12 NutritioN FroNt

Research indicates that food choices can often make

a big diference in your childs behavior.
By julie matthews
T
heres a lot of evidenceboth
scientific evidence and anec-
dotalindicating that children
with autism can improve and even re-
cover from the disorder, and that mak-
ing strategic changes to the foods that
our children eat may be fundamental
to that recovery, and to engaging their
potential. Ive personally consulted
with hundreds of parents who have
witnessed the power of diet, and attri-
bute much of their childs improvement
to food and nutrition choices. Many
feel that diet was the factor that helped
their child most, and some cited it as
the main factor in their childs recovery
(losing their autism diagnosis).
By understanding the underlying
biochemistry and systems afected by
autism, parents can infuence the be-
havior, cognitive function, and health
of their children. Food and nutrition
play a key role, and attention to these
factors can help balance biochemistry,
effect systemic healing, and provide
relief of autism symptoms. Certain food
substances (most notably, gluten and
casein, the principal proteins in wheat
and cows milk, respectively) are known
to be problematic for many children
with autism[1], while other foods that
are rich in healing nutrients are known
to be benefcial.
A whole body disorder
Historically, autism was considered a
mysterious brain disorder, implying
that it began and ended in the brain. In
recent years, a more appropriate whole
body disorder perspective of autism
has emerged, based on the theory that
the brain is afected by the biochemistry
of the body. Martha Herbert, MD, PhD,
an assistant professor of neurology at
Harvard Medical School, was one of
the frst experts in the feld to describe
autism in this way, and she refers to the
brain as downstream from the body.
Common physical symptoms in
children with autism include diarrhea,
constipation, bloating and gastrointesti-
nal (GI) pain, frequent infections, sleep-
ing challenges, and infammation/pain.
[2] The fact that there are physical as
well as behavioral symptoms illustrates
that autism isnt solely a brain disorder.
When we appropriately identify autism
as a whole body disorder, we can com-
prehend how what happens inside the
body and cells afects the brainand
how the food we feed a child afects the
body and its biochemistry.
For many children with autism, fac-
tors such as nutrient defciencies, im-
balanced biochemistry, and digestive
problems can play a significant role
in causing or exacerbating symptoms.
Altering food choices can afect physi-
ological functioning and help improve
physical and behavioral symptoms.
how food mAtters
A healthy diet and good digestion are
essential for good health. For many chil-
dren, the physiological and behavioral
symptoms of autism may stem from or
be aggravated by impaired digestion and
gastrointestinal (GI) health. Research
has identifed that unrecognized gas-
trointestinal disorders... may contribute
to the behavioral problems of the non-
verbal autistic patients.[3]
Poor digestion can lead to a condition
known as leaky gut (increased intestinal
permeability), which can result in mal-
absorption of nutrients, infammatory
responses to foods that arent broken
down, and overload of the detoxifcation
system. Adequate nutritional status, es-
sential to proper biochemical and brain
functions, requires both the consump-
tion of nutrient-dense foods and proper
digestion to break down and absorb
those foods.
Impaired digestion can stem from
negative environmental factors (as well
as genetic susceptibility), lack of ben-
efcial bacteria, infammation, and im-
mune system response to certain foods;
and studies have shown leaky gut [4]
low levels of benefcial fora,[5] infam-
mation, oxidative stress[6], nutrient
defciencies, and immune response to
food[7] [8] in children with autism. Ad-
ditionally, the response to certain foods,
such as gluten and casein, can create an
opiate or infammatory reaction that can
afect the brain.
Thus, it is essential to understand
and address gut issues in autism. The
largest part of the immune system is
located in the gut, and the immune
system is often imbalanced in autism,
resulting in an inability to fght virus-
es, yeast, and other pathogens proper-
ly, while contributing to an overactive
infammatory and allergic response.
Toxins originating in the gut, often
from bad (pathogenic) bacteria and
yeast, can afect the brain. Foods that
arent digested properly can create
inf lammatory and immune system
responses that also afect the brain.
