Autism Spectrum Disorders
Research on the dietary connection
Autism, PDD, Aspergers
Autism used to occur in about 15 of every 10,000 births (1 in 667 children) but that number has risen until today more than 1 in every 68 children in general, and 1 in 42 boys is on the “autism spectrum.” See CDC report. Autism has gone from a rare disorder to a syndrome that is tragically common in the U.S.
Symptoms of Autism
Autism is a spectrum disorder, so there is great variety in symptoms and severity, but the following characteristics are usually present:
- Difficulty with communication
- Difficulty relating to other people
- Difficulty making eye contact
- Repetitive behaviors
- Resistance to change
- Sensory problems: abnormal reactions to sound, light, touch, texture of food, etc.
- Poor digestive system, constipation, diarrhea
Some claim that there are the same number ...
… of autistic children as there have always been but that we are just better at identifying the problem. If this were true, it would mean that there would be hundreds of thousands of autistic adults – “Rainmen” – in our midst. It would also imply that parents are not capable of noticing when their child, who had been developing normally, suddenly loses his ability to speak or to relate to them.
Conventional medicine has little to offer the families of autistic children. However, many parents, physicians, and other professionals have used a wide variety of non-drug methods to help the children, and there have been impressive results. But both mainstream medicine and the government agencies responsible for dealing with these issues remain unconvinced.
Pure Facts articles on autism
NOTES on studies of gluten/casein that showed no results
Several studies were done that showed no connection between gluten/casein control and autism. Close inspection of some of these studies is interesting:
- In the Sponheim study of 1991, and the Vlissides study on schizophrenia of 1986, the diet used apparently did not exclude casein, but only gluten. Since both proteins have similar effects, it is not surprising that they saw no difference before and after the 6 month diet trial. “If you limp because you have 2 nails stuck in your shoe, and you take out one, you will still be limping.”
- The Storms study of 1982 used a gluten/casein diet but for only 10 days. It takes longer than that to see a response, according to Dr. Cade.
The studies listed below are organized by date, with the most recent date first.
If you are trying to find a particular author, see the Index below which lists all the primary authors alphabetically with their publication dates.
- Alberti 1999
- Brown 2001
- Cade 1999
- Cade 2000
- Curtis 2008
- Dufault 2012
- Harris 1998
- Lucarelli 1995
- Martineau 1985
- McDougle 1996
- Mutter 2005
- Mutter 2005a
- Patel 2007
- Rimland 1978
- Vojdani 2003
Dufault 2012: Review of diet & toxins and autism
A macroepigenetic approach to identify factors responsible for the autism epidemic in the United States. Dufault R, Lukiw WJ, Crider R, Schnoll R, Wallinga D, Deth R. Clinical Epigenetics 2012 Apr 10;4(1):6.
” The number of children ages 6 to 21 in the United States receiving special education services under the autism disability category increased 91% between 2005 to 2010 while the number of children receiving special education services overall declined by 5%. The demand for special education services continues to rise in disability categories associated with pervasive developmental disorders. Neurodevelopment can be adversely impacted when gene expression is altered by dietary transcription factors, such as zinc insufficiency or deficiency, or by exposure to toxic substances found in our environment, such as mercury or organophosphate pesticides. . . . In the current review, we utilize a novel macroepigenetic approach to compare variations in diet and toxic substance exposure between these two geographical populations [Italy & U.S.] to determine the likely factors responsible for the autism epidemic in the United States.”
Quote from text: “Children with autism may be Zn (zinc) deficient and often have MT (metallothionein) dysfunction. Because of their diminished capacity to excrete toxic heavy metals, the severity of their condition is associated with their toxic metal burden. This macroepigenetic model proposes that autism prevalence is related to the consumption of HFCS and the overall exposure to Hg (mercury) in the U.S.”
Curtis 2008: Review of articles
Nutritional and environmental approaches to preventing and treating autism and attention deficit hyperactivity disorder (ADHD): a review. Curtis LT, Patel K. Journal of Alternative and Complementary Medicine. 2008 Jan-Feb;14(1):79-85.
” Review of journal articles found on the PubMed database and from information from several conference proceedings. . . . Autistic spectrum disorders and ADHD are complicated conditions in which nutritional and environmental factors play major roles. ”
Patel 2007: Case studies, children with autism treated by chelation, etc.
A comprehensive approach to treating autism and attention-deficit hyperactivity disorder: a prepilot study. Patel K, Curtis LT. J Altern Complement Med. 2007 Dec;13(10):1091-7.
