By Krysteena Stephens, M.A., IMFT, edited by Victoria Dunckley M.D.
Inflammation in the gut can lead to inflammation in the brain.
Any person browsing through the job listing classifieds in recent years may have noticed a marked increased in positions related to working with children diagnosed with Autism Spectrum Disorder (ASD), a pervasive developmental disorder characterized by impairments in communication and social interactions, restricted interests, and repetitive behaviors. Autism Spectrum Disorder is reported by the CDC to affect approximately 1 in 88 children
, a shocking statistic that has increased in recent years. Parents and researchers are searching for new answers as to the cause of this disorder, one of them being environmental factors and bodily inflammation linked with food allergies, sensitivities or intolerances.[*]
Recent research has unveiled much support in this area. For example, one study compared the prevalence of health conditions associated with children with ASD and found that allergies, particularly food allergies, were more prevalent in children with ASD than those without.  It is also well known that many children with ASD also exhibit picky eating, gastrointestinal issues, or other general food aversions. Additionally, there are reported cases of children with ASD who were placed on gluten-free and/or casein-free diets who showed a noticeable decline in symptoms. 
In a NY Times article published last year, science writer Moises Velasquez-Manoff presents a similar theory based on the fact that a third of all documented cases of ASD appear to be the result of inflammatory responses which occur while the child is in the womb. The author explains how the body produces an inflammatory response when it feels like it is under attack from something foreign in an attempt to return to homeostasis. Such a response occurs with food allergies and intolerances. In autistic individuals, the inflammatory response overpowers the anti-inflammatory response in varying degrees, which is why autistic symptoms present on a spectrum.
Duane Law, a naturopath and acupuncturist, has also completed research on inflammation, allergies, and the stress response. In one of the chapters of his new book, Before Meds/After Meds, Law discusses how food intolerances and associated cravings occur: when our digestive systems are not able to properly break down some of the foods we ingest, the perception that we may have just swallowed a foreign substance sends the body in to an attack mode characterized by inflammation. If it’s serious enough, our fight-or-flight response kicks in, stress hormones are released, and sugar[†] is poured from cells into our blood stream to make sure we have enough energy to run or fight against the hypothetical danger.
An increase in blood sugar levels results in an increase in dopamine, the reward neurotransmitter (the same neurotransmitter that accounts for addictive behaviors) and causes us to feel cravings. In other words, the foods that we so often crave, like refined sugar, sweets, and bread, are the foods that we may in fact be sensitive to because our body cannot naturally process them. In regards to children with ASD, the picky eating characteristic that is so often identified in children with this disorder may actually be the result of this inflammatory response, causing them to be more prone to craving foods their bodies are intolerant to, thus exacerbating their symptoms and creating a vicious cycle.
So how do you know if your child with Autism Spectrum Disorder has a food intolerance and what can you do to help?
Unfortunately, food intolerances are not always easy to diagnose and treat. Pediatricians often test for food allergies, which are more physically noticeable as they cause acute reactions. However, food sensitivities may trigger delayed symptoms anywhere from two days to several weeks after ingestion. Because offenders may cross the blood brain barrier, they can cause changes in mood, behavior and cognition. Elimination diets are often helpful at discovering whether your child has a food sensitivity.[‡] This can be done by removing the food in question (e.g. gluten or dairy) for at least two weeks then reintroducing the food item and noticing any adverse reactions. Parents may also look for a reduction in ASD symptoms in their children once the food is removed.
Incorporating antioxidants into the diet may also assist in decreasing inflammation associated with food intolerances in children with ASD. Research shows that antioxidants such as blackberries, blueberries, and strawberries are helpful in reducing symptoms associated with bodily inflammation.Omega 3 fatty acids are also known to be a natural anti-inflammatory and are obtained by eating wild fish like salmon, tuna, or mackerel, or may be taken in supplement form such as Cod Liver Oil with EPA and DHA. Although consuming some Omega 6 fatty acids are necessary for a healthy diet, eating too much can also cause an inflammatory response which may lead to an increase in symptoms for children with ASD. It is best to increase the intake of Omega 3’s and keep Omega 6’s like flour, grains, and dairy, to a minimum.
For any parent of a child with Autism Spectrum Disorder, instilling a healthy, anti-inflammatory diet and assessing for the presence of food allergies or intolerances may be a wise and beneficial addition to their child’s treatment and help aid in the overall reduction of symptoms. For more information on accepted standards for elimination protocols, see this patient handout provided by the University of Wisconsin Medical School’s integrative medicine program.
Guest blogger Krysteena Stephens, M.A., IMFT, is a marriage and family therapist intern with a special interest in the relationship between nutrition and mental health disorders.
[*]Although allergies, sensitivities, and intolerances are often used interchangeably, they represent different mechanisms and cause different symptoms. For simplicity’s sake, the term intolerance will be used generically here to encompass allergic and sensitivity reactions as well as true “intolerances,” which are due to an enzyme deficiency (such as lactase), while the terms allergy and sensitivity are explained below.
[†] High blood sugar is yet another inflammatory factor contributing the food-inflammation cycle.
[‡] Although there are specialized labs that can test for food sensitivities by testing for IgG antibodies rather than the IgE antibodies triggered by an allergic reaction, elimination protocols remain the gold standard for evaluating food sensitivities. In other words, a child may test negative for a food sensitivity panel but still respond positively to elimination of certain foods.
 Gurney JG, McPheeters ML, Davis MM., (2006). Parental report of health conditions and health care use among children with and without autism: national survey of children's health. Archive of Pediatric Adolescent Medicine. 160(8):825-830. doi:10.1001/archpedi.160.8.825. http://www.ncbi.nlm.nih.gov/pubmed/16894082
 Geneviève Nadon, Debbie Ehrmann Feldman, Winnie Dunn, and Erika Gisel, (2011). Association of sensory processing and eating problems in children with autism spectrum disorders. Autism Research and Treatment, vol. 2011. doi:10.1155/2011/541926. http://www.hindawi.com/journals/aurt/2011/541926/
Buckley, Julie A., Herbert, Martha R., (2013). Autism and dietary therapy: case report and review of the literature. Journal of Child Neurology. doi: 10.1177/0883073813488668.
 Grimble, RF, (1994). Nutritional antioxidants and the modulation of inflammation: theory and practice. New Horiz. 1994 May;2(2):175-85.http://www.ncbi.nlm.nih.gov/pubmed/7922442