Nutrition Intervention for Autism Spectrum Disorders
Nutrition Intervention for Autism Spectrum Disorders
Julie MatthewsCertified Nutrition Consultant
Trudy Scott - Research Assistant
Nourishing HopeNourishing Hope
The food we feed a childhas significant impact
Background and BiochemistryBackground and Biochemistry
Nutrition BasicsNutrition Basics
Diet OptionsDiet Options
Nutrition BoostersNutrition Boosters
Beginning & Evolving a DietBeginning & Evolving a Diet
What is Autism and Autism Spectrum Disorder (ASD)?
Social:Social: Not playful, avoids eye contactNot playful, avoids eye contact
Communication:Communication: Not use gestures, receptive and Not use gestures, receptive and expressive language poorexpressive language poor
Unusual interests and behaviors:Unusual interests and behaviors: Repetitive Repetitive actions, hand flapping, picky eating, actions, hand flapping, picky eating, ““stimmingstimming””
Autism, PDD, Autism, PDD, AspergerAsperger’’ss Syndrome, ADHDSyndrome, ADHD
Physical:Physical: Constipation, diarrhea, hyperactivity, Constipation, diarrhea, hyperactivity, fatigue, aches and pains, digestive pain and gas, fatigue, aches and pains, digestive pain and gas, difficulty sleeping, anxietydifficulty sleeping, anxiety
Underlying Causes and Contributors
Genetics: Genetics: MTHFR, GST, COMT. Involving the systems of methylation, sulfation, detoxification, digestion, gut/brain barrier, inflammation, immune function.
Environmental: Environmental: Toxins, vaccinations, nutrient Toxins, vaccinations, nutrient deficiencies, antibiotics and deficiencies, antibiotics and dysbiosisdysbiosis, endogenous , endogenous toxins (opiates from food, microbial toxins)toxins (opiates from food, microbial toxins)
Biochemistry
Affects of Faulty Sulfation
Complex and InterrelatedWhole Body Disorder
Brain is Downstream
Yeast toxinsUndermethylatedneurotransmittersBrain inflammationIncreased toxicity
Nutrient deficiencies
Opiates
Why the GI System is So Important• Physical barrier of defense against bacteria, viruses, etc.• The largest part of the immune system is contained
within the gut (70%)• Vitamins/minerals cofactors for enzymatic reactions and
metabolism, etc.• Nutrients are precursors for neurotransmitters • The greatest concentration of serotonin, 90%, is found in
the GI tract
The Health of the GI System Determines Function of Body
From Lisa Lewis, Ph.D.
How Diet Can Help -Support Digestion & Biochemistry
• Leaky Gut and Gut Inflammation– Remove foods that inflame gut– Add foods that heal the gut– Add foods that supply beneficial bacteria
• Nutrient Deficiencies– Increase the quality of food and digestibility
• Yeast Overgrowth– Remove sugars– Remove starches– Add probiotic-rich foods
• Toxicity and Poor Detoxification– Avoid food additives– Avoid toxins in food supply and meal preparation
• Faulty Methylation and Sulfation– Remove phenolic foods– Improve methylation and sulfation through supplementation
Feeling Better >>> Learning Better
Feeling Better >>> Learning Better
Symptoms Diet May Improve
• Ability to focus• Eye contact• Aggression• Gastrointestinal problems• Language• Sleep difficulties• Toilet training• Rash or eczema may improve• Behavior
From Lisa Lewis, Ph.D
Autistic Spectrum Disordersare caused by
genetic predispositions combined with environmental factors
that create disordered biochemistry and damaged organs & systems.
