The Foods that Works Best for Children with Autism: Advanced Health:

Autism spectrum disorder (ASD) is defined as a complex neuro- developmental syndrome, beginning before three years of age. It is characterized by widespread problems with social interactions, trouble with communication skills, and stereotyped patterns of interests and activities. There is likely not one root cause, but several — if not hundreds — of environmental factors associated with the increasing occurrence of autism today (Bjorklund et al. 2016).

Food may be one of the biggest contributing factors for causing and improving autism symptoms through its direct impact on a person’s microbiome, brain and gastrointestinal tract. Scientific research is clearly demonstrating that how food today is grown, processed, stored, cooked, and ultimately consumed is dictating a wide range of positive and negative effects when it comes to autism.

The majority of foods commercially grown in the Western Hemisphere today are laden with life-threatening pesticides, processed with poisonous chemicals and packaged with tons of sugar. Heavily protected by the government as legally safe despite only a few centuries ago being labeled as dangerous for human consumption, these mass produced foods are often found in our grocery stores, restaurants and other food dispensaries and sold as “healthy” have found themselves to define what we now call the “standard American diet”. Scientists around the world are now closely studying the direct impact of standard American diets and its link to causing a myriad of illnesses. It is no secret that the results have not been promising.

Have you ever wondered if what you eat may be loaded with poisons that are actually making you sick when all along you thought you were doing the right thing? Have you ever wondered if food can spare us from disease and premature death, it may also cause most illnesses. I, for one, definitely know that to be the case having cured thousands of patients suffering from the most deadly diseases, such as cancer and heart disease using food as my primary medicine.

An increasing number of scientists are now recognizing the enormous beneficial effects of “food as medicine” as a stand-alone remedy. This year alone I have already addressed this topic in previous blog posts you can find here:

What we are more frequently seeing in clinical practice is not overt disease, but complex, chronic syndromes. Autism is just that— a syndrome. Children with autism are not “diseased”; they just share a collection of similar “disorders” which determine the severity of where they land on the autism spectrum. Because pharmaceuticals are not the best solution for effectively addressing this growing epidemic, different dietary interventions have been well studied to address how to make the most meaningful impact. Some of these diets include the ketogenic diet and the gluten- and casein-free diet:

Ketogenic Diet: Long-chain triglycerides constitute most of the fat in the ketogenic diet. It’s characterized by high-fat content with sufficient protein for growth but not enough to raise the levels of carbohydrates for metabolic needs. As a result, the ketogenic diet keeps glucose concentrations low and forces the body to use fat as a primary fuel source. This dietary approach is typically studied as a ratio of 4:1, lipid to non-lipid (protein + carbohydrate) ratio with around 75-80% fat, 10-15% protein, and 5% carbohydrate. This intervention also involves intermittent fasting (i.e., 14-16 hours at night) has been shown to work wonders in children with epilepsy and other neurological disorders (Neal et al., 2008) in studies done at Johns Hopkins Medical School. Note:
Gluten-free and casein-free diet (GFCF): By removing two commonly consumed proteins: casein, found in all animal milk and its byproducts, and gluten, found in wheat, barley, rye, and some types of oats through cross-contamination, the GFCF diet decreases damage to the gastrointestinal tract and overfeeding of pathogenic bacteria. It has led to dramatic improvements in behavior and other symptoms in autistic children (Hyman et al. 2016) along with enhancing their long-term developmental outcomes (Whiteley et al. 2013).

In order to tease out which dietary intervention, if any, is more effective in children diagnosed with ASD, El-Rashidy and colleagues (2017) compared the effects of these two different approaches versus a standard American control diet in 45 autistic children. The children were randomly assigned to three groups:

Group 1: Ketogenic diet — Children were placed on the less restrictive Modified Atkins Diet (MAD) —, with 60% fat, 30% proteins, and 10% carbohydrates by teaching parents how to cook meals, calculate dietary carbs and measure urinary ketones. (Note: While urinary ketones aren’t the best measurement to guarantee one is in ketosis, they are helpful in guiding the parent to understand if they are achieving a desired nutritional ketosis).
Group 2: GFCF Elimination diet — Parents and children in this group were instructed to avoid all milk and milk-derived products along with gluten (found in wheat, barley, rye, and some types of oats). While not as restrictive as the ketogenic diet, parents still needed to be trained on how to make meals without these common food additives and learn how to read food labels carefully to ensure none of their meals had hidden sources of dairy or gluten.
Group 3: Control diet on “Standard American diet”. These children and parents were not given any instructions on changing their diet and were allowed to eat whatever they preferred.

