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Food, Inflammation, and Autism: Is There a Link?

Evidence for environmental influences either triggering or worsening autism continues to grow. While we know certain foods can exacerbate autistic symptoms, it also appears that food sensitivity reactions might be initiators for the autistic process itself—as early as the womb. Read More

How to detect allergies

This looks like it could be a handy app to detect food allergies. If you can forego the slightly gimmicky exterior, this site has lots of useful information on the effect of diet and other lifestyle factors on inflammation.

So much we do not yet understand

Gifted individuals also are recognized to have food and environmental allergies at a greater frequency than the general public.

There is much talk on whether autism spectrum disorders lie on an even larger spectrum with giftedness. Prodigies are known to have an increase of autism in their family lineage. Autism and giftedness can also coincide in a single individual.

What is the flip switch detouring one person to one end of the spectrum whereas another detours to the other?

Many questions. Few answers.

scientific studies on diet & autism

Here is page showing research on diet & autism

http://www.feingold.org/Research/autism.html

Garbage science

There was an interesting article on Slate the other day about how this gluten intolerance nonsense is really just in people's heads. http://slate.me/17205W8.

You would think an article on Psychology Today would explore that angle, rather than rehash fad diet nonsense, particularly since there isn't a single clinical study that shows restricting children's diets has any measurable effect on ASD.

Advances in medicine often start with observational studies

Mike D wrote:
There was an interesting article on Slate the other day about how this gluten intolerance nonsense is really just in people's heads. http://slate.me/17205W8.

You would think an article on Psychology Today would explore that angle, rather than rehash fad diet nonsense, particularly since there isn't a single clinical study that shows restricting children's diets has any measurable effect on ASD.

The evidence suggests (you can look at review articles in Pubmed) that some ASD children will respond to the intervention and some won't, just as some ADHD cases will respond and some won't, depending on whether the person's immune system is reacting to the antigen. In people's heads? Tell that to a mother who's had their autistic child's self injurious behavior improve after they've removed gluten. Tell that to someone with a movement disorder that's resolved after removing gluten--whose brain MRI clearly shows a dramatic decrease in inflammation.

Then get back to me.

Aww jeez

This crap again? And from someone who purports to be an M.D. no less.

Thanks for the anecdotal evidence and the link to pubmed. With all due respect, I've already been through all of it with an autism quack who tried to peddle this nonsense, and more, for my own son.

For the very, very small percentage of children who have celiac disease or other verifiable food allergy, yes, eliminating gluten would likely have a positive effect.

For the other 98%, no. Frankly, it's unconscionable for a doctor to make parents think they can magically "fix" their autistic kids by depriving them of two fifths of their nutritional needs.

In my opinion, a good doctor would advise parents of children with ASD to insure their kids get a complete, varied diet -- not restrict foods based on wishful thinking or the fad du jour.

#kthxbye

re: aww jeez

Celiac disease prevalance is about 1%. Sensitivity to gluten, however, runs about 15-18% of the general population, and is probably higher in the mental health population. My guess is it's around the same if not higher for dairy.

That being said, the way I approach this in my practice is that I ask the parents (of all patients, not just autistic patients) whether they've tried any special diets before, whether they've noticed any senstivities to food dyes and that sort of thing, if there are any GI symptoms like loose stools, constipation, or bloating, or food cravings--all of which can be signs of a food senstivity. I also ask about rashes and seasonal allergies; sensitive individuals tend to have multiple sensitivities.

When we're deciding on a treatment plan, we talk about whether they are willing to try dietary changes. Often, especially with parents of autistic patients, they are too overwhelmed to try food elimination initially. But the issue may be revisited over time, especially if we don't see improvement with other interventions, or if there are a lot of GI symptoms.

I would never suggest to anyone that food elimination will be a magic bullet. A two week trial of food elimination is safe and it's free, so it falls under the realm of "we're not sure if this will help or not but it might and it can't hurt, so let's try it." Even with a varied diet most autistic children have multiple micronutrient deficiences, so that is addressed separately.

