How can nutrition be used to treat autism? Julie Matthews shares her beliefs that diet and nutrition are fundamental to the health and healing of children on the autistic spectrum.
The most successful recovery stories as told by parents whose children are on the autistic spectrum always include diet intervention and improvements in nutrition intake. Diet, nutrition and supplementation are fundamental to the health and healing of children with autism. It is most effective when nutrition is applied as a complement to physician recommended medical treatments, behavioural and cognitive therapies.
While there are a number of effective “autism diet” options to choose from, beginning nutritional intervention need not be overwhelming. Ten years ago, the diet choice was simple – there was only the Gluten-Free Casein-Free Diet. Eliminating gluten (the protein in wheat) and casein (the protein in dairy) was the primary focus and this diet has proven to be very beneficial for many children on the spectrum.
Today, additional advances in nutrition research and anecdotal data have resulted in broader dietary strategies: Specific Carbohydrate Diet (SCD), Body Ecology Diet, Feingold Diet, Low Oxalate Diet, and others. Significant scientific data and overwhelming anecdotal analysis indicate a link between autism symptoms and diet. As reported by Autism Research Institute (ARI) in a survey of thousands of parents; The Gluten- (wheat) and Casein- (dairy) free diet has a 69% improvement rating, and the Specific Carbohydrate Diet has a 71% improvement rating. That is, most parents who diligently apply diet and nutrition intervention report some positive affect on behaviour, cognition, general health, or wellbeing.
The common symptoms reported by parents to improve with diet are: stimming, language, attention, hyperactivity, learning, fatigue, aggression, self-injurious behaviour, rashes, digestion, diarrhoea, constipation, gas, and more. Several dietary options exist for children and adults on the autistic spectrum. The best for a particular individual depends on many factors such as digestive capacity, bio-individuality, family history and symptoms. Currently, the two most common diets are the GFCF Diet and SCD.
The GFCF Diet is the typical place to begin when initiating nutritional intervention for autism. This entails the removal of all gluten and casein containing foods from your child’s diet. Gluten is the protein found in wheat, rye, barley, spelt, kamut, and commercial oats. Gluten can be found in bread, crackers, pasta, cereal, packaged foods, baked goods, and many other items. Casein is the protein found in milk which is used in dairy products such as whole and reduced fat milk, cheese, cream, butter, ice cream, yogurt, cottage cheese, sour cream, powdered milk additives in food, and more.
When ingested by children with a compromised digestive tract – common with autism – gluten and casein proteins can cause gut inflammation, pain, and digestive problems. If the protein is not properly broken down during digestion, it can form opioids (opiate or morphine-like compounds). Scientists believe that opioids in gluten and casein are problematic for children with autism because these children often have an abnormal gastrointestinal tract. These medical issues can be diagnosed by physicians who treat children with autism.
The properties of gluten and casein can lead to digestive problems such as diarrhoea, constipation, gas, bloating, as well as foggy thinking and inattentiveness.
Most of the foods containing these offending gluten and casein proteins are easy to identify. However, some gluten and casein sources can be sneaky, with the offending ingredients not apparent when reading a product’s label – such as soy sauce and malt (barley). Some products, like potato chips and fries, are often dusted with wheat flour (gluten) during processing. This information is not listed on the product label but can be verified with the product manufacturer. It’s important to follow an autism diet strictly.
When beginning a GFCF Diet, be careful not to introduce too many GFCF junk foods such as cookies, sweets, and crisps. Even though they don’t include gluten or casein, the sugars can feed yeast, imbalance blood sugar, and de-regulate energy. Remember, diet is more than just the removal of offending foods – attention must be placed on ensuring healthy and nutritious food intake.
As the GFCF Diet is implemented, improvements in autism symptoms are often noted as the diet evolves and progresses. Some children experience rashes and eczema clearing up whilst others note improvements in behaviour, concentration, cognitive ability, eye contact, gastrointestinal issues and speech. There are many good books to assist parents in effectively implementing the GFCF Diet (see further reading) and the food marketplace is increasingly GFCF friendly.
Specific Carbohydrate Diet The SCD is the second most applied diet for autism. While most begin with GFCF, some begin with SCD (for reasons particular to their child’s circumstance). Others, who began with GFCF will evolve to SCD to see what further gains can be made, often when digestive problems persist and greater attention is required.
In addition to helping alleviate many of the traditional symptoms of autism, this diet is very helpful for those who have inflammatory bowel conditions and chronic diarrhoea. It can also help to alleviate constipation in some children.
