Health Brief
An estimated 1 in 100 children is diagnosed with autism in the United States. Nutrients have received attention as both a causative and curative factors in autism. Many are concerned with the increasing number of children with autism spectrum disorders and gastrointestinal symptoms, this health brief will discuss a few of these issue and some solutions.
Issue:
Autism has a collection of behavioral symptoms including dysfunction in social interaction and communication in affected children. Children usually show symptoms of ASD in the first 3 years of life. Research has shown that children with autism also have a high prevalence of gastrointestinal (GI) symptoms including inflammation (1). Studies have concluded that ASD children experience increased frequency of GI symptoms compared to normal healthy children(2). Many families with autistic children are seeking alternative therapies and interventions to help with GI and autistic symptoms. Unfortunately many of these newer, publicized interventions offer little scientific research. The most popular scientifically unproven intervention for ASD is the gluten free, casein-free diet (GFCF). Clinicians working with ASD children are often asked advice and find that they are unable to offer the most credible information (3). The fact is that autistic children often have problem-feeding and restrictive eating behaviors that put them at high risk for poor nutritional intake. Restrictive diets (like GFCF) may put children with ASD at more of a nutrition risk and supplementing children above recommended amounts may lead to toxicity (4). However dietary changes can improve nutrition for ASD children (3).
Programmatic bottom line/ Policy implications:
These steps are suggested to help autistic children:
1-Implement a whole foods meal plan and remove artificial food ingredients, limit pesticide exposure, and avoid processed foods and added sugars.
2-Children should have a balanced diet of basic nutrients, adding extra dietary supplements if needed.
3-Clinicians should address problem-feeding behaviors and correct them.
4-GI symptoms can be alleviated by increasing fiber, adding probiotics, digestive enzymes and omega-3 fatty acids.
5-Help identify food allergies in ASD children and eliminate them in child diet. Lastly, if a child has an allergy they may need to try gluten-free, casein-free diets as needed for treatment of autism (4).
How we know:
Studies using endoscopy found GI inflammation in children with ASD(2). The GFCF diet is hypothesized based on that autistic symptoms may be a result from opioid peptides found when gluten and casein foods fail to completely breakdown. The intestinal permeability allows peptides to cross the blood brain barrier affecting the opiate system and neurotransmission within the CNS. This may explain why ASD children have GI symptoms. When children can’t adequately express their pain of GI discomfort verbally they react with extreme behaviors. Small studies have been done of children with ASD and have found that the GFCF diet decreases autistic symptoms but no major studies have been done that show these results (3). If child is diagnosed with gluten or casein allergy these diets may need to implemented.
Findings from research:
Study results of 51 ASD children and a control group of 35 normal children showed that there was a significant increase in parent reports of diarrhea, constipation, flatulence, general bowel symptoms, and increased doctor visit because on bowel concerns in ASD children compared to normal healthy children (5). Small studies found that GFCF diets were found to relieve some of autistic symptoms but results varied (3).
Conclusion:
Steps should be taken to help improve nutrition status of ASD children including dietary interventions to relieve GI symptoms. Alternative therapies and intervention may be necessary but parents need to understand all of the complications and restrictiveness of alternative diets before implementing (4).
Works Cited:
1- Horvath K, Perman JA. Autism and Gastrointestinal Symptoms. Current Gastroenterology Reports. 2002; 4: 251-258.
2- Levy SE, Souders MC, Ittenbach RF, Giarelli E, Mulberg AE, Pinto-Martin JA. Relationship of Dietary Intake of Gastrointestinal Symptoms in Children with Autistic Spectrum Disorders. Biological Psychiatry. 2007; 61(4):492-497.
3- Elder JH. The Gluten-Free, Casein-Free Diet in Autism: An Overview with Clinical Implications. Nutr Clin Pract. 2008;23:583
4- Strickland E. Eating for Autism: The 10-Step Nutrition Plan to Help Treat Your Child's Autism, Asperger's or ADHD. Philadelphia, PA: DA Capo Press; 2009.
5- Smith RA, Farnworth H, Wright B, Allgar V. Are there more bowel symptoms in children with autism compared to normal children and children with other developmental and neurological disorders? SAGE Publications and the National Autistic Society. 2009; 13(4):343-355.