Labcorp offers a gluten senstivity screen/panel that is covered by insurance and includes testing for IgG antibodies to gluten. So far there's no dairy/casein equivalent that's covered by insurance, but like I said in the article, the gold standard is the elimination trial anyway.

If it doesn't help, the family can simply resume their regular diet.

Going gluten free/dairy free is not easy, so when a family sticks to I have to believe it's because they are seeing enough of a benefit that they'll tolerate the inconvenience factor.

re: aww jeez

I remember being overwhelmed at first by what to feed my kids. But let me tell you, having them on a special diet is WAY easier than dealing with the behavior problems they have when they are eating gluten and dairy. My husband thought it would interfere with our "quality of life" if we weren't able to take the kids to eat wherever we wanted. To me, "quality of life" is feeling good and not being at wit's end with my kids who are only acting up because they don't feel good. Doctors always criticize these special diets as lacking in variety, but my kids are way healthier than most of their peers who subsist almost entirely on typical kid food: macaroni and cheese, pizza, and sugary crap. I don't know why people get so angry about the idea of trying something to help their kids to heal and feel (and act!) better. It can make all the difference in the world. And if it doesn't? Go back to feeding them whatever they want. But you can probably tell by what it is they self-select (cereals, sweets, pastries, etc.) what they'd really be better off without (unless we're talking fruits and vegetables, which I doubt is the case). I also suspect that if there's some anger surrounding the issue of gluten-free diets, there's some defensiveness and denial going on. Otherwise, people would just react neutrally to a suggestion that can only help and do no harm.

re: Aww jeez

I am glad to see that "someone who purports to be an M.D" is on to the logic of eliminating toxins from our diets. I have gotten zero help from Western medicine with the various health issues I've faced in my family. It was a naturopath who figured out every single problem. For example, I had suffered from heart palpitations for 20 years and finally when it got so bad I couldn't stand it anymore (skipped beats every three beats for a month solid), I sought the help of a naturopath - someone who specializes in figuring out how what we are eating - or not eating - is affecting our health. Guess what it turned out to be? Gluten and dairy. No, I don't have celiac disease, no, it was not just in my head, and no, it was not a fad I was following. I haven't had a single skipped heart beat in months since I took gluten and dairy out of my diet. M.D.s had never helped me in twenty years of seeking answers. It is not just people who have celiac disease or another "verifiable food allergy" who have problems with gluten and dairy, and the problem is that continuing to ingest them can create other allergies. Gluten and dairy can destroy the lining of the intestines, which is the biggest source of immune protection we have. "Leaky gut syndrome" is when the intestinal barrier lets large particles of undigested food into the bloodstream, which can wreak havoc neurologically and cause the body to perceive other foods as allergens. When I took my son in for an IgG test, it came back showing him to be sensitive to about twenty things. All I had to do was eliminate the top three (gluten, dairy, and eggs), and that was enough to help his intestines to heal and to be able to tolerate the other foods on the list. My daughter, who also doesn't qualify as part of the 2% you claim actually might need food "restriction," has completely overcome her acid reflux, anxiety, and frequent colds by not eating gluten and dairy. Believe it or not, some things ARE as simple as avoiding certain foods (gluten and dairy being high on the list of things to avoid). My kids aren't "deprived" of any nutritional needs. And they sure do feel good now. I'm grateful that the authors of this article have attempted to spread the good idea about taking our health - and our kids' health - into our own hands.