This diet involves the removal of all complex sugars and starches, with the exception of honey and fruit sugar. When putting this diet strategy into place, parents remove maple syrup, cane sugar, agave nectar, brown rice syrup and other sources of sugars from snacks and meals. SCD also removes all starches and all grains, including potatoes and sweet potatoes.
The goal of the Specific Carbohydrate Diet is to reduce gut inflammation and aid healing by “starving out” bad gut bugs and avoiding foods that require carbohydrate digesting enzymes. Children with autism frequently lack these enzymes and have digestive systems that are attacked by pathogenic bacteria such as clostridia; they often need specific nutrition and diet support. By eliminating problematic foods, the bugs cannot continue to feed, and they die out. As these bacteria are eliminated from the body and enzyme function improves, children with autism experience healing. They feel better and some autism symptoms are alleviated.
As parents implement the SCD, they cook meals for their children and family that are centred around meat, fish, eggs, nuts and seeds, certain beans, all non-starchy vegetables, and fruit. They introduce honey and fruit sugar to their recipes and meal preparation. This diet is not a low carbohydrate diet but a specific carbohydrate diet that focuses on non-starchy vegetables, fruit, honey, and certain beans for carbohydrates and avoids other sugars and starches. An autism nutritionist might also suggest that a parent implement SCD without casein in case the child is sensitive to it.
Because SCD is more restrictive than the GFCF Diet, parents don’t usually begin their dietary intervention journey with SCD. However, if there is a significant inflammatory gut condition diagnosed by an autism paediatrician, some parents will go straight to SCD. There is no reason not to begin with SCD; it’s an excellent diet for autism. A variation of SCD is the GAPS Diet (Gut and Psychology Syndrome), created by Natasha Campbell-McBride. It includes the essentials of SCD, plus the addition of wonderful healing principles such as fermented foods and homemade broths.
Feingold Diet / Phenols The Feingold Diet removes phenols and salicylates. Artificial ingredients such as artificial colouring, flavouring, aspartame and artificial preservatives are made from a petroleum base and are strong phenols. Salicylates are naturally occurring phenols in plants, particularly in fruits such as apples and grapes.
Some children’s bodies have difficulty processing phenols and a build up of phenols in the system can affect behaviour and the body’s physical condition. This was first discovered by Dr. Ben Feingold, who noticed that these phenols created hyperactivity in some children. Although phenols and salicylates do occur naturally in healthy foods, children who are sensitive to these chemicals can have significant reactions.
Children with autism, ADHD and other neurological and immune system disorders commonly have faulty sulfation systems and cannot process phenols and salicylates well. Common physical signs of phenol sensitivity in children include dark circles under the eyes, red cheeks/ears, ear infections, asthma, sinus problems, diarrhoea, hyperactivity, impulsivity, aggression, headaches, head banging/self-injury, impatience, short attention span, difficulty falling asleep, night walking for several hours, inappropriate laughter, hives, stomach aches, bed wetting and day wetting, dyslexia, sensitivity to noise/lights/touch, speech difficulties, tics and some forms of seizures.
When implementing the Feingold Diet, people avoid phenols and salicylates that are not tolerated – typically determined through food trial/testing. These substances and foods may include: colouring, artificial flavours, preservatives, vanillin, aspirin, almonds, peanuts, oranges, apples, apricots, all berries, cherries, chili powder, cider vinegar, cocoa, cloves, cucumbers, currants, red grapes, raisins, plums, prunes, tangerines, tomatoes and wine vinegar.
The Feingold Association of the United States reports that 70 out of 100 people using this diet can expect good results, although their studies used only approximations of the diet. Participants of their surveys have indicated that the diet success rate is just above 90%. A qualified autism nutritionist can help a parent implement this diet and suggest supplements and substances that add sulfate to aid sulfation, and enzymes to help break down remaining phenols.
Low Oxalate Diet The low oxalate diet is a newer diet for autism that came about from the work of Susan Owens and the observation from parents that foods high in oxalates were problematic for their children.
While this is a newer diet, there is a lot of science that helps explain what might be going on for some children with autism. Oxalates are sharp crystals and are the same ones responsible for certain forms of kidney stones. Oxalate crystals can be inflammatory and damaging to a child’s delicate biochemistry and the low oxalate diet reduces these compounds.
