Diet in Autism
Often the nutritional status in Children with autism remains compromised. They usually have vitamin A, vitamin B - 6, vitamin B-12 and folic acid deficiencies. This could be due to many reasons like difficulty to swallow and digest many foods items, sensory problems like food preferences, diarrhea, constipation, frequent infections, bloating and gastrointestinal (GI) pain. When things go awry in the “gut,” negative behavioral changes and cognitive problems occur or are exacerbated. Hence, an alteration in the diet with respect to the nutritional requirement after assessing the other aspects like the swallowing and digestive ability is necessary so as to improve the quality life of the patient.
A few diet recommendations specific to autism are listed below:
- Gluten-Free and Casein-Free Diet (GFCF)
- Specific Carbohydrate Diet (SCD)
- Body Ecology Diet (BED)
- Lutein-Free Diet (aka Sara’s Diet)
The most specialized diet commonly prescribed for children with autism is the Gluten free and Casein free diet (GFCF- diet).
There are several theories as to why the GFCF diet may be beneficial. One hypothesis is that autism patients have difficulty digesting gluten & casein, causing the formation of peptides-gluteomorphin & caseomorphin and their absorption into the blood stream. These two peptides which appear to have chemical structure similar to opiates can cross the blood brain barrier and cause symptoms like delayed social and language skills & some behavioral issues.
Gluten and glutenlike proteins are found in wheat and other grains, including oats, rye, barley, bulgar, durum, kamut and spelt, and foods made from those grains. They are also found in food starches, semolina, couscous, malt, some vinegars, soy sauce, teriyaki sauce, flavorings, and artificial colors and hydrolyzed vegetable proteins.
Casein is a protein found in milk and foods containing milk, such as cheese, cream, butter, yogurt, ice cream, whey and even some brands of margarine. It also may be added to non-milk products such as soy cheese and hot dogs in the form of caseinate. The GFCF diet mainly eliminates all wheat (and wheat products) and milk (and milk products). Although it may sound difficult, several alternatives are easily available.
Specific Carbohydrate Diet (SCD)
Removes all complex sugars and starches (except honey & fruit sugar) in addition to gluten and casein. Eliminating sugars and starches starves out the yeast and bad bacteria (which feed on complex sugars), therefore helps reduce side effects created by yeast and bacteria overgrowth, which include gastrointestinal issues, headaches and hyperactivity.
In this diet meat, fish, eggs, nuts and seeds, certain beans, all non-starchy vegetables, and fruit are allowed. This is not a low carbohydrate diet but a specific carbohydrate diet. Diet focuses on non-starchy vegetables, fruit, honey, and certain beans for carbohydrates and avoids other sugars and starches.
Body Ecology Diet (BED)
The Body Ecology Diet is an anti-Candida diet focused on clearing up yeast and dysbiosis (imbalance of bad bacteria in the gut).Based on the concept of a natural balance of microorganisms that are involved in a range of functions in the body, and that this balance might be lacking in individuals with autism. The three basic elements are adding cultured foods (such as yogurt and fermented vegetables), integrating “good” fats (flaxseed and extra virgin olive oil), and significantly reducing carbohydrate and sugar intake. Even if someone chooses a different diet, many of the Body Ecology principles can also be applied, such as the inclusion of fermented foods, soaking grains, and consuming more non-starchy vegetables full of minerals and alkalizing to the body. Fermented foods in particular are wonderful for supplying good bacteria that are known to reduce pathogenic bacteria such as clostridia, and for overall digestive and immune function.
Lutein-Free Diet (aka Sara’s Diet)
Eliminates lutein, a pigment nutrient found in some fruits and vegetables such as spinach, corn, carrots, oranges and peaches. Lutein has been found to trigger severe allergic reactions, which often express themselves as gastrointestinal issues. This diet also incorporates removal of soy and restriction of gluten and casein.
It is important to monitor and moderate the intake of certain additional food based substances while following any autism diet.
Common problematic food substances are:
- Phenols and Salicylates
These compounds are removed in the Feingold diet and Failsafe diet.These are present in tomatoes, apples, peanuts, bananas, oranges, cocoa, red grapes. It also eliminates foods with artificial ingredients, colorings and flavorings. According to some studies, children with autism are short of the enzyme that breaks down phenols and amines in food. When children consume salicylates, they can get a wide range of symptoms including hyperactivity, fatigue, diarrhea, and other negative gut symptoms, sleeping challenges, aggression and irritability.
- Amines and glutamates
These compounds are also removed in Failsafe along with phenols and salicylates. Amines are phenolic-like substances and can affect children similarly to salicylates. Amines occur in banana, chocolate, red wine, beer, soy sauce, aged cheese and meats, bone broths, and slow cooked meats.
Normally, a healthy gut will not absorb too many oxalates from the diet, because as they come through the digestive tract they are metabolized by the good bacteria in the gut or bind to calcium and are excreted in the stool. Oxalates are sharp crystals that can lead to oxidative damage and contribute to gut inflammation in individuals with issues processing them. High oxalate foods include beans, chocolate, almonds and other nuts, beans, spinach, leafy greens, sweet potatoes, berries, and more. It is also theorized that oxalates contribute to further inflammation in the intestines and more profound leaky gut, and may be the reason that some children have trouble healing leaky gut and yeast overgrowth; although, more study on oxalates and the low oxalate diet needs to be done.
- A Big NO…
Simple sugars can be very hazardous to those with Autism. This increases the energy levels on a temporary basis which can be attributed to hyperactive behavior intermittently. Sugar substitutes like dates, honey can be used. Artificial sweeteners must be strictly avoided too. Artificial colors, flavors or any preservatives must be strictly kept at bay. Avoid big fishes as they are concentrated with toxins from the sea especially mercury, an immunotoxin that can lead to lowering the capacity of the immune system. Toxins like Monosodium Glutamate-MSG (ajinomoto used in Chinese foods) can cause over-excitation in the brain leading to hyperactivity, hence must be avoided.
- Say YES to…
A Rainbow diet: This is a diet consisting of colorful vegetables and fruits, in plenty. Introduce new vegetables and fruits slowly. The human brain needs lot of antioxidants, phytonutrients, vitamins and minerals to work its best. All the mentioned nutrients are packed in veggies and fruits. Use of probiotics in food can help soothe the gut and improve its functioning. Probiotics are found in naturally fermented foods like idlis, dhoklas, etc. They are easy to digest and can be made colorful and nutritious by adding veggies and sprouted pulses. Children generally love such snacks and they are easily consumed.
- Points to remember
- Do not include processed foods at all in the diet.
- All foods should be as natural as possible.
- Fruits and vegetables should be given raw and fresh.
- Give small and frequent meals.
- Give plenty of water daily.
- Do not allow children to skip meal.
- Make them chew food properly before swallowing.
- If having difficulty in chewing change food consistency as per need.
- Limit fried foodstuff.
- First include foods allowed in diet.
- Once child starts taking allowed foods in good amount slowly stop avoided food.
- Maintain food dairy.
- Try to incorporate colorful variety of food.
- Read label carefully for gluten & casein.
- All children on elimination diets should be under the care of a nutritionist.