” . . .This study examined 10 children aged 4-10 years old who had been diagnosed with both autistic spectrum disorder and ADHD by outside physicians or psychologists. These 10 children presented consecutively in an environmental medicine clinic in Buffalo, New York. The children were given comprehensive nutritional/environmental/chelation treatment for 3 to 6 months in addition to their usual behavioral, educational, speech, and physical therapies. . . . All 10 children showed significant improvement in many areas of social interaction, concentration, writing, language, and behavior. Urinary lead burden dropped significantly in all 10 children. . .
Mutter 2005: Letter re autism & mercury exposure
Mercury and autism: Accelerating Evidence?, Mutter J, Naumann J, Schneider R, Walach H, Haley B. Neuro Endocrinol Lett. 2005 Oct;26(5):439-46.
” Institute for Environmental Medicine and Hospital Epidemiology, University Hospital Freiburg, Germany. firstname.lastname@example.org.. . . Recently, it was found that autistic children had a higher mercury exposure during pregnancy due to maternal dental amalgam and thimerosal-containing immunoglobulin shots. It was hypothesized that children with autism have a decreased detoxification capacity due to genetic polymorphism. In vitro, mercury and thimerosal in levels found several days after vaccination inhibit methionine synthetase (MS) by 50%. . . . Repetitive doses of thimerosal leads to neurobehavioral deteriorations in autoimmune susceptible mice, increased oxidative stress and decreased intracellular levels of glutathione in vitro. Subsequently, autistic children have significantly decreased level of reduced glutathione. Promising treatments of autism involve detoxification of mercury, and supplementation of deficient metabolites. ”
Mutter 2005: Dental amalgam, mercury as toxin
Amalgam risk assessment with coverage of references up to 2005 Mutter J, Naumann J, Walach H, Daschner F.,Gesundheitswesen. 2005 Mar;67(3):204-16.
“. . .Amalgam contributes substantially to human mercury load. Mercury accumulates in some organs, particularly in the brain, where it can bind to protein more tightly than other heavy metals (e. g. lead, cadmium). Therefore, the elimination half time is assumed to be up to 1 – 18 years in the brain and bones. Mercury is assumed to be one of the most toxic non-radioactive elements. . . . Review of recent literature suggests that mercury from dental amalgam may lead to nephrotoxicity, neurobehavioural changes, autoimmunity, oxidative stress, autism, skin and mucosa alterations or non-specific symptoms and complaints. The development of Alzheimer’s disease or multiple sclerosis has also been linked to low-dose mercury exposure. There may be individual genetical or acquired susceptibilities for negative effects from dental amalgam. Mercury levels in the blood, urine or other biomarkers do not reflect the mercury load in critical organs. Some studies regarding dental amalgam reveal substantial methodical flaws. Removal of dental amalgam leads to permanent improvement of various chronic complaints in a relevant number of patients in various trials. Summing up, available data suggests that dental amalgam is an unsuitable material for medical, occupational and ecological reasons. ”
MedLine (article in German)
Vojdani 2003: Genes, diet, & toxins cause autoimmunity in autism
Infections, toxic chemicals and dietary peptides binding to lymphocyte receptors and tissue enzymes are major instigators of autoimmunity in autism Vojdani A, Pangborn JB, Vojdani E, Cooper EL., International Journal of Immunopathology and Pharmacology. 2003 Sep-Dec;16(3):189-99
” Similar to many complex autoimmune diseases, genetic and environmental factors including diet, infection and xenobiotics play a critical role in the development of autism. In this study, we postulated that infectious agent antigens such as streptokinase, dietary peptides (gliadin and casein) and ethyl mercury (xenobiotic) bind to different lymphocyte receptors and tissue enzyme (DPP IV or CD26). … A significant percentage of children with autism developed anti-SK, anti-gliadin and casein peptides and anti-ethyl mercury antibodies, concomitant with the appearance of anti-CD26 and anti-CD69 autoantibodies. … bacterial antigens (SK), dietary peptides (gliadin, casein) and Thimerosal (ethyl mercury) in individuals with pre-disposing HLA molecules, bind to CD26 or CD69 and induce antibodies against these molecules. In conclusion, this study is apparently the first to demonstrate that dietary peptides, bacterial toxins and xenobiotics bind to lymphocyte receptors and/or tissue enzymes, resulting in autoimmune reaction in children with autism. ”
Brown 2001: Thimerosal & blood mercury levels
Theoretical estimation of blood mercury levels from Thimerosal injections using a one compartment biokinetic model. (An analysis to “bound” potential mercury tissue levels), Brown, DR. Prepared for the IOM meeting on Thimerosal and Vaccines , Boston, July 16, 2001
His Interpretations and Suggestions section contains what should be a strong indictment very carefully toned down:
“(3) Because the risk to children is believed to be as much as 10 times greater than risk to adults, the fact that estimates are slightly below the toxic levels would not be considered evidence of safety;
(4) . . . It is possible that single doses of Thimerosal would not be hazardous while repeated doses would bioaccumulate and be potentially toxic.”
Cade 2000: Gluten/casein-free diet study on children; 81% improved
Autism and Schizophrenia: Intestinal Disorders, Cade R et al. Nutritional Neuroscience, March 2000
“. . . A gluten-casein free diet was accompanied by improvement in 81% of autistic children within 3 months. Our data provide support for the proposal that schizophrenia and autism are due to absorption of exorphins formed in the intestine from digestion of gluten and casein.”
Cade 1999: Peptides, animal study on autism & schizophrenia
A Peptide Found in Schizophrenia and Autism Causes Behavioral Changes in Rats. Cade R & Sun Z. The National Autistic Society, 1999, Vol. 3(1) 85–95
“. . . About 65 seconds after treatment with different doses of ß-CM7, [casomorphine] rats became restless and ran violently, with teeth chattering and with rapid respiration. Seven minutes later, the rats became inactive with less walking, distancing themselves from the other rat in the same cage, and sitting in, or putting their head against, the corner of the cage. The sound response was reduced and social interaction was absent. One hour later, the rats showed hyperdefensiveness. The above behavioral effects of ß-CM7 did not occur when rats were pretreated with naloxone (2 mg/kg, IP). The rats receiving saline did not show any behavioral changes throughout the 2 hour period of observation. ß-CM7 also demonstrated analgesic effects, which could be blocked by naloxone. The results suggest that ß-CM7 may play a role in behavioral disorders such as autism and schizophrenia.”
Alberti 1999: Study on PST (sulfation) of children with autism
Sulphation deficit in “low-functioning” autistic children: a pilot study, Alberti A, Pirrone P, Elia M, Waring RH, Romano C, Biological Psychiatry 1999 Aug 1;46(3):420-4
“The hypothesis that autistic behavior might be related to metabolic dysfunctions has led us to investigate in a group of “low functioning” autistic children and in an age-matched control group each made up of 20 subjects, the sulphation capacity available. … The inability to effectively metabolize certain compounds particularly phenolic amines, toxic for the CNS, could exacerbate the wide spectrum of autistic behavior.” [See also Harris 1998 for info about salicylate & the PST enzyme] MedLine || Full Text || Get Password
Harris 1998: PST enzyme inhibited by salicylates
Inhibition of phenolsulphotransferase by salicylic acid: a possible mechanism by which aspirin may reduce carcinogenesis, Harris RM, Hawker RJ, Langman MJ, Singh S, Waring RH, Gut 1998 Feb;42(2):272-5
“. . .Salicylic acid consistently and selectively inhibited the P form of phenolsulphotransferase at subtherapeutic concentrations in both tissue samples. A 50% inhibition of sulphation by the P phenolsulphotransferase occurred at salicylic acid concentrations of about 40 and 130 microM in platelets and bowel mucosa respectively.”> [While this is a possible benefit in inhibiting cancer, it may not be a benefit in ADHD and Autism.
McDougle 1996: Double-blind study of tryptophan & autism
Effects of tryptophan depletion in drug-free adults with autistic disorder. McDougle CJ, et al., Archives of General Psychiatry, 1996 Nov;53(11):993-1000
“…Tryptophan depletion led to a significant increase in behaviors such as whirling, flapping, pacing, banging and hitting self, rocking, and toe walking … In addition, patients were significantly less calm and happy and more anxious…short-term reduction of serotonin precursor availability may exacerbate some symptoms characteristic of autism in some patients.”
MedLineNote: Tryptophan is contained in numerous foods such as milk and turkey. In a milk-free diet, it may be important to increase other foods containing tryptophan
Lucarelli 1995: Allergy diet and autism
Food allergy and infantile autism, Lucarelli S, et al., Panminerva Med 1995 Sep;37(3):137-41
“…We noticed a marked improvement in the behavioural symptoms of patients after a period of 8 weeks on an elimination diet … Our results lead us to hypothesise a relationship between food allergy and infantile autism as has already been suggested for other disturbances of the central nervous system.”
Martineau 1985: Vitamin B6 & Magnesium for autism
Vitamin B6, magnesium, and combined B6-Mg: therapeutic effects in childhood autism., Martineau J, Barthelemy C, Garreau B, Lelord G, Biol Psychiatry 1985 May;20(5):467-78
“… The behavioral improvement observed with the combination vitamin B6-magnesium was associated with significant modifications of both biochemical and electrophysiological parameters: the urinary HVA excretion decreased, and EP amplitude and morphology seemed to be normalized. These changes were not observed when either vitamin B6 or magnesium was administered alone.”
Rimland 1978: Double-blind study of autism & Vitamin B6
The effect of high doses of vitamin B6 on autistic children: a double-blind crossover study., Rimland B, Callaway E, Dreyfus P, Am J Psychiatry 1978 Apr;135(4):472-5
The authors used data from an earlier nonblind study to identify 16 autistic-type child outpatients who had apparently improved when given vitamin B6 (pyridoxine). In a double-blind study each child’s B6 supplement was replaced during two separate experimental trial periods with either a B6 supplement or a matched placebo. Behavior was rated as deteriorating significantly during the B6 withdrawal.
The Diet Connection
The Autism Research Institute has reported that 56% of 899 families who had tried the Feingold diet found that it was helpful for their child. See ARI’s Parent Ratings of all Treatments.
While autism is extremely complex, and there may be multiple causes, a diet that removes harmful additives is an important piece of the puzzle. Sometimes we hear back from families whose child had been diagnosed as autistic, only to have the diagnosis dropped once they went on the Feingold Program; but for most families, nutrition is only a part of the answer.
Following is a very short discussion of some of the research, and you can see more by visiting the links at the bottom of the page.
It has only been a relatively few years since the official cause of autism was the “refrigerator mother.” That was during the same period of time that asthma was considered the result of the “overbearing, dominating mother.” It does make one wonder about the poor child with both asthma and autism, doesn’t it?
Dr. Bernard Rimland was the first to reject the notion that autism was a psychiatric condition caused by a rejecting mother, and found that it is a biological disorder. He established a nonprofit organization as an international source of research and information for biomedical treatments in 1967. He passed away at the age of 78, November 21, 2006. “Dr. Rimland will go down in history as the person who ended the dark ages of autism and spearheaded the fight to bring hope and help to autistic children,” said Dr. Stephen M. Edelson, his successor at the helm of the Autism Research Institute. Read more about Dr. Rimland and the history of autism treatment.
In 1994, Dr. Rosemary Waring in England found that children with autism are deficient in an enzyme called phenol-sulphotransferase-P (PST). There were very low levels of PST in every child tested.
If you have a PST deficiency, it is harder to get rid of natural toxins (like salicylate) or phenolic additives (like food dyes) which require PST, and you would also have trouble coping with many of your own body chemicals (like neurotransmitters) which require PST to function correctly.
There could be many reasons why PST is deficient, but one that Waring suggested was sulfate starvation, since sulfate is the substrate from which PST is made. Apparently there is some difficulty creating sulfate from sulfur or sulfites available through foods. Some people report good results from epson salt (magnesium sulfate) baths. The baths provide sulfate absorbed through the skin, magnesium (which relaxes muscles) absorbed through the skin – and besides a warm bath is always soothing.
An interesting study (Harris 1998) also showed that salicylate suppresses the production of PST. Although the study authors consider this an advantage for control of cancer, it is obviously not an advantage if you don’t have much PST to begin with.
Dr. Cade (1999; 2000) reported in that abnormal peptides and antibodies to milk and wheat proteins were found in the urine of both autistic children and schizophrenic adults. See abstract. A diet free of both these proteins resulted in improvement of all the schizophrenics and 81% of the autistic children. It is unusual in that before implementing the diet for the adults, he had them go through a dialysis procedure which removed the damaging proteins all at once. Whether that is normally necessary for results is not known, but might depend on how long such proteins normally circulate in the blood before being excreted naturally. See abstract.
Dr. Shaw of the Great Plains Laboratory has found that children with autism often have abnormal fungal metabolites in their urine, as well as abnormally low cholesterol levels. He has developed a number of blood and urine tests specifically to help determine where the problems lie for the individual child.
Dr. Wakefield, a British gastroenterologist, found that the walls of the intestine of many autistic children are inflamed with the measles vaccine virus, causing what he named autistic enterocolitis. Because this involves the implied culpability of vaccine components, it has become extraordinarily controversial.
For those children to whom small sounds appear to be abnormally loud, causing them pain as well as difficulty in comprehending speech, auditory integration training holds out some hope. See the link to the Georgiana Institute below for more information.
Many children (and adults) with autism have symptoms overlapping ADHD. They are also prone to seizures and a variety of gastroenterological (GI) problems. The Feingold diet itself often helps some of these symptoms. Some doctors recommend starting the diet as a first intervention resulting in a “cleaner” diagnosis of remaining symptoms (those not related to diet) to address via other treatments. Parents have reported to us consistently that when the child is on the Feingold diet, other necessary treatments appear to work better. The reason for this is not yet known, but we are happy to be a piece of the puzzle.