The results of this simple 6 month study were profound. Both group 1 and 2 showed significant improvements in:

Speech, Language, and Communication
Sociability
Sensory and Cognitive Awareness
Health, Physical, and Behavior.

Specifically, the ketogenic diet group had statistically significant improvements in speech, sociability, and cognitive awareness with some decrease in behavioral problems. The dairy-free and gluten-free diet group had statistically significant improvements in speech and behavior only with some improvements in sensory/cognitive awareness.

No significant improvements in autism symptoms were seen in the control group — the children consuming the standard American diet. This meant they were unlikely to experience any benefit in their overall development and autism symptoms if they chose to not change their diet.

The above mentioned study was a very simple intervention. Imagine the additional benefits of the child undergoing a full workup not limited to more extensive food sensitivity testing, heavy metal and industrial toxin detection, mold and microbiome analysis to gain insight on how the whole body and mind are functioning and leading to diseases like autism. The immense value of these additional diagnostic tests can give a great deal of insight on what exactly is going wrong inside our body and how best to personalize a patient’s treatment plan.

Even if one does not have access to additional workup, using “food as medicine” can be the simplest, cheapest, and most effective way to help lessen autism symptoms. As the results clearly demonstrated in this study, removing excess sugar, wheat, dairy and dramatically lessening saturated fat from animal protein along with incorporating nightly fasting of 14 to 16 hours can make a world of difference. Although we focus so much on eliminating things that we sometimes forget that it’s just as important to be including things, too! For example, adding more dark green leafy vegetables grown above the ground, mushrooms and lentils to replace the items eliminated can significantly decrease impulsiveness while improving focus in children with attention-deficit/hyperactivity disorder (ADHD), autism and many other cognitive disorders.

Sadly enough, food is still not being used as a mainstream treatment for autism and many other chronic diseases in conventional clinical medicine. We continue to blame conditions like autism, diabetes, or cancer on bad luck or bad genes. Fortunately, as science continues to prove the importance of “food as medicine”, more healthcare providers are starting to understand that diet plays an enormous role in human health and disease. The hope is that we will all begin to recognize the benefit of “food as medicine” and care for patients and ourselves more holistically.

My Takeaways:

The severity of autism tends to decrease among children who stop consuming all dairy products, gluten and drastically limit their overall animal protein and sugar consumption. If they are able to adhere to this diet and possibly try to fast for at least 12+hours at night for over 6 months, it can dramatically decrease all autism symptoms. The key is to find the “best” diet where both the family and children can consistently adhere to.
What’s unique about the ketogenic diet with the primary focus on longer periods of intermittent fasting consumed with minimal consumption of animal protein and grains (i.e., corn, soy, wheat, rice) is dramatically improving cell function. Because the powerhouse of cells (“mitochondria”) are able to function more easily and not be damaged by industrial toxicants, heavy metals and other pesticides commonly found in all animal products and GMO crops, it directly translates to a dramatic decrease in inflammation -- the root of most chronic diseases.
Enhancing one’s cell function, the symptoms of autism can be significantly reduced (as we saw in the study). For example, if a ketogenic diet is begun early on in epilepsy, the seizure disorder can be easily treated and even reversed, almost as if it left a biological footprint in DNA of the nervous system.
In my clinical experience, for someone transitioning from the standard American diet, it is often easier to start with drinking 3-4 cups of water upon awakening and then when super hungry, start the first meal with having a high percentage of cooked vs. raw green vegetables complemented with mushrooms, lentils or a small serving of ancient whole grains (i.e., amaranth, millet, or quinoa). When the focus is on what to add versus just on what to eliminate (i.e., dairy, wheat, fish, eggs, meat, and sugar), I find patients feel more satiated, energized and experience more cognitive and emotional clarity.
Dramatically changing a diet is not easy; support is vital to one’s success. In this study, participants in the experimental study groups had access to a specialized kitchen and tons of support on how to change their family and child’s diet in a step-by-step fashion. The keto group had access to low carbohydrate biscuits, cakes, and bread and the GFCF group had access to alternatives to gluten and casein. Access to foods, especially foods that have not been traditionally eaten, is required for an intervention to be successful. It will not only improve adherence, but it will enhance sustainability of the intervention. Support with ready-made meals or preparing diet-friendly meals in advance increases success. Seek out help; we all need the extra support when we are making small and big lifestyle shifts.
While out of the scope for this blog post, it’s important to remember all persons with autism have impaired gut function and various nutrient deficiencies. Their gut struggles to heal when injured on a microscopic level and hence, directly impacts the level of clinical improvement noted. Because children with autism need a full workup, patients with ASD may require several months of dietary intervention before seeing significant clinical and symptomatic improvement. This study was only 6 months long. Holistic interventions, working on every aspect of someone’s health, need a good amount of time (i.e., 9-12 months) to yield significant improvements since you are fundamentally changing a person’s cellular function and gene expression.

