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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.

 

良好的營養如何改變生活：特殊需求家庭的指南

照顧有特殊需要的人士，既充滿回報也充滿挑戰。小小的成功，例如引入一種新食物、改善睡眠或減輕消化不適，都可以對日常生活產生重大影響。然而，許多照顧者可能忽略了營養對這些結果的深遠影響。

在與自閉症譜系障礙（ASD）、注意力不足過動症（ADHD）、唐氏綜合症及其他發展障礙人士的密切合作中，我親眼見證了量身訂造的營養如何改善身體健康、提升行為表現及促進整體健康。

讓我們一起探討可以幫助特殊需要人士茁壯成長的科學原理和實用策略。

 

常見的營養挑戰與解決方案

  1. 消化問題

許多特殊需要人士會遇到消化問題，例如便秘、腹脹或腹瀉。這些問題可能影響情緒、行為、睡眠及整體生活質素。

實用飲食解決方案：

  • 逐步增加纖維攝取量： 加入水果、蔬菜、豆類及全穀物，以促進腸道規律。
  • 添加益生菌： 包括乳酪、納豆或泡菜等發酵食品，以促進腸道微生物群平衡。在使用補充劑前諮詢醫療專業人士。
  • 保持水分充足： 確保足夠的飲水量以防止便秘並支持消化。

解決消化問題可改善舒適感、行為及整體健康。

 

  1. 偏食問題

由於對質地、味道或氣味的感官敏感，自閉症或ADHD的兒童特別容易出現偏食問題。這可能導致長時間、壓力大的用餐時間及飲食單一化。

管理偏食的策略：

  • 設定時間限制： 將用餐時間限制在20至30分鐘內，使用計時器並向孩子解釋：「當計時器響時，用餐時間結束。」避免之後提供零食，以鼓勵按時進食。
  • 建立固定的用餐規律： 指定用餐地點，並設立如洗手等用餐前的例行活動，讓孩子知道是用餐時間。
  • 設立清晰的規則： 使用簡單的規定，例如「就餐時要坐好」及「不允許玩具或屏幕在餐桌上」。以具體的反饋表揚積極行為，例如：「今天試了一種新食物，做得很好！」
  • 減少分心： 關閉背景噪音，並移除餐桌上無關的物品，幫助孩子集中注意力進食。
  • 統一照顧者的做法： 確保所有照顧者遵循相同的用餐規則，以避免混淆並確保一致性。

何時尋求幫助： 如果偏食問題持續，請諮詢營養師、職業治療師或餵食治療師以獲取專業策略。

 

  1. 誤導性的飲食限制

一些家庭可能基於未經證實的方法（例如IgG食物敏感測試）而限制食物，例如蛋類、奶製品、麩質或堅果。然而，除非有醫療專業人士建議，這些限制通常是沒有必要的。任意移除整個食物類別可能導致營養不足並增加餐單計劃的壓力。

應採取的步驟：

  • 如果懷疑食物過敏或不耐受，請諮詢有牌照的過敏科醫生或醫療專業人士。
  • 除非有醫療建議，應專注於均衡飲食，包含多種營養豐富的食物。

美國過敏、哮喘及免疫學學院（AAAAI）及加拿大過敏及臨床免疫學學會（CSACI）等權威機構均不建議使用IgG測試來診斷食物過敏或敏感，因為缺乏科學證據支持。

 

  1. 精神藥物的副作用管理

為ADHD或行為問題而處方的藥物（如興奮劑或抗精神病藥物）可能影響食慾、體重及整體營養。

常見副作用：

  • 興奮劑： 可能減少食慾，導致體重下降或營養不足。
  • 抗精神病藥物： 通常會增加食慾，導致體重增加及提高肥胖相關疾病的風險。

家庭可以採取的措施：

  • 監測食慾： 記錄進食模式，並與營養師一起調整份量或用餐時間。
  • 針對食慾減少： 提供高營養密度的小份量食物，例如奶昔、堅果醬及全脂乳製品。
  • 針對食慾增加： 著重低卡路里、高纖維的食物，例如水果、蔬菜及全穀物，以控制體重。
  • 鼓勵體能活動： 定期運動有助於保持健康體重、改善情緒及增強整體健康。

 

  1. 快速進食行為

由於感官敏感或衝動性，一些神經多樣性人士可能進食過快，導致飲食過量、消化不良或腹脹。

減緩進食速度的小貼士：

  • 鼓勵充分咀嚼，並在每一口之間喝水。
  • 使用較小的餐具或提供較小份量，自然減慢進食速度。
  • 營造平靜、無干擾的環境以促進專注進食。
  • 通過一起用餐示範慢速進食行為。

減慢進食速度有助於消化，幫助識別飽腹感，並使用餐時間更愉快。

 

  1. 食物添加劑與過動

研究表明，某些人工食物添加劑可能導致敏感兒童出現過動行為。然而，這些影響通常較小且並非普遍。

常見問題添加劑：

  • 日落黃（E110）
  • 奎寧黃（E104）
  • 胭脂紅（E122）
  • 鮮紅AC（E129）
  • 檸檬黃（E102）
  • 麗春紅（E124）

實用步驟：

  • 保持食物日記以記錄飲食與行為之間的模式。
  • 以新鮮水果、蔬菜、瘦蛋白及全穀物等天然食品為主。
  • 閱讀標籤，避免含有已知敏感成分的產品（如果懷疑有敏感）。

 

  1. 腸腦軸（Gut-Brain Axis）

腸腦軸是一個連接消化系統與大腦的雙向通訊系統。健康的腸道微生物群與以下好處相關：

  • 改善消化及減少不適感。
  • 通過血清素生成改善情緒調節。
  • 通過褪黑激素調節提升睡眠質量。
  • 潛在減少煩躁或攻擊等挑戰性行為。

腸道健康與免疫力：
約70%的免疫系統位於腸道，幫助調節炎症及增強身體防禦能力。健康的腸道微生物群還可以降低兒童患濕疹及花粉熱等過敏性疾病的風險。

 

結語

良好的營養是改善特殊需要人士健康及福祉的基石。通過解決特定挑戰——無論是消化問題、飲食習慣還是藥物副作用——家庭都可以在日常生活中創造有意義的改變。

早期介入至關重要。在童年時期建立健康的習慣，為終生的身心健康打下基礎。通過耐心、創意及專業支持，家庭可以賦予所愛之人蓬勃發展的能力。

讓我們共同努力，一餐一餐地建設一個更光明、更健康的未來。

 

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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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