Role of Nutrition and Special Diets in Autism
Nutritional needs are different for children and adults with autism, as they very often suffer from various nutrient deficiencies. Recent research has also confirmed that, contrary to commonly-held beliefs, the presence of gut and nutritional problems in children with autism is in most cases not due to picky eating or receiving medication. The real biological reasons for nutrient deficiencies in autism are still not entirely clear, and may differ from individual to individual, but are thought to be due mostly to impaired digestion and absorption of nutrients from the gut, as well as the increased need for these nutrients by the body. The body of a person with autism – cells, tissue and various body systems – is under constant stress, and the need for quality nutrients is high.
Children and adults with autism suffer from health problems much more commonly than their peers. These health problems can include seizures, headaches, gastrointestinal problems, metabolic and mitochondrial conditions, compromised immune system including allergies and autoimmune disorders and many more (for references see our scientific review Medical Comorbidities in Autism Spectrum Disorder). It is also a sad fact that mortality is significantly increased in autism, with much higher death rates than in the general population.
Symptoms of health problems in autism are not always visible on the surface or easy to detect, but they may influence the child’s behaviour, worsen severity of their autism-related symptoms, and undermine their quality of life. On the other hand, diagnosis and treatment of these health issues can often lead to an improvement in many symptoms.
It is important to remember that autism is not a single condition but includes many diverse groups of individuals who are affected by autism for different underlying biological reasons and suffer from different comorbid health problems. It is therefore not surprising that no single health concern, including nutritional deficiencies or food sensitivities, will impact every individual with autism, nor is any single treatment approach appropriate for all. While, for example, dietary intervention in particular is reported to be beneficial in a large number of cases, there is no ‘one size fits all’ diet. Similarly, treatment with nutritional supplements that address metabolic problems are shown to have life-changing effects in some children and adults with autism, but have no effect at all in others. However, while it is often not clear if simply supplementing nutrients that are lacking will bring about visible improvements in person’s symptoms, it stands to reason that supplementing what is missing will at least prevent the body being pushed into further stress and developing more serious health problems later in life (see section 2.2 of the Westminster Commission report).
Many individuals with autism have low levels of certain vitamins and minerals, including: zinc, magnesium, iron, vitamins B-6 and B-12, vitamins D and E, and folates. Supplementing some of those nutrients can not only normalise their levels but can address some of the underlying biomedical problems frequently found in autism, such as immune abnormalities or metabolic problems, and is sometimes reported to result in improvements in autism-related symptoms and behaviours. *
Gastrointestinal problems are common in autism and can include reflux, chronic constipation or diarrhoea, colic, impaired intestinal lining, impaired digestion/break down and poor absorbing of essential nutrients into the bloodstream, bacterial dysbiosis (presence of harmful bacterial in the gut), food allergies and sensitivities and many others. These problems often stay hidden and go untreated because they frequently present in unusual ways and through problem behaviours such as irritability, aggression, destructive behaviours, hyperactivity, sleep problems, anxiety, obsessive and rigid behaviours, strange posturing (for example bending over furniture) or movements, bloating, screaming, chest banging, biting and other types of self-harm.
Several very promising treatments are being studied at the moment following many positive reports by parents and doctors. Some of those approaches include daily supplementation with digestive enzymes and probiotics, or special diets that restrict sugar and complex carbohydrates. A diet that excludes gluten (protein found in wheat and some other grains) and casein (protein found in milk) has gained wide popularity amongst parents and clinicians in recent years. The positive effects of this diet in a number of children and adults are likely linked to the recent discovery that some individuals with autism are sensitive to common food proteins such as those found in wheat and milk.
Allergies and food sensitivities are present in many children and adults with autism, who also often suffer intolerances to various things in their environment. Sometimes their immune system does not work as well as compared with non-ASD people. Those problems are occasionally visible on the surface, as in the case of eczema, asthma, allergic rhinitis (runny or stuffed sinuses, red eyes), or frequent ear infections. On the other hand, these problems can sometimes be hidden, with the only visible signs being worsening of problem symptoms and behaviours—for example, sleep problems, irritability and tantrums, hyperactivity, lack of focus, daytime fatigue, anxiety, obsessiveness—that are often wrongly attributed to ‘being autistic’.
Treating allergies and avoiding foods and things in the environment that a person with autism is sensitive to can often result in improvement in negative and challenging behaviours and better overall functioning. Many parents and professionals have reported improvements in their child’s behaviour and functioning at school and at home when offending foods are avoided, as for example in the case of foods containing gluten.
It is important to always seek advice and recommendations of a qualified practitioner before undertaking any dietary or other intervention.
