Vegetables and protein (fish, poultry, meats, and beans) are the most common food aversions. Some children even reject fruits. The diet becomes extremely restricted to bland, white foods, including sweets, breads, pasta, crackers, pretzels, chips, and macaroni and cheese. These foods are glycemic and raise blood glucose, quickly increasing the demand for insulin production. Zinc is part of the insulin molecule and is depleted, resulting in abnormal taste and taste perception. What develops is an aversion to the flavors in natural foods and increased cravings for highly sweetened foods and those foods containing MSG. (MSG affects the brain’s perception of flavor.) The diet becomes more narrow, and nutritional status declines, resulting in more limited food choices. The white diet and vegetable aversion is common among children in Western cultures due to the high exposure to processed and sweet foods. For children with sensory and developmental issues, the aversions are much more pervasive and serious.
There are three potential contributors that lead to the limited appetite, cravings, and food aversions:
1. The formation of opiate-like peptides from gluten and milk products, resulting in cravings for the foods that are the sources.
2. Zinc deficiency or deficiencies in zinc metabolism and function. Zinc is responsible for sensory development and function, including taste and taste perception.
3. The presence of toxic metals that can interfere with sensory development and function.
The negative effect of this combination can result in faulty messages from the sensory receptors to the brain and dysfunctional interpretation of those messages by the brain. Perception is the “truth” for that person. This is why begging, bribing, and punishing do not and will not work.
The solution is multifaceted. Correction of nutritional deficiencies and elimination of toxic metals are mandatory and involve appropriate therapeutic supplementation based on findings. Foods that cause reactions and/or opiate-like peptides need to be eliminated as healthy, safe foods are introduced and accepted.
For those with texture issues, it is important to adapt the diet to the child’s oral and food developmental stage. If textures are a sensory issue, no matter how tasty the food, it will not be consumed. By providing the food in a sensory-pleasing form, the child benefits nutritionally and begins to find mealtime more pleasant and rewarding. Purees are generally helpful. They are better tolerated and can open the door for getting more types of foods into the diet. Many family dishes, including soups, casseroles, or the meat and vegetable main dish, can also be served pureed for the child who has sensory texture issues. In this way, the whole family is enjoying the same meal.
Many of the recipes in this book have been selected to expand nutritional intake, especially using the Trojan Horse Technique-hiding a small amount of the new food (especially vegetables and proteins) within a very well tolerated and acceptable food. Each child differs and, therefore, it is important to identify what foods will work as “carriers” to get the new foods in.
Purees can be made from cooked fresh or frozen vegetables and/or purchased baby foods. If your child is offended by being served baby food, simply keep it well hidden. Create interesting new names for the foods and see that others in the family join in consuming them. The secret to success in introducing these new foods is to combine a small amount with the food the child already likes. For many children, this is the only way new foods can be introduced.
Start with 1 tablespoon (15 g) or less-and then increase when tolerated. Hide the cooked vegetable purees anywhere you can, selecting colors that are not obvious when added to the carrier food. The carrier food needs to be one that the child enjoys. It may even be a food that is being slowly eliminated. Include pureed fruits to improve the taste. Here are some examples of places to hide foods (and even supplements):
Spaghetti Sauce. Blend the pureed vegetables thoroughly with at least three times as much spaghetti sauce; then hand-mix the new blend in with the rest of the sauce. Carrots, beets, sweet potatoes, turnips, squash, green beans, and peas are easy to hide in spaghetti sauce. Watch the amount of green if it is a food color that your child rejects.
Muffins, Cakes, and Brownies. Well·pureed foods are easy to hide in these batters, including pureed chicken and turkey. A chicken/vegetable/fruit muffin becomes a healthy meal!
Pancakes. Not only can pureed vegetables and fruits hide well in the batter, but they are also a good hiding place for supplements such as protein powders, calcium, magnesium, and zinc.
Peanut Butter. If a child likes peanut butter, it is an excellent medium for adding small amounts of protein and nutritional supplements.
Meatballs. If these are well liked, especially with spaghetti sauce, the job becomes a whole lot easier. Well-pureed vegetables and fruits are an excellent thickener/filler for meatballs. Make many and freeze them, and then bring them out for snacks.
Juices, especially those with a strong flavor, such as pineapple juice, grape juice, nectars, apple cider, and orange juice.
Smoothies, Fruit Purées, and Applesauce. These offer an unlimited opportunity for expanding nutrition and an excellent way to hide supplements. Protein powders can be included to expand protein intake, especially for those with texture issues who avoid meat, beans, and other sources of protein. Always start with the fruit your child favors and then expand.
Let chocolate be your friend. There are sources of GFCF chocolate chips, sauces, powders, and so forth. Check the product search section of the GFCF Diet site (www.gfcfdiet.com/directory.htm).
Add unflavored gelatin to cooked purees to lend more substance and improve digestion.
The above is an excerpt from the book The Kid-Friendly ADHD & Autism Cookbook: The Ultimate Guide to the Gluten-Free, Casein-Free Diet
by Pamela J. Compart, M.D. and Dana Laake, R.D.H., M.S., L.D.N.
Copyright © 2008 Pamela J. Compart, M.D. and Dana Laake, R.D.H., M.S., L.D.N
Pamela J. Compart, M.D., is a developmental pediatrician in Columbia, Maryland. She combines traditional and complementary medicine approaches to the treatment of ADHD, autism, and other behavioral and developmental disorders. She is also the director of HeartLight Healing Arts, a multidisciplinary integrated holistic health care practice, providing services for children, adults, and families.
Dana Godbout Laake, R.D.H., M.S., L.D.N., is a licensed nutritionist in Kensington, Maryland. Within her practice, Dana Laake Nutrition, she provides preventive and therapeutic medical nutrition services. Her practice includes nutritional evaluation and treatment of the full spectrum of health issues affecting adults and children with special needs.