Nutrition affe
cts this chemistry
and the body
Nutrition affe
cts this chemistry
and the body
Holistic Nutrition Approach
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#1 Cleaning up the Diet
Diet Basics#4
#2 Cleaning up the Home
Beginning an ASD Diet#5
Removing FoodIntolerances#6
Evolving the diet:Nutrition Boosters
#7
Refining the ASD Diet
#8
Cleaning up the Gut
#9
Supplement Specifics
#10
#3 SupplementBasics
Immune Support
#11
Detox#12
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From Nourishing Hope
Nutrition Basics
Macronutrients: Fats, Protein,and Carbohydrates
Unhealthy Ingredients to Avoid
• Artificial colors/flavors and preservatives
• MSG (hydrolyzed protein, yeast extracts)
• Pesticides
• Aspartame and other artificial sweeteners
• Trans fats (hydrogenated fat)
• Excessive/Refined Sugar
• Nitrates/nitrites (bacon, hotdogs, lunch meat)
A Healthy Diet
• Whole foods
• Unprocessed
• Organic
• Fermented foods: rich in probiotics
• Grass-fed/pastured meat and eggs
• Good fats
• Free of food intolerances
Fats• Brain development and brain function • Hormone balance and mood• Formation/fluidity of cell membrane• Creating energy in cell and helps burns fat• Reduces inflammation
Supplement with vitamin E to prevent oxidation of fats.Omega 3 Omega 6 Omega 9 Saturated Fat
Borage oil (GLA) Evening primrose oil (GLA)
Black currant oil (GLA) Nuts/seeds and their oil Hemp seeds/oil (GLA)
Grapeseed oil
Fish oil or
cod liver oil Flax seed oil
DHA and EPA supplements
AVOID Vegetable oil: canola, safflower, corn,
soy oils
Olive oil Avocado
Nuts/seeds
Coconut oil
Palm/Red Palm oil
Animal fats Ğ ghee/dairy,
bacon
Fats• 30+% Many children - 40% or more.
– Breast milk is 53% fat (25% saturated).
• Proceed slowly - not everyone can digest fats well. Problematic for those with:– High oxalates– Gallbladder/bile imbalances– Enzyme insufficiency
• Signs of poor fat digestion– Stool light tan or gray in color, large in volume.
Sometimes stool will float. Malodorous flatulence.
Vital Roles of Saturated FatBrain—Saturated fats are important for development of the brain
Bones – Saturated fats help the body put calcium in the bones
Liver – Saturated fats protect the liver from poisons
Lungs – Can’t function without saturated fats—protects against asthma
Immune System – Enhanced by saturated fats—fights infection
Essential Fatty Acids – Work together with saturated fats
Coconut Oil:• Contains many antifungal
and antiviral components
• Anti-inflammatory effects
• More easily digested and absorbed
• Used immediately to create energy
• Enhances absorption of minerals
Coconut Oil:Coconut Oil:• Contains many antifungal
and antiviral components
• Anti-inflammatory effects
• More easily digested and absorbed
• Used immediately to create energy
• Enhances absorption of minerals
Benefits of Cholesterol
• Brain development and function• Boosts mental performance• Aids digestion• Builds strong bones• Builds muscle• Building block for hormones• Regulates your blood sugar• Repairs damaged tissue• Protects against infectious diseases
Key Nutrients for Brain Development
• Vitamin A - Cod liver oil; liver, butterand egg yolks from grass-fed animals
• Vitamin D - Cod liver oil; lard, butter and egg yolks from grass-fed animals
• Choline - Cod liver oil, egg yolks
• DHA - Cod liver oil; liver, butter, egg yolks from grass-fed animals
• Zinc - Red meat of grass-fed animals, shellfish
• Tryptophan - Meat of grass-fed animals
• Cholesterol - Dairy foods, eggs, seafood, meat of grass-fed animals
Variety and qualityare the keys to
fat intake
Variety and qualityVariety and qualityare the keys to are the keys to
fat intakefat intake
Vitamin A• Protein assimilation• Calcium absorption• Proper growth and healing• Speech/language• Vision• Proper function of the glands• Thyroid function• Immune system function• Production of stress and sex
hormones
Vitamin D• Healthy bones• Proper growth• Mineral absorption• Muscle tone• Immune system function• Healthy nervous system • Cell function• Insulin production• Reproduction
Animal Fat (Grass-fed) is High in Vitamins A and D
Animal Products - Quality is essential
Grass-fed/pastured Commercial•Rich in DHA (brain development)
•Rich in Vitamin A •Rich in Vitamin D •Higher in CLA•Higher in Tryptophan (sleep and mood)
*Organic is not necessarily grass-fed
•Unhealthy animals -unhealthy food
•Inflammatory grains -create inflammatory food
•Low in Vitamins A and D•Low in anti-inflammatory fats
•Higher in arachidonicacid (inflammatory)
Consider RAW Dairy• PASTEURIZED Dairy - Inflammation and gut reaction
– Casein molecule altered
– Lectins (grain-fed milk)
• Raw dairy is not for everyone - however some who cannot tolerate pasteurized dairy can consume raw dairy
• Use with SCD - homemade 24-hour raw milk yogurt
• Raw butter - very little casein• Fatty acids (such as butyric acid)
– Nourish brain and intestinal lining– Antimicrobial properties
• Phosphatase - calcium absorption• Enzymes for digestion• Natural probiotics• Milk fat reduces asthma
See RealMilk.comInformation & SourcesSee RealMilk.comInformation & Sources
Protein
• Protein (essential amino acids) building blocks for: – Muscle and tissue growth and repair, neurotransmitters,
immune responses, enzymes, detoxification • Bio individuality - amounts vary. • Some children cannot process protein well:
– High ammonia, low HCl, low zinc, B6, or iron
Signs of protein deficiency: Stunted growth,lack of appetite, edema, suppressed immune system, muscle wasting, anxiety, sparse hair, dry skin
Avoid Soy
• Not good substitute for dairy
• Very difficult to digest
• Irritate the gastrointestinal tract
• Blocks absorption - calcium, magnesium, iron, copper and especially zinc - due to phytic acid and oxalates
• Blocks thyroid function
• Endocrine disruption in the reproductive hormones of both males and females
• When eggs (and dairy) are not tolerated, protein becomes limited
• When nuts and beans are not tolerated, protein intake becomes even more limited
• Grains, nuts, beans, and other starches - inflammatory to the gut.