Ninety percent of the brain chemical
serotonin stems from the gut, and it
JULIE MATTHEWS...
is a certifed nutrition con-
sultant dedicated to improving
peoples health through
nutrition, specialized diets, and
holistic wellness coaching. She
presents at the national Autism
Research Institute conferences,
and is the author of Nourishing Hope for Autism.
Visit her website at www.nourishinghope.com.

Autism Diets: its Not

rocket Science
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The Autism File FEB-MARCH 2012
NutritioN FroNt 13
has a profound efect on the gut/brain
connection and regulating gut motil-
ity and pain sensitivity.
According to Hippocrates, All dis-
ease begins in the gut, and this cer-
tainly proves true with autism. In fact,
the gut was coined the second brain
by Columbia Universitys Michael
Gershon, MD, who spent many years
studying the gut-brain connection.
Derrick MacFabe, MD, director and
assistant professor at the University of
Western Ontarios departments of psy-
chology and psychiatry, identifed this
gut-brain connection in autism. In his
recent study on propionic acid, a fatty
acid that originates in the gut, he found
that in rats, propionic acid caused be-
havioral and biochemical symptoms
similar to those found in autism.[9]
Choosing A
diet
I hope t hat
parents and
practitioners
can see the
possibilities
for positive
infuence and
realize that diet
can help autism.
Diet is a powerful
personal
tool; it has few downsides and is acces-
sible to everyone. With diet, parents
have great control over choices that
can have immediate positive impact
in the health of their children.
The most successful parents (and
children) in my private practice are
those who take steps to carefully and
conscientiously make diet changes.
They have seen from the experience
of others that recovery is possible
and that it can, through calculated
food choices, make a diference for
their child. While modern medi-
cal channels present few options,
parents are following Hippocrates
traditional advice by letting food be
their medicine.
There are many autism diets to
choose from, and deciding how to
begin can seem overwhelming, but it
neednt be. While eliminating gluten
and casein has been the primary
onus of autism dietsvia the glu-
ten-free casein-free (GF/CF) diet
additional advances in biomedical
nutrition research and mom-cen-
tric anecdotal data have resulted in
broader dietary strategies for autism.
Because every child is diferent, a
diet that helps one child may not
be the best for another. Each child
has unique biochemistry, immune
functioning, genes, environment as-
saults, and eating preferences.
Some of the most effective and
popular diets apart from GF/CF in-
clude the specifc carbohydrate diet
(SCD), the gut and psychology syn-
drome (GAPS) diet, the paleo/primal
diet, the body ecology diet, the low
oxalate diet, the Feingold diet and the
Failsafe diet. I describe these diets in
my book, Nourishing Hope for Autism,
along with the biochemistry that is af-
fected and how to choose the best diet
for an individual. For the simplicity of

As a parent, you have at your disposal a very powerful

healing tool that can complement behavioral and
other treatments recommended by your autism
pediatricianand its as simple as your childs diet.
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The Autism File FEB-MARCH 2012
14 NutritioN FroNt
5 strategic food choices to
help improve symptoms
Nix the yeast, by removing sugars and yeast-containing foods from the diet,
reducing or removing refined starches (such as white bread and baked goods, and
white rice), and adding probiotic-rich foods (such as non-dairy yogurt and kefir)
that naturally combat yeast growth. Yeast overgrowth is often triggered by heavy
antibiotic use (common in children with autism, who tend to have poor bacteria-
fighting ability) and can cause gut inflammation and decrease gut function.
Boost Biochemical pathways via vitamins B12, B6, and folate.
Methylation, transsulfuration, and sulfation are just one set of biochemical
pathways that dont function optimally for many children with autism [11].
These pathways lead to the production of glutathione and other substances
used for detoxification, immune function, gut integrity, and antioxidant
statustherefore, children with autism commonly have impaired detoxification
and digestion, and oxidative stress. In addition, methylation is required for
properly activating neurotransmittersif these arent working properly, the
likelihood of anxiety, depression, ADHD, and sleeping issues is increased.[12]
soothe gut iNflammatioN Improving digestion, reducing inflammation,
and healing the gut are important steps in overall health and healing. Commonly
reported benefits include reduced diarrhea and constipation, improved behavior,
greater language skills, and fewer skin rashes. Remove foods that inflame the
gut, such as gluten, casein, and soy; and add foods that heal the gut and are
anti-inflammatory, such as antioxidant-rich fruits and vegetables. Also add foods
that supply beneficial probiotics, and foods that support beneficial bacteria
growth (prebiotics), such as raw dandelion greens, garlic and onions.