Dr. Bhandari and the Advanced Health Team Are Here to Support Your Health

Our expert team of integrative holistic practitioners work with patients suffering from chronic health concerns. We help our patients reverse disease by better understanding how the body optimally functions and providing personalized treatment plans. To learn more and book an appointment, contact Advanced Health or call 1-415-506-9393.

References

Bjørklund, G., Saad, K., Chirumbolo, S., Kern, J. K., Geier, D. A., Geier, M. R., & Urbina, M. A. (2016). Immune dysfunction and neuroinflammation in autism spectrum disorder. Acta neurobiologiae experimentalis.

El-Rashidy, O., El-Baz, F., El-Gendy, Y., Khalaf, R., Reda, D., & Saad, K. (2017). Ketogenic diet versus gluten free casein free diet in autistic children: a case-control study. Metabolic brain disease, 32(6), 1935-1941.

Hyman, S. L., Stewart, P. A., Foley, J., Peck, R., Morris, D. D., Wang, H., & Smith, T. (2016). The gluten-free/casein-free diet: a double-blind challenge trial in children with autism. Journal of autism and developmental disorders, 46(1), 205-220.

Neal, E. G., Chaffe, H., Schwartz, R. H., Lawson, M. S., Edwards, N., Fitzsimmons, G., ... & Cross, J. H. (2008). The ketogenic diet for the treatment of childhood epilepsy: a randomised controlled trial. The Lancet Neurology, 7(6), 500-506.

San Mauro Martin, I., & JA, B. O. (2019). Impulsiveness in children with attention-deficit/hyperactivity disorder after an 8-week intervention with the Mediterranean diet and/or omega-3 fatty acids: A randomised clinical trial. Neurologia (Barcelona, Spain).

Whiteley, P., Shattock, P., Knivsberg, A. M., Seim, A., Reichelt, K. L., Todd, L., ... & Hooper, M. (2013). Gluten-and casein-free dietary intervention for autism spectrum conditions. Frontiers in human neuroscience, 6, 344.

Author

Dr. Payal Bhandari M.D. Dr. Payal Bhandari M.D. is one of U.S.'s top leading integrative functional medical physicians and the founder of San Francisco' top ranked medical center, SF Advanced Health. Her well-experienced holistic healthcare team collaborates together to deliver whole-person personalized care and combines the best in Western and Eastern medicine. By being an expert of cell function, Dr. Bhandari defines the root cause of illness and is able to subside any disease within weeks to months. She specializes in cancer prevention and reversal, digestive & autoimmune disorders. Dr. Bhandari received her Bachelor of Arts degree in biology in 1997 and Doctor of Medicine degree in 2001 from West Virginia University. She the completed her Family Medicine residency in 2004 from the University of Massachusetts and joined a family medicine practice in 2005 which was eventually nationally recognized as San Francisco’s 1st patient-centered medical home. To learn more, go to www.sfadvancedhealth.com.