Normally, a healthy digestive system will not absorb too many oxalates, found in various foods in a child’s diet. Oxalates pass through the digestive tract and they are metabolized by the good bacteria in the gut or bind to calcium and are excreted. When the digestive system of a child with autism is diagnosed as leaky, oxalates are absorbed and high levels end up in the blood, urine, and body tissue. Once the oxalates are in the tissue, they create inflammation and pain in a child’s body. It is also theorized that oxalates contribute to further inflammation in the intestines and more profound leaky gut, and may be the reason that some children have trouble healing leaky gut and yeast overgrowth, although more study on oxalates and the low oxalate diet needs to be done.
Parents whose children respond positively to the low oxalate diet report that high oxalates in their children affected: recurring body pain, urinary tract infections, skin sensitivity, irritable bowel/diarrhoea and yeast/fungal overgrowth.
A parent cooking for a low oxalate diet will typically limit and/or omit the following from a child’s snacks and meals: spinach, broccoli, brussel sprouts, sweet potato, spinach, beans, kiwi, strawberries, oranges, kidney beans, cinnamon, chocolate, red raspberries, blackberries, blueberries, tomato, almonds, cashews, pecans, peanuts, beetroot, carrots, carob, cocoa powder, flour, potato, stevia, soy beans, pasta, blue cheese, red cabbage, butternut squash, purple grape juice, grapefruit, garlic, oatmeal and more. A comprehensive list of oxalate levels in foods can be found in the parent autism diet guide, Nourishing Hope for Autism.
Body Ecology If a child’s pediatrician has performed yeast tests and they have come back positive, many parents consider implementing the Body Ecology Diet along with physician recommended yeast removal treatments. When there is a systemic yeast diagnosis, it’s important for parents to know that they are not alone. Many children with autism have problems with yeast growth in their systems and help for this condition is well within reach. In order to combat these bad gut bugs that cause children to experience lethargy, spaciness, inappropriate laughter, insomnia, constipation, diarrhoea, joint/muscle pain, and poor memory, some parents implement the Body Ecology Diet. It provides the child with autism with a system of healing that establishes and nourishes the growth of beneficial bacteria and balances the digestive tract.
Regarding this bacteria, Donna Gates, the creator of the Body Ecology Diet, says; “This microscopic militia serves as a child’s key line of defense against disease-causing unfriendly microbes (bad gut bugs)”. This diet is designed to help your child “cultivate, nourish, cleanse and repair their impaired inner ecosystem.” It is very important for parents of children with autism to understand that their digestive system is intimately linked to the immune, endocrine, circulatory, and central nervous system.
The Body Ecology Diet incorporates excellent principles of proper food combining, acid/alkaline balance with low acid-forming foods, low sugars and starches, easily digestible foods, fermented foods, and other solid nutrition recommendations to clear up candida overgrowth in the body. The diet allows a few grains such as quinoa, millet buckwheat, and amaranth, when properly soaked. The Body Ecology Diet incorporates the addition of cultured foods, a change to the quality of fats and oils consumed and a drastic reduction in the intake of carbohydrates and sugars.
Acid/alkaline is the principle of eating mostly alkaline forming foods. This will assist the body in maintaining a slightly alkaline blood pH. When the body is too acidic it leaches alkalizing minerals from the bones to balance the pH. Alkalizing the system supports the health of the gut as well. The standard Western diet is very acid forming with sugar, meat, processed foods, and refined grains and carbohydrates all culprits. As meat is acid-forming, this diet uses much less animal protein than the SCD and others. The most alkalizing foods are most mineral rich so vegetables top the list.
Whichever diet you choose to support the child with autism, you will find a range of support both online and in books, with research being conducted all the time. Taking into consideration your child’s unique and individual needs, the right diet can help your child lead a healthy and fulfilled life.
Nourishing Hope for Autism by Julie Matthews
Cooking to Heal: Nutrition & Cooking Class for Autism and Special Diets (Book and DVD) by Julie Matthews
Gut and Psychology Syndrome: Natural Treatment for Autism, ADD/ ADHD, Dyslexia, Dyspraxia, Depression, Schizophrenia by Dr. Natasha Campbell McBride
Breaking the Vicious Cycle: Intestinal Health Through Diet by Elaine Gottschall
The Body Ecology Diet: Recovering Your Health and Rebuilding Your Immunity by Donna Gates
The Kid-friendly ADHD and Autism Cookbook: The Ultimate Guide to the Gluten-Free, Casein-Free Diet by Pamela Compart and Dana Laake
Healthy Living Cookbook: Recipes for the Specific Carbohydrate Diet: The Grain-free, Lactose-free, Sugar-free Solution to IBD, Celiac Disease, Autism, … Cystic Fibrosis, and Other Health Conditions by Raman Prasad