactose intolerant. You can use yoghurt to make yoghurt parfaits, smoothies, ice cream/ ice lollies, and dips.

 

  1. Kiwis

Kiwis are very rich in vitamin C, potassium and fibre. Regular consumption of kiwis has proven to have beneficial effects on immune function and gastrointestinal function. Research found individuals with constipation had their bowel function improved after consuming two green kiwis a day for 4 weeks.

 

  1. Bananas

Many people thought bananas are high in carbohydrates and therefore fattening.  In fact, one medium banana contains only 105 kcal and 3.1 grams dietary fibre. It is a great source of potassium, a mineral that helps regulate your body’s sodium level and remove the excessive amount of water.  It’s an excellent way to counteract the excessive consumption of sodium from frequent takeaways!

 

  1. Flaxseeds

If you have constipation, try dietary supplementation of flaxseeds of up to 2 tablespoons a day for a 3-month trial. Try adding flaxseeds to breakfast cereal, yoghurt, soup or salad. Have a small glass (150ml) of fluid with each tablespoon of flaxseeds taken. Flaxseed oil does not contain any dietary fibre; however is an excellent source of omega-3 fatty acids that are beneficial to heart health.

 

  1. Tomatoes

Tomatoes contain fibre and potassium which can relieve bloating. Tomatoes are also a source of lycopene, which is a powerful antioxidant. Research found that lycopene may help protect skin from sun damage and reduce the risk of prostate cancer. The absorption of lycopene is greater from processed tomatoes (such as canned tomatoes, tomato paste, ketchup, soup and juice) than fresh tomatoes. This is because the food processing breaks down the tomato cell matrix and makes the lycopene more available. Addition of oil to tomatoes during cooking also greatly increases the absorption of lycopene.

 

Extra dietary tips that can help you feel less constipated and bloated:

  • Aim for 5 or 6 small meals/ snacks each day on a regular schedule. Do not skip meals!
  • Slowly increase the amount of fibre you eat to 25 to 35 grams per day. Choose whole grains (such as whole wheat, rye, oats, bran, and brown rice), seeds, nuts, and fruits and vegetables.
  • Drink plenty of fluids – aim at least 8 cups per day. You may need even more with higher amounts of dietary Fluid helps your body process fibre without discomfort.
  • If you experience a lot of bloating and wind, limit intake of gas-producing foods such as legumes and lentils, onion, Brussels sprouts, cauliflower, leeks, sugar-free candies or chewing gum, and beverages sweetened with high-fructose corn syrup or sorbitol.

 

Sally’s Nutrition Blog @ Hong Kong Tatler: http://hk.asiatatler.com/wellness/5-foods-to-eat-for-a-flat-belly

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