*This article contains several excerpts from the publication "Treatments and therapies for autism - Treating Autism Guide for Parents”. Treating Autism is a leading UK charity focusing on addressing health issues in autism. Their website treatingautism.org.uk offers links to resources such as various publications and information sheets, that are aimed at both parents and professionals.
The charity Food for the Brain (foodforthebrain.org) aims to raise awareness of the importance of optimum nutrition in mental health. Our not-for-profit clinic, the Brain Bio Centre (brainbiocentre.com), has experienced specialist nutritional therapists who work with individuals utilising a comprehensive, holistic nutritional therapy (biomedical) approach to support mental health.
Written by: Treating Autism and Food for the Brain
Taking Positive Action on Dementia Awareness Week 2016
This week is Dementia Awareness Week and our May E-news is dedicated to raising awareness of the role diet, nutrition and lifestyle can play in preventing this destructive disease as part of our ‘Take Positive Action’ Campaign’.
Take positive action to reduce the risk of Alzheimer's and dementia
Memory loss, poor concentration and depression are common early signs and symptoms of Dementia, which can be frightening and very isolating for those experiencing them. May is officially dedicated to Dementia Awareness across the globe with a large number of charities and organisations campaigning to raise awareness about this neurodegenerative condition. There are an estimated 46.8 million people worldwide living with dementia and the number has been predicted to double every 20 years, reaching 74.7 million in 2030 and 131.5 million in 2050. (1) In the UK alone, 1 in 14 people over 65 have Alzheimer's disease (2), a form of dementia which accounts for about two thirds of all dementia cases. However, most people don’t know that up to 50% of the risk of Alzheimer's, is attributable to modifiable diet and lifestyle related factors and with these figures looming over us, it is crucial that there is more awareness generated on taking a positive approach to preventing Dementia and the symptoms that come with it. Prevention is an area which is not spoken about enough, since 2008 less than 1% has been spent on prevention research. Funding has been largely focused on finding medication to treat Dementia rather than prevention. However, the recent research for drugs has been fruitless. There is no drug that slows down the disease process in Alzheimer's and because of this, many people feel that there is nothing they can do to help themselves or help their family members. There are, however, many studies showing how key nutrients like B vitamins, following a balanced diet, avoiding certain foods which can impair brain function and adopting healthy lifestyle habits can do a lot to optimise the health of the brain, therefore slowing down or preventing degeneration. In a study carried out by David Smith at the University of Oxford, a group of people showing signs of Mild Cognitive Impairment (MCI) were given a supplement of B vitamins and others were given a placebo. In those with high homocysteine levels, the specific areas of the brain associated with Alzheimer's disease shrank 8 times more slowly in those taking B vitamins than in those on the placebo. Furthermore, cognitive decline was slowed in the B vitamin group. This is strongly indicative that the B vitamins may be substantially slowing down, or even potentially arresting, the disease process in those with early stage cognitive decline. To read more research on Alzheimer’s and nutrition, please follow the link here.
Join us and take the 6 Prevention Steps
At Food for the Brain our aim is to empower people to take positive action through adopting a holistic approach in preventing cognitive decline and Alzheimer’s through nutrition and lifestyle changes. This month we are inviting you all to get involved in our ‘Take Positive Action’ campaign by helping to raise awareness of the role diet and nutrition can play in reducing the risk of Alzheimer's. Join us in taking 6 key diet and lifestyle prevention steps and also donate a small sum if possible to help us further our campaign.
Over the next 4 months we would like as many people as possible to take our free online Cognitive Function Test, then start following the 6 prevention steps and let us know how you get on. For a suggested donation of £5, which will help over 2,000 more people a month in accessing positive steps forward through our free Cognitive Function Test and resources, we will provide you with a ‘6 Prevention Steps E-guide’. This guide builds upon information on our website outlining key nutritional and lifestyle advice, as well as providing some fantastic ‘brain-friendly’ recipes donated by acclaimed chefs Anton Mosimann, Oliver McCabe and health-focused restaurant chain LEON. The guide also includes a number of beneficial discount codes for related health-foods, supplements and homocysteine home-test kits, through the support of York Test and Holfordirect.com.
At the Food for the Brain office we will be ensuring we follow the 6 steps and encouraging our family to do so too. We want you to keep us posted on your progress and experiences with the Cognitive Function Test and the ‘6 Prevention Steps’ via our ‘Take Positive Action’ Facebook page until September initially, when we will be campaigning for World Alzheimer’s Day on the 21st.
Take positive action by following the 6 steps yourself, share the 6 steps with others and donate to support our campaign. Your support will help us reach more people fearful of this debilitating disease and empower them to take positive steps to reduce their risk.
To donate to Take Positive Action and receive your e-guide please follow the link here.