• Difficult to be vegetarian with some diets, as meat is relied upon with SCD and other diets.
• Can be difficult to get enough protein–Eat eggs if tolerated–Free form amino acids (5 grams amino acids = 30 grams dietary protein)
Note on Vegetarian Diets
Carbohydrates
• Add complex carbohydrates: whole grains, vegetables, fruit, starchy vegetables
• Reduce refined carbohydrates: flour products (bread, crackers, chips), cookies, pasta
• Avoid Sugars: Refined sugar, honey, juices– 4-5 grams per serving (1 teaspoon “sugars”) = 2 oz fruit juice, 2 tsp
dried fruit, 1 TBSP ketchup– Keep to 4 servings/day
• Sugar cravings - Yeast overgrowth, stress/anxiety (sensory sensitivity), and blood sugar imbalances All grains problematic for some
• All starches & sugars (except monosaccharides) problematic for some (SCD)
Diet Options
Diet Options to Choose FromASD Diet Options ARI Survey Results
parents’ reporting noticeable symptomatic improvement
GFCF (Gluten-free and Casein-free)No gluten (wheat, rye, barley, spelt, kamut, and oats) or casein (dairy)
GFCF - 65% improvedNo Dairy - 50% improvedNo Wheat - 49% improved
Food Sensitivity EliminationEliminating all other food sensitivities: Soy, corn, eggs, citrus, peanuts, chocolate, cane sugar
No Eggs – 49% improvedNo Chocolate – 49% improvedNo Sugar – 48% improvedRotation Diet – 49% improved
Feingold Diet/Low PhenolsRestricts high phenolic foods, including all artificial ingredients and high salicylate fruits
54% - improved
SCD (Specific Carbohydrate Diet)Restricts carbohydrates to only fruits, non-starchy vegetables, and honey. No grains, starchy vegetables, or mucilaginous fibers
SCD - 66% improvedCandida Diet – 54% improved
Body Ecology DietAnti-yeast diet combining principles of anti-yeast diets including no sugar, acid/alkaline, fermented foodsNourishing Traditions/ Weston A. PriceGood quality fats, soaking and fermenting for digestionLow Oxalate DietRestricts high oxalate foods (nuts, beans, greens)
Selecting a DietFoundational Diets
• GFCF – Start here. 65% improved.
• Specific Carbohydrate Diet – For bowel inflammation, diarrhea, gut dysbiosis that is not improving. 66% improved.
• Body Ecology Diet – For yeast overgrowth
• Weston A. Price - Not ready to eliminate foods yet. Focus on nourishment.
Additional Diets
• Food Sensitivities. Elimination and Rotation Diets.
• Feingold/Phenols – For red cheeks, red ears, hyperactivity/fatigue, irritability, aggression
• Low Oxalate Diet – For pain (body or GI), urinary incontinence, pain, or irritation, constipation or diarrhea not relieve by SCD, continued stimming after meals, poor growth
Nutrition BoostersFoods and preparation methods that
increase nutrient density and digestibility
Grandmaknew bestGrandmaknew best
Nutrients Needed for Pathways
Helpful SupplementsDigestive EnzymesDigestive EnzymesProbioticsProbioticsCod liver oil/fish oil/Cod liver oil/fish oil/EFAsEFAsMagnesiumMagnesiumCalciumCalciumZincZincB6B6Vitamins A, C, and EVitamins A, C, and ECoQ10CoQ10Glutathione/NACGlutathione/NACMethylationMethylation: B12, : B12, folinicfolinic or 5MTHF, TMG/DMGor 5MTHF, TMG/DMGTransfer factorTransfer factorAmino acidsAmino acids
Nutrient-dense Foods• Sweet potatoes: beta carotene, vitamin C, magnesium, fiber
• Leafy greens: calcium, vitamin C, folic acid, beta carotene, magnesium, iron
• Whole grains: selenium, vitamin E, magnesium, B6
• Nuts and seeds: calcium, magnesium, iron, zinc, B6, vitamin E, folic acid
• Beans and legumes: folic acid, B6, zinc, iron
• Blackstrap molasses: iron, magnesium
• Organic liver: iron, vitamin C, B12, folic acid, beta carotene, vitamin A
• Hemp seeds: GLA, omega-3, vitamin E, L-arginine. All essential amino acid.
• Nettles (can make a tea ): calcium, magnesium, potassium, iron, antioxidants
• Kombu and seaweed: calcium, magnesium, iron
• Eggs, from pastured hens (if not sensitive): B12, vitamin A, B-vitamins, vitamin D, vitamin E, selenium, calcium, iodine, zinc, iron, choline
• Animal protein and fats (grass-fed): Vitamin A, vitamin D, DHA, tryptophan
Good ways to Boost Nutrient Levels
• Cook and puree orange vegetables (or any). Freeze in ice cube trays and add to smoothies
• Cook and puree any vegetables and add to meatballs, meat patties, meatloaf, or pasta sauce
• Cook allowable grains or gluten-free pasta in homemade broth
• Nettles can be consumed as a tea, or added to a homemade broth
• Seaweed - Add kombu or other sea vegetable to cooking grains, soups, tomato sauce, even boiling pasta
Juicing
• Higher concentration of nutrients – Chlorophyll and phytonutrients
• Get nutrients without needing to eat/chew vegetables • Children that like liquids, juices and smoothies
Add vegetable juice to smoothies. Add a bit of fruit to vegetable juice for flavor or added sweetnessAdd supplements to vegetable juice (instead of fruit juices)
Preparation tip
Preparation tip
Start with Add as you evolve taste Go cautiously (high sugar)•Cucumber•Celery•Fennel•Ginger•Lemon•Green apples
•Parsley, cilantro•Kale or other greens•Cabbage (ulcers)•Cranberries
•Carrot•Beet•Fruit: Apple, pear
Soaking “seeds” – easy to doGrains, nuts, seeds, beans
• Increases digestibility • Reduces inflammatory response• Breaks down phytic acid and oxalates• Fermenting grains breaks down lectins
Nuts - Soak in water (with or w/o salt) for 7-12 hours. Drain and
refrigerate, use to make nut milk, or drain and dehydrate (eat or make nut butter)
Grains - Soak in water for 8-24 hours with 2 TBSP lemon juice
or vinegar. Drain and cook with fresh water.
Beans - Soak in water for 8-24 hours with hearty pinch of baking soda. Drain and cook with fresh water.
Preparation tip
Preparation tip
Fermented Foods – Rich in ProbioticsFunctions of good bacteria
– Regulate peristalsis and bowel movements– Break down bacterial toxins – Make vitamins needed and utilize: B1, B2, B3, B5, B6,
B12, A and K– Digest protein into amino acids (for use by the body)– Produce antibiotics and antifungals– Help breakdown sugars, lactose, and oxalates– Support immune system and increase number of immune
cells– Balance intestinal pH– Protect against environmental toxins: mercury, pesticides,
pollution
Raw fermented foods contain billions of bacteria/serving!