Oimprove detoxificatioN When childrens detoxification systems arent working
optimally, as is common with autism,[13] toxins from food and the environmentsuch
as salicylates, artificial food ingredients, monosodium glutamate (MSG), mercury,
and aluminumcan cross the blood-brain barrier and affect the brain, causing
hyperactivity, aggression, irritability, and self-injurious behavior.[14] Avoid food
additives and toxins in the food supply by serving organic foods, and add foods that
support the liver, such as sulfur-rich cruciferous vegetables (such as broccoli, Brussels
sprouts), and eggs, beets, grass-fed liver, and probiotic-containing lacto-fermentations.
Osupport digestioN When digestion is poor and the gut is too permeable, nutrients
arent absorbed properly. This leads to nutrient deficiencies, which can negatively affect all
cellular function, including brain function.
Nutrient deficiencies are common
among children with autism [15, 16,
17], and poor quality and limited diets
exacerbate the problem. In addition to
providing a wide variety of nutrients
through foods, supporting
digestion is important, and
supplementation including
B6, magnesium and vitamin C
has shown to be supportive.
[18, 19]. Measures to address
nutrient deficiencies can
include increasing the quality
and digestibility of food, sneaking
in vegetables for children who
are picky eaters, juicing
vegetables, preparing
homemade bone broths,
and adding appropriate
supplementation.
this discussion, Ill focus on the GF/
CF diet since its the most common
place to start and has some of the
best results for people new to special
healing diets.
the gf/Cf diet
When parents decide to do diet,
they typically begin with the GF/
CF diet, which entails the removal
of all gluten- and casein-containing
foods from a childs diet. Gluten is a
protein found in wheat, rye, barley,
spelt, kamut, and commercial oats;
and casein is a protein found in dairy.
When ingested by children with
a compromised digestive tract (com-
mon with autism), these proteins can
cause gut inf lammation, pain, and
digestive problems. If the protein isnt
properly broken down during diges-
tion, it can form opioids (opiate or
morphine-like compounds).[20] Sci-
entists believe that opioids in gluten
and casein are toxic for children with
autism when they have an abnormal,
leaky gastrointestinal tract.[21] The
properties of gluten and casein can
lead to digestive problems such as di-
arrhea, constipation, gas, and bloat-
ing, as well as foggy thinking and
inattentiveness for many children
with autism.
Studies and many thousands of
parental reports indicate physical
symptoms and autistic behaviors can
decrease on the GF/CF diet. Accord-
ing to parents surveyed by the Autism
Research Institute, the GF/CF diet
is helpful for 70 percent of children
with autism spectrum disorder, even
though a food sensitivity panel may
not show a reaction to these foods.
[22] Therefore, I typically recommend
a GF/CF trial period, often beginning
the diet by removing frst one and then
the other, so that both are removed.
Most of t he foods cont ai ni ng
these offending proteins are easy
to identify. You ll need to avoid any
breads, crackers, pasta, or bakery
items made with wheat and other
gluten grains, and all dairy foods,
such as milk, cheese, butter, yogurt,
and cream. Some sources, however,
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The Autism File FEB-MARCH 2012
NutritioN FroNt 15
can be sneaky, as some foods con-
tain ofending ingredients that are
not apparent, such as soy sauce
(except gluten-free soy sauce), po-
tato chips and fries (often dusted
with gluten during processing, al-
though it may not be listed on the
labelensure they are gluten-free
by checking with the company), and
malt (derived from barley).
When beginning the GF/CF diet,
be careful not to introduce a bunch
of GF/CF junk foods, such as cookies,
candy, and chips. Even though they
dont include gluten or casein, the sugar
can feed yeast, imbalance blood sugar,
and dysregulate energy. Remember,
diet is more than just the removal of
offending foodsattention must be
placed on ensuring healthy and nutri-
tious food intake. While following any
autism diet, it is important to monitor
and moderate the intake of certain
additional food-based substances as
needed. Common problematic food
substances are:
` Phenols and salicylates (removed in
the Feingold Diet and Failsafe diet).