16th May 2016
Learning the Language of your Genes - Preventing Alzheimer's with Nutrition
It is now well-known that what we eat affects our health in many ways. But did you know that your diet and lifestyle has the ability to influence your genes? This relatively new field of research called Nutrigenomics explores how nutrition can influence our gene expression by merging together the science of genomics, molecular biology, bioinformatics, epidemiology and nutrition. It is essentially a branch of research under the umbrella of Epigenetics, which is the study of how trait variations in our genes are caused by external factors such as diet and lifestyle (1).
Scientists have only just begun to touch the tip of the iceberg of what we know about how nutrients and how our lifestyle can affect the expression of our genes. Genetically we are all very similar, however, our genetic blueprint holds a range of variations that can predispose us to certain health conditions, such as Diabetes Type 2 or Atherosclerosis (2). The way in which we live our lives and what we eat can switch certain genes on or off, thereby affecting what health conditions or diseases we become predisposed to.
This concept is revolutionary, and above all empowering as we are beginning to realise that we aren't necessarily doomed by the genes we have. For example, if your mother or father have suffered with Dementia it doesn't necessarily mean that you too will at some point suffer with the same condition. You are ultimately in control of your own health and can increase your chances of living a long, happy and healthy life by avoiding certain foods and choosing healthy lifestyle habits.
Mark Adam Hyman, an American physician, scholar and New York Times best-selling author, wrote in one of his many books, “The new science of nutrigenomics teaches us what specific foods tell your genes. What you eat directly determines the genetic messages your body receives. These messages, in turn, control all the molecules that constitute your metabolism: the molecules that tell your body to burn calories or store them. If you can learn the language of your genes and control the messages and instructions they give your body and your metabolism, you can radically alter how food interacts with your body, lose weight, and optimize your health”(3).
With that in mind, how can we apply the same principle to avoiding a condition like Alzheimer’s? Scientists have discovered a group of genes that have the potential to affect, to varying degrees, the chances of developing late onset Alzheimer’s. One of these genes which has been identified as having a significant influence on this disease is called apolipoprotein E (APOE). This gene is found on chromosome 19 and comes in different forms, each representing varying risks. For example, around a quarter of the general population inherits one copy of the APOE ε4 gene, which increases their risk of developing Alzheimer’s by up to four times. Research to identify other genes related to this condition continues to unfold more information that was previously not understood (4).
In 2011, four of the largest AD research consortia - the Alzheimer’s Disease Genetics Consortium (ADGC), the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE), the European Alzheimer Disease Initiative (EADI), and the Genetic and Environmental Research in Alzheimer Disease (GERAD) consortium came together to form the International Genomics of Alzheimer’s Project. It is the largest study of the genetics of Alzheimer’s to date with the aim of discovering and mapping the genes that contribute to Alzheimer’s disease. So far, none of the new genes discovered have an effect as big as that of APOE ε4, with most of them influencing the risk of Alzheimer's disease by just a few percent (5).
It is of course understandable for someone who has a relative that suffers with Alzheimer’s to worry whether they too will at some point develop the disease. The evidence does show that people with close relatives diagnosed with the disease are at double the risk of developing it themselves. However, this does not mean that they will inevitably go on to acquire Alzheimer’s later on in life. Having a good, well-balanced diet as well as adopting healthy lifestyle habits can reduce the risk significantly of developing of this disease. For many, over 60’s especially, it is worth taking a homocysteine test as a build up of levels of this amino acid in our blood has been linked to Alzheimer's Disease as well as other chronic conditions. For more information on how you can lower your levels of homocysteine such as by increasing on your intake of B vitamins, follow this link to our webpage.
Our own Cognitive Function Test is a valuable tool for individuals to assess their own cognitive function against others of a similar age and provides a personalised nutrition and lifestyle report, identifying areas, such as low levels of B vitamins or low levels of Omega 3 fats that can increase someone’s risk of cognitive decline. The test aims to empower people who may be concerned about cognitive decline, either putting their mind at rest, or helping them to feel more informed about their circumstances, and in both cases providing them with some positive steps they can take through nutrition and lifestyle to support better cognitive function going forward. To test yourself follow the link here and see what dietary and lifestyle changes you can be making to optimise your cognitive functio
2nd February 2016
Alzheimer's - drugs or vitamins?
At Food for the Brain we are not against medication and we hope to see a successful drug discovered for health conditions, such as dementia, just like anybody else. It saddens us however to regularly see one-sided news reporting. In terms of disease modifying treatments for dementia/Alzheimer’s Disease, almost all new drug discoveries are hyped-up to be much more effective actually then they in reality are. On the other hand, a number of much more significant studies on the effects of some dietary modification or certain specific supplements on dementia/Alzheimer’s are simply ignored or mis-reported in the mainstream media. The growing emotional and financial cost of dementia (including Alzheimer’s) is so high that we cannot afford to choose sides – there is only one side and that is evidence.
