Dietary Intervention & Autism Spectrum Disorders

Report
Dietary Intervention &
Autism Spectrum Disorders
Hannah Kaye
Nutritional Therapist
www.hannahkaye.co.za
Outline for today – Part 1
1. Research
2. Diet
3. Why special diets may
help your child
4. Diet options
5. Gluten & Casein Free
6. Food elimination
7. Feingold / Low Phenol
Outline for today – Part 2
8. SCD
9. GAPS
10. Good nutrition and
overcoming common
problems
Autism Spectrum Disorders
are caused by
genetic predispositions
combined with environmental
factors
that create
disordered biochemistry and
damaged organs & systems.
Complex & Inter-related Whole
Body Disorder
Brain is Downstream
Yeast toxins
Undermethylated
neurotransmitters
Brain inflammation
Increased toxicity
Nutrient deficiencies
Opiates
©Julie Matthews, CNC 2007
Research
Pediatrics, 2008
ADHD & Food Additives Revisited, 19;17
“ there was a trend for more hyperactive behaviors
associated with the food additive drink in virtually
every assessment. Thus, the overall findings of the
study are clear and require that even we skeptics,
who have long doubted parental claims of the effects
of various foods on the behavior of their children,
admit we might have been wrong.”
Clinical Paediatrics, 2011
Dietary Sensitivities & ADHD Symptoms: 35
years of Research, 50;4
“ Of children with suspected sensitivities, 65%-89%
reacted when challenged with at least 100 mg of AFC.
Oligoantigenic diet studies suggested that some children
in addition to being sensitive to AFCs are also sensitive
to common non salicylate foods (milk, chocolate, soy,
eggs, wheat, corn, legumes) as well as salicylatