Autism and food

It’s one thing to write about what kids and adults with autism should or shouldn’t eat to help them, but it’s quite another to put that into practice. For a start, autism often involves extreme discomfort from lack of sensory processing, verbal and non-verbal communication difficulties and impaired social interaction. We’ve previously blogged about a book entitled Carley’s Voice, written by the father of an autistic Canadian young lady, which describes her journey. When she was eleven, she learned how to communicate via computer and was found to be exceptionally smart. She wrote a chapter of the book herself in which she describes what it feels like to live in her shoes and why repetitive behaviour and forming solid habits are important because they make autistic people feel safe and grounded.

Since filtering out senses and feeling totally bombarded with visual and textural input as well as tastes and smells is an intense experience, ritualistic eating often helps autistic people to feel more secure. For example, some can’t handle crunchy foods, preferring well-cooked or smooth textures, and some get overstimulated by colourful foods. Or it can be a combination of these problems,and understandable how parents often end up allowing autistic children to eat what they want, opting to help them feel more comfortable over enforcing balanced meals. However, autistic people are typically deficient in micronutrients, which only exacerbates their autism.

Nutritionists almost universally agree that 5 nutritional steps can make a big difference:

1. Low GI diet
2. Boost Glutathione
3. Nurture beneficial gut bacteria
4. Get the right balance of fats
5. Optimise vitamin D levels

Dramatic swings in blood sugar are associated with eating simple carbs, found in most processed foods and sugary drinks. Research has shown that eating less of these foods has resulted in improved or fewer symptoms of autism.

Glutathione is an antioxidant found in cruciferous vegetables and enhanced by optimal levels of Bvitamins, as well as C,D and E. It works to detoxify and eliminate environmental toxins such as heavy metals, pesticides and chemicals from the body. Found to be very significantly reduced in people with autism, this interferes with the ability to remove these poisons, which hinders brain development.

Many studies have shown the gut and brain to be closely linked, so much that alterations in gut bacteria affect neurological function. For this reason, it is particularly important for people with autism to protect their beneficial bacteria. Good quality probiotics and fermented foods (such assaurkraut, kim-chi, and kombucha) are rich in beneficial bacteria and support good digestion, absorption, and are key for people with autism.

Polyunsaturated fatty acids (PUFAs) omega 3 (found most abundantly in oily fish, such as salmon, mackerel and anchovies as well as in flax seeds) and omega 6 (in meat, eggs, dairy, nuts andseeds) are essential for healthy brain development. These fats, especially omega 3, have been found to be lower in people with autism and correlated to core symptoms, such as hyperactivity.

Vitamin D is naturally produced by the skin in response to sunlight exposure and is very important for neurodevelopment and function. In a 2015 meta-analysis, including 11 studies and a total of 870 autistic subjects and 782 healthy controls, levels of serum vitamin D in participants with autism were found to be significantly lower than controls, suggesting that lower vitamin D level might be a risk factor for autism. White getting optimal vitamin D – not too little and not too much – is key, it is best to get a vitamin D test, which can be purchased online, before beginning supplementation.

People living in the north of England generally require supplementation, and (while functional levels are somewhat lower) optimal levels fall between 70-100mg/ml.

Ritual approaches to eating in autism are undisputedly difficult to change. Sometimes refusal to eat certain things is associated with medical issues like tummy ache, which can’t be communicated. After making sure there are no medical problems or food allergies the main things to remember are patience, perseverance and creativity. Parents might look for patterns in eating and if colour or texture is a problem, try different methods of cooking or different vegetables and foods. Incorporating new foods into cooking may help autistic children adjust. There is also a strong argument for occupational, behavioural or speech therapy if their mouth muscles are underdeveloped and they can’t properly chew or move food around their mouth. Emily Kuschner, a clinical psychologist at a Centre for Autism Research in Philadelphia suggests taking a step-wise approach, first, simply looking at the new food together. From there, perhaps suggest that the two of you smell it and/or touch it. These are great opportunities for playing games and having fun with food. When you feel the child is ready, suggest licking or tasting the food. Other ideas might be finger painting with sauces or letting them decorate a dinner plate with vegetables. The main thing to remember is that autistic children usually become less selective as they get older, so just keep working with them.

References:

1. Ranjan, S. and Nasser, J. (2015). Nutritional Status of Individuals with Autistic Spectrum Disorders: Do We Know Enough? Advances in Nutrition6(4) pp. 397-407.
2. Mehl-Madrona, L., Leung, B. et al. (2010) Micronutrients Versus Standard Medication Management in Autism: A Naturalistic Case–Control StudyJournal of Child and Adolescent Pharmacology 20(2) pp. 95-103.
3. Currais A, Farrokhi C et al. (2016). Dietary glycemic index modulates the behavioral and biochemical abnormalities associated with the autistic spectrum disorder Molecular Psychiatry 21(3) pp. 426-436.
4. Van Konynenburg, R. (2005). Glutathione Depletion in Autism and the Spin-off for CFS
5. Krajmalnik-Brown, R, Lozupone C et al. (2015). Gut bacteria in children with autism-spectrum disorders challenges and promises of studying how a complex community influences a complex disease Microbial Ecology in Health & Diseasedoi: 10.3402/mehd.v26.26914
6. Rodakis J. An n-1 case report of a child with autism improving on antibiotics and a father’s quest to understand what it may mean Microbial Ecology in Health & Disease
7. Brigandi SA, Shao H et al. Autistic children exhibit decreased levels of essential fattyacids in red blood cells International Journal of Molecular Sciences 16(5) pp. 10061-76.
8. Ooi YP, Weng SJ et al. (2015). Omega-3 fatty acids in the management of autism spectrum disorders: findings from an open-label pilot study in Singapore European Journal of Clinical Nutrition69(1) pp. 969-971.
9. Bent S, Hendren RL et al. (2014). Internet-based, randomized, controlled trial of omega-3 fatty acids for hyperactivity in autism Journal of the American Acadamy of Child and Adolescent Psychiatry53(6) pp. 658-66.
10. Mercola, J. (2011). How to Get Your Vitamin D to Healthy Ranges.
11. Wang T, Shan L et al. (2015) Serum concentration of 25-hydroxyvitamin D in autism spectrum disorder: a systematic review and meta-analysis European Child and Adolescent Psychiatry 25(4) pp. 341-350.
12. Nath, S. (2014). Feeding Problems in Children with Autism.
13. Encouraging Picky Eaters with Autism to Try New Foods. (2013).

Nuri Adams-Davies is a final-year student of naturopathic nutrition at CNM Manchester, and formerly a support worker for Special People North. She is particularly interested in helping people with special needs. See her blogs about improving and maintaining health at http://vitalitynutritionuk.wix.com/vitalitynutrition.