` Amines and glutamates (also
removed in Failsafe, along with
phenols and salicylates).
` Oxalates (reduced in the low-
oxalate diet).
In addition to removing prob-
lematic foods, such as wheat, dairy
and others, its also important to add
nutrient-dense foods. These include
grass-fed meat, pastured eggs, live
lacto-fermented foods (such as non-
dairy yogurt and raw cultured veg-
etables), organic and locally grown
produce, homemade bone broths
such as chicken stock, and freshly
pressed vegetable juices.
you CAn do it
You may be thinking, My child is
picky and very infexible with eating
new foods. Im never going to be able
to get him to eat anything other than
wheat and dairynever mind any-
thing healthy. I appreciate these con-
cerns! Ive had some very picky eaters
in my nutrition practicemany chil-
dren ate only bread and dairy; others
subsisted on just pancakes and fries.
However, there are solid reasons why
these children were so one-sided in
their food choices. When the body
creates opiates from foods, one can be-
come addicted to them and thus crave
nothing but those foods; or, when yeast
overgrowth is present, a preference
for only carbs and sugars can result.
Children eventually narrow their food
choices to include only those that make
them feel better (in the short term).
Its worth trying diet because once
the child gets past the cravings (in a
few days to a few weeks), they often
expand their food choices dramati-
cally. Ive polled many parent groups
The Autism File FEB-MARCH 2012
16 NutritioN FroNt
and fnd this true
a majority of the
time. Now, there are
some children who
are very self-limiting,
and it takes time to change
their dietsbut keep at it.
Sometimes, as occupational therapy or
sensory integration begins to address
food textures, a child begins to expand
more. Also, seek out the support of a
feeding therapist if you have a picky
eaterthey can be incredibly helpful.
You can help the situation by get-
ting creative. Make foods crunchy or
smooth based on your childs prefer-
ences. Begin to add new food options,
such as gluten-free pasta, before re-
moving existing foods. Be aware that
brand preference may be based on the
presence of MSG or other additives that
can be addicting and make that food
exciting. Add enough salt to make
your versions of favorite foods more
f l avorf ul don t
go overboard, but
dont feel you need
to limit salt.
Today, g r owi ng
numbers of parents are
wisely and correctly applying
autism diets with great success. These
diets and nutritional approaches are
helping children recover from autism.
Any childs diet can change, and recov-
ery is possible. It may take time and re-
quire great patience, but you can make
improvements. Its crucial that parents
believe its possible for their children
to change and improve. By envision-
ing the changes, you project a positive
image that is important for your child
and the success of your overall eforts.
Ive never known a child who didnt
beneft from dietary intervention, and
Ive never seen a childs diet that didnt
(with proper attention) eventually ex-
pand and improve.
1. Knivsberg AM, Reichelt KL, Nodland M. (2001) Reports
on dietary intervention in autistic disorders. Nutritional
Neuroscience, 4(1):25-37.
2. Molloy CA, Manning-Courtney P. Prevalence of chronic
gastrointestinal symptoms in children with autism and
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3. Horvath K, Papadimitriou JC, Rabsztyn A, Drachenberg C,
Tildon JT. Gastrointestinal abnormalities in children with
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4. DEufemia P, Celli M, Finocchiaro R, et al. Abnormal
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5. Finegold SM et al. Gastrointestinal microfora studies in
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6. Adams JB, Audhya T, McDonough-Means S, Rubin RA,
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2011 Jun 8;8(1):34.
7. Jyonouchi H, et al. Proinfammatory and regulatory
cytokine production associated with innate and
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Neuroimmunol. 2001 Nov 1;120(1-2):170-9.
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with infammatory responses and cytokine production
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spectrum disorder. Neuropsychobiology. 2002;46(2):76-
84.
9. MacFabe DF, et al. Neurobiological efects of
intraventricular propionic acid in rats: possible role
of short chain fatty acids on the pathogenesis and
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