In this case it is the confusing messages sent by the Alzheimer’s Research UK (ARUK). For instance a paper published in 2012 reported that B vitamins given to those with pre-dementia (mild cognitive impairment) dramatically reduces shrinkage of the Alzheimer’s brain areas and reduces further memory loss – so therefore B vitamins represent a disease modifying treatment. This study was part-funded by ARUK, however, last week we are told by ARUK’s Eric Kerran that a new drug, solanezumab is the ‘first disease modifying treatment’! (as reported on www.bbc.co.uk).
If we were to compare B vitamins with solanezumab (designed to clear out amyloid protein from the brain that can build up and contribute to dementia) the effect of solanezumab is very small in comparison to that reported with B vitamins, which mostly work through its effect on lowering homocysteine levels.
In this new drug solanezumab there’s no change in rate of brain shrinkage, which is critical if the drug is going to modify the disease process - not just marginally slow it down. There are also only very minor improvements in memory. Nevertheless, the press coverage reported a different story, “First treatment to slow Alzheimer’s disease unveiled in landmark breakthrough,” in the Telegraph and Newsweek’s title was “New drug shows promise for early-stage Alzheimer’s”, “Hugely significant…first drug actually slowing down the course of the disease …verge of a radical breakthrough.” commented another ARUK spokesman (for the full story: Policy on Alzheimer’s: sure we want a cure, just so long as it’s not cheap click here)
Considering the positive headlines, it surely creates a view that the whole scientific community agrees with the positive media’s stance, however, the press stories were printed even before the study on solanezumab itself was published! Detailed analyses of the complex results of this study by other specialists in the field have since emerged, reporting what actually happened. Margaret McCartney, writing for the British Medical Journal wrote that in one memory test, those on the drug, out of a possible score of 30, scored 1 point higher than those on a placebo. In the other two tests used the difference was also very small. In contrast, there was a virtual cessation of any further memory loss in the B vitamin study over 2 years.
Also, on a very important measure - the Clinical Dementia Rating (CDR), there was no change between Solanezumab and the placebo, which is bad news because it means no-one, actually got better. To give another comparison, the difference between the placebo group (28%) and the B vitamin group (58%) reverting to zero on the CRD was 30%. In other words B vitamin treatment doubled the proportion of people reverting to zero on the CDR according to Dr Celeste de Jager. In the drug study there is no difference between drug and placebo.
The best memory test results for the drug, the MMSE and ADAS-Cog tests, showed a 34% slowing down of decline in scores compared to those on placebo over 18 months. In the B vitamin trial, those starting with high homocysteine had a complete prevention of any further decline in episodic memory and in semantic memory over 2 years.
But perhaps the biggest difference was between the rates of brain shrinkage. Solanezumab treatments resulted in a non-significant 2% reduced rate of brain shrinkage compared to the placebo. In contrast, in the B vitamin study there was an average 30% reduction in the rate of brain shrinkage, which went up to 53% in those with raised homocysteine and 73% in those starting with good omega-3 levels that were supplemented B vitamins, compared to placebo.
Beyond the particular outcome of the solanezumab study, more and more research is indicating that amyloid plaques are not in-fact a cause in Dementia but an effect (leading to more damage).
The brain produces more amyloid protein as a response to a number of neurological conditions. This may be the results of (at least in part) poor methylation (homocysteine levels reflect poor methylation and B vitamins can effectively reduce homocysteine). The solanezumab drug reduces amyloid protein, but if fails to address the cause. A recent study conducted at the University of California has shown that omega-3 supplementation also helps the body get rid of amyloid protein and probably even more effectively together with vitamin D. So omega-3 (and possible more effective with vitamin D) can possibly do what the drug does but without the side-effects, and B vitamins help to reduce the formation of amyloid protein to start off with. Looking at it from this point of view, we already cover three disease modifiable factors, B vitamins, vitamin D and omega-3, albeit there are likely only effective in individuals with low levels.
Considering all this, and that omega-3 and B vitamins to reduce homocysteine levels have with minor-no side effects and solanezumab (a monoclonal antibody drugs which has to be given by injection every few weeks) is associated with haemorrhage (which occurred in a small percentage of people on this study), we find it odd that news, even from respected organisations such as ARUK, can be so unbalanced in favour of drugs. Again we are not against medication but the growing emotional and financial cost of dementias is so high that we cannot afford to choose one over the other, and neither should we have to. In an ideal world solanezumab would have been tested also in conjunction with omega-3, B vitamins, and vitamin D to learn what the best possible outcome is.
One option for now is to try Food for the Brain’s validated free online Cognitive Function Test (only takes around 15 minutes) which also works out your preventable risk factors and gives you a personalised report of key changes to reduce your risk of dementia.
11th August 2015
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