An estimated 1 in 100 children is diagnosed with autism in the United States. Nutrients have received attention as both a causative and curative factors in autism. Many are concerned with the increasing number of children with autism spectrum disorders and gastrointestinal symptoms, this health brief will discuss a few of these issue and some solutions.
Issue:
Autism has a collection of behavioral symptoms including dysfunction in social interaction and communication in affected children. Children usually show symptoms of ASD in the first 3 years of life. Research has shown that children with autism also have a high prevalence of gastrointestinal (GI) symptoms including inflammation (1). Studies have concluded that ASD children experience increased frequency of GI symptoms compared to normal healthy children(2). Many families with autistic children are seeking alternative therapies and interventions to help with GI and autistic symptoms. Unfortunately many of these newer, publicized interventions offer little scientific research. The most popular scientifically unproven intervention for ASD is the gluten free, casein-free diet (GFCF). Clinicians working with ASD children are often asked advice and find that they are unable to offer the most credible information (3). The fact is that autistic children often have problem-feeding and restrictive eating behaviors that put them at high risk for poor nutritional intake. Restrictive diets (like GFCF) may put children with ASD at more of a nutrition risk and supplementing children above recommended amounts may lead to toxicity (4). However dietary changes can improve nutrition for ASD children (3).
Programmatic bottom line/ Policy implications:
These steps are suggested to help autistic children:
1-Implement a whole foods meal plan and remove artificial food ingredients, limit pesticide exposure, and avoid processed foods and added sugars.
2-Children should have a balanced diet of basic nutrients, adding extra dietary supplements if needed.
3-Clinicians should address problem-feeding behaviors and correct them.
4-GI symptoms can be alleviated by increasing fiber, adding probiotics, digestive enzymes and omega-3 fatty acids.
5-Help identify food allergies in ASD children and eliminate them in child diet. Lastly, if a child has an allergy they may need to try gluten-free, casein-free diets as needed for treatment of autism (4).
How we know:
Studies using endoscopy found GI inflammation in children with ASD(2). The GFCF diet is hypothesized based on that autistic symptoms may be a result from opioid peptides found when gluten and casein foods fail to completely breakdown. The intestinal permeability allows peptides to cross the blood brain barrier affecting the opiate system and neurotransmission within the CNS. This may explain why ASD children have GI symptoms. When children can’t adequately express their pain of GI discomfort verbally they react with extreme behaviors. Small studies have been done of children with ASD and have found that the GFCF diet decreases autistic symptoms but no major studies have been done that show these results (3). If child is diagnosed with gluten or casein allergy these diets may need to implemented.
Findings from research:
Study results of 51 ASD children and a control group of 35 normal children showed that there was a significant increase in parent reports of diarrhea, constipation, flatulence, general bowel symptoms, and increased doctor visit because on bowel concerns in ASD children compared to normal healthy children (5). Small studies found that GFCF diets were found to relieve some of autistic symptoms but results varied (3).
Conclusion:
Steps should be taken to help improve nutrition status of ASD children including dietary interventions to relieve GI symptoms. Alternative therapies and intervention may be necessary but parents need to understand all of the complications and restrictiveness of alternative diets before implementing (4).
Works Cited:
1- Horvath K, Perman JA. Autism and Gastrointestinal Symptoms. Current Gastroenterology Reports. 2002; 4: 251-258.
2- Levy SE, Souders MC, Ittenbach RF, Giarelli E, Mulberg AE, Pinto-Martin JA. Relationship of Dietary Intake of Gastrointestinal Symptoms in Children with Autistic Spectrum Disorders. Biological Psychiatry. 2007; 61(4):492-497.
3- Elder JH. The Gluten-Free, Casein-Free Diet in Autism: An Overview with Clinical Implications. Nutr Clin Pract. 2008;23:583
4- Strickland E. Eating for Autism: The 10-Step Nutrition Plan to Help Treat Your Child's Autism, Asperger's or ADHD. Philadelphia, PA: DA Capo Press; 2009.
5- Smith RA, Farnworth H, Wright B, Allgar V. Are there more bowel symptoms in children with autism compared to normal children and children with other developmental and neurological disorders? SAGE Publications and the National Autistic Society. 2009; 13(4):343-355.