Food selectivity is a condition characterized by aversion to a large number of foods. It is a very common symptom in people with Autism Spectrum Disorder (ASD), as shown by a study conducted by the University of Marília in São Paulo. This is because it involves a sensory issue, which is highly present in the autism spectrum. People with autism may have a more rigid eating pattern—meaning they always eat the same foods—so a break in routine, with the introduction of new food groups, leads to discomfort and rejection.

For families with children with autism, food selectivity is a daily challenge, as these children often prefer only one specific type of food, which isn’t always the healthiest option. We spoke with nutritionist Prof. Dr. Rosana Farah, a specialist in eating disorders, who explained more about this issue. “For autistic individuals, ideally things should always remain the same, with the same shape and presentation. This is why ‘packaged’ foods may be preferred, as they always have the same smell, color, texture, and crunch,” she explains.

The nutritionist points out that the degree of food selectivity and aversion can be triggered by behavioral factors such as hypersensitivity, past experiences with choking, reflux, allergies, as well as nutritional issues like nutrient deficiencies and gastrointestinal disorders that worsen loss of appetite.

The biggest challenge, then, is learning how to best manage food selectivity in a way that does not make the child feel forced to change habits, but rather incorporates diverse eating gradually into their routine. In this context, a multidisciplinary approach involving a nutritionist, physician, speech therapist, and occupational therapist is essential to break down barriers and support both the child and their family.

Nutrition as a key pillar of treatment

The role of nutritionists in managing food selectivity is fundamental for nutritional re-education and the introduction of healthy foods into a child’s or adolescent’s diet. The more a child restricts their variety of food groups, the higher the risk of clinical consequences, including nutritional deficiencies, being overweight, and obesity. Without proper treatment, various nutritional harms may occur, such as vitamin and mineral deficiencies, tooth loss, and intestinal issues.

The assessment process carried out by a nutritionist must be personalized according to the specifics of each case. According to the expert, an assessment is never a one-time task—it must be built through a relationship of trust with the child and their family or caregivers. In addition to analyzing weight and height, it is also essential at the beginning to understand the family dynamics and the child’s relationship with food.

Prof. Rosana emphasizes the importance of identifying the food patterns the child accepts and the shared characteristics among those foods, such as color, consistency, and texture. From there, new foods can be gradually introduced according to the child’s own pace.

One approach involves food chaining techniques, which use the foods the child already likes as a base to present new options with similar color, texture, or food group. An example would be replacing store-bought French fries with homemade fries.

The role of the family in dietary re-education

The family plays a fundamental role in helping build dietary diversity in the child’s life, since they are present daily during meals. They should aim to reframe these moments, bringing a sense of calm and comfort so that children feel safe and encouraged to try new flavors.

The expert stresses that “families themselves need care too, because stress and emotional exhaustion—as well as feelings of guilt and pressure—are very common. Families must be guided and supported in acquiring new habits to break vicious cycles.”

Instituto C’s work in nutritional education

That’s why the support offered by organizations like Instituto C is crucial in helping families take the first step toward addressing this issue. At Instituto C, our team works within the framework of social nutrition, with clinical interventions only in extreme cases. Our focus is on nutritional education, offering guidance so families can better manage food selectivity.

Food selectivity is the most common concern brought to the nutrition team by mothers of children with ASD, according to Raquel Kanup, a nutritionist at Instituto C.

Raquel explains that food selectivity should also be addressed through joint efforts that include public health policies. That’s where the institute acts as an intermediary. “If the family lives in São Paulo, and the child with food selectivity also has an ASD diagnosis, I guide them on how to request a referral from their public health unit (UBS) nutritionist to access specialized services for treating food selectivity in ASD cases (such as Instituto PENSI),” she says.

Furthermore, when food selectivity is present, some children cannot stay in school for the full day because they are unable to eat at school. In such cases—when they have no access to proper treatment and, consequently, no adapted school meals—the nutritionist schedules a consultation with the family to create a report requesting meal adjustments. This document is sent to the school or the municipality’s school meal department to request accommodations.

Managing food selectivity through a multidisciplinary approach increases the chances of children adapting to the introduction of new foods in a more peaceful and suitable way. This allows us to support even more families dealing with food selectivity, especially those raising children with autism.

To that end, we are seeking volunteer nutritionists to join our team and help us address this issue that is so prevalent in our daily work. This professional will work with us on a mission that can truly transform the reality of many children. Click here to learn more!

This article was developed with support from Raquel Kanup, nutritionist at Instituto C, and Rosana Farah, professor, Ph.D., and specialist in eating disorders.