Fermented Foods – Rich in ProbioticsDairy-free:• Raw sauerkraut • Beverages (contain yeast that kills candida):
• Kombucha• Coconut juice kefir• “Sodas” (hibiscus/rosehip tea with kefir starter)
• Nut milk yogurt
Dairy: Milk-based yogurt/kefir
Dairy-free:• Raw sauerkraut • Beverages (contain yeast that kills candida):
• Kombucha• Coconut juice kefir• “Sodas” (hibiscus/rosehip tea with kefir starter)
• Nut milk yogurt
Dairy: Milk-based yogurt/kefir
HomemadeBone & Vegetable Broths
• Grass-fed/pastured chickens or beef bones– Add 2 Tablespoons of vinegar - increases the
calcium and magnesium
• Vegetables, seaweed, greens, nettles• Nutrient dense, easy to assimilate nutrients
– trace minerals, amino acids, calcium, magnesium, potassium, iron
Cook grains, soups, and/or pasta in broths -nutrients will absorb into food
Preparation tip
Preparation tip
Grandmaknew bestGrandmaknew best
Bone Broths and Gelatin
Bone broth contains gelatin:• Gelatin’s colloidal properties aid digestion of all foods• Glycine: Sleep, detox environmental toxins,
component of glutathione, improves gastic acid secretions and protein digestion
• Proline: Formation of connective tissue: skin, gut, ligaments
• Broken down by DPPIV• Free glutamate - potentially problematic for
glutamate sensitive children
Bone broth contains gelatin:• Gelatin’s colloidal properties aid digestion of all foods• Glycine: Sleep, detox environmental toxins,
component of glutathione, improves gastic acid secretions and protein digestion
• Proline: Formation of connective tissue: skin, gut, ligaments
• Broken down by DPPIV• Free glutamate - potentially problematic for
glutamate sensitive children
Water and Salt
• Purified Water– Avoid tap water, fluoridated and chlorinated water– Get a water filter (point of entry, reverse osmosis, carbon block or
ionic - not Brita). Avoid bottled water (plastic and transportation).• Nutritive Salt
– Salt cravings - sign of nutrient deficiencies– Avoid stripped white “table salt” - may contain aluminum– Choose nutritive salt with trace minerals – Celtic Sea Salt or Himalayan crystal salt
• Sole - water and salt combine to make minerals ionic – They are highly absorbable, alkalizing, and help with elimination– Add 1 tsp to 8 oz glass of water– See Water and Salt, by Handel and Ferreira
Beginning and Evolving a Diet
Begin by Removing Artificial Ingredients
Avoid trans fats (hydrogenated oil, fried foods, margarine, mayo, commercial peanut butter)
Avoid artificial sweetener & high fructose corn syrup
Avoid artificial ingredients (artificial colors, flavors, and preservatives)
Avoid MSG (hydrolyzed vegetable/soy protein, autolyzed yeast, yeast extract, natural flavors)
Avoid Nitrates/nitrites
Eliminate Foods, Additives and Factors that Irritate the GI Tract
Food intolerances (IgG test and LEAP test)
MSG
Carageenan
Olestra
Lectins, oxalates and phytates from “seeds”(grainseven non-gluten, bean, nuts, seeds)
Yeast, antibiotics, and some medications (NSAIDS)
Avoiding Toxins in the Kitchen
Toxins Around the Kitchen Safer Cooking Alternatives
Avoid aluminum cans Buy in glass
Avoid storing in plastic Store in glass w/metal or plastic lid
Avoid Teflon, copper, and aluminum pans
Use stainless steel (attracts a magnet), cast iron or enameled cast iron
Avoid the microwave, do not reheat in plastic Heat in oven or on stove
Avoid plastic wrap & aluminum foil Use wax paper or glass with lid
For Picky Eaters• Always provide food child likes in addition to "new" food.• Only offer one new food at a time. • Include small portion of new food and serve everyone at the table.• Involve your children in food preparation of "new" food.• Small taste ~ 1/2 teaspoon. Let child determine amount.• Inform them. Let child know whether it is sweet, salty or sour.• Let them spit it out. • If at First You Don't Succeed, Try and Try Again! At least 15 times!• Try new food in a texture they prefer - crunchy, smooth, etc.• Avoid being emotionally “attached” - children sense anxiety.
– Keep mealtime calm. Visualize child eating/enjoying new foods.• Avoid forcing or pushing - maintain trust. • Choose rewards or other encouragement.• Make sure the whole family participates.• Make it fun!
Evolving the Diet• Involve the family as much as possible• Remove known food allergens: peanuts, etc.• Begin to add nutrient dense whole foods• Add fermented foods• Introduce new GFCF substitutes before removing
familiar gluten/casein foods• Implement GFCF (or other foundational diet) for 3-6
months– Regardless of test results– Begin with casein-free, then gluten-free
• Determine other food sensitivities – Based on dietary challenge testing (and/or lab results) – Be careful not to substitute soy (for dairy) and corn (for gluten)
– often equally problematic
Chart Progress and Further Refine
• Correlations not always clear - Keep diet record.• Add one food at a time - Take note.• Avoid changing foods & supplements simultaneously. • Watch for symptoms or regression:
– Sometimes a “regression” is actually a sign of healing, i.e. removal of gluten/casein may cause opiate withdrawal
– However, sometimes a new food substitution (corn) is problematicand needs to be removed
• Look for improvement• See what’s remaining, and consider additional diets/dietary
intervention. Changing the diet or layering diets.• Seek help from a nutrition consultant or qualified
practitioner/physician
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For food sources, diet resources, and scientific references