"In people's heads"

Exactly. I am one of those mothers who can attest to the extreme behavioral changes in my children when they're eating gluten or not. My kids are not autistic, but my son sure acts like it when he is inadvertently given gluten. And my daughter (age 8) had five huge temper tantrums in as many days during the week I tried introducing gluten back into her diet. Why isn't anecdotal evidence convincing? You should try spending some time with my kids both on and off gluten. That would be all of the evidence you'd need.

re: "In people's heads"

Oops - this was meant to follow the "Advances in medicine often start with observational studies" section. Sorry about that.

re: Garbage science

You mention "restricting children's diets," yet what I notice is that kids with ASD have restricted their own diets. For example, one teenager with Asperger-like behavior whom I just spent the weekend with ate nothing but Lucky Charms. On the other hand, my kids just had a lunch of gluten-free turkey sandwiches with spinach and onions, avocados, and blueberries. Which meal would you consider more restricted? Which more healthful? Which kid do you think feels better? When my son was inadvertently given a brownie and Oreos at school, he became anti-social, defiant, and whiny for two days afterward. But because he doesn't have a "true allergy" to gluten (i.e., no instant rash or anaphylactic shock), the doctors don't believe we need to "restrict" his diet. Thankfully there are naturopaths out there (and the authors of this article) who understand that food absolutely impacts how we feel and behave.

Thank you Dr. Dunckley!

At least some MDs are getting the hang of the fact that food matters. My son was diagnosed PDD NOS as a very young child and later graduated to ADHD. He was medicated at age 5 and was doing a lot better but at age 7, he suddenly couldn't control his bowels. He had 4 accidents that terrified him and everyone in our family. I knew that if other kids found out about these problems, he would never live it down - his social life which was already precarious, would be OVER. I contacted his pediatrician who said he had overflow incontinence - he should be made to sit on the toilet each night at the same time to train himself to void his bowels. HA! You try making an ADHD 7 year old sit on a toilet! I talked to his psychiatrist who told me it was the same thing and told me that angry people do that. Well, yes, my son was very angry but that was more the result than the cause! So we got an allergy test via blood from Alletess (see foodallergy.com). It tests for allergies AND SENSITIVITIES. He is now 10 and there has never been another accident since we went off of 29 foods to which he was allergic/sensitive for 1 year. Now we cheat on that diet because it's so impossible but he can handle the cheating. He just can't handle the full brunt of all of those foods his body can't handle. He finished 4th grade at the top of his class (despite persistent behavioral issues.) FOOD MATTERS.

My own experiences...

I have Asperger's and found my brain fog signiificantly improved when I went on a vegetarian diet that inadvertantly also omitted gluten products. I didn't stay on that diet, and the fog did come back, and don't know if it was all the healthy veggies or the omission of gluten that helped, but that's my experience. For what it's worth, I do have a sister with Asperger's also, who is a near celiac, and she swear that it's the gluten that cused lots of her symptoms.

This article immediately

This article immediately caught my eye. One of my cousins has a son with ASD and we were just discussing the lifestyle modifications that they were trying. Right now they have him on a gluten free diet, and it is amazing the difference it made. It has been a very long process but he is finally starting to feel more comfortable in different situations and is not as attached to his mother. This was a huge feat for them and they believe it is largely due to diet and lifestyle modifications. I wonder if they have looked into the allergy portion of this treatment. From this article it seems like allergic reactions can play a large role in worsening symptoms. I never would have thought that allergies could present as behavioral changes. This article was very informative and definitely makes me want to learn more about this treatment option. With ASD there are not many treatment out there, therefore lifestyle modifications are a huge factor.

Blood Testing

There is a blood test that is far more effective than any other test for Food Sensitivities, and it has helped a tremendous amount of patients, including children with ASD. The test I'm referring to is the ALCAT test for Food and Chemical Sensitivities. It is not a traditional antibody test such as IgG. Rather, it detects live cellular reactions and therefore is more accurate and specific of foods that actually trigger the immune system unnecessarily and cause chronic inflammation. The test is offered by a company/laboratory called Cell Science Systems, and their website is www.alcat.com. A good point of contact there is Rodrigo at ext.170 or rraphael@alcat.com as he is always willing to help patients get tested through their providers.

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Victoria L. Dunckley, M.D., is a board-certified child and adolescent psychiatrist specializing in treating children with complex diagnoses and/or treatment-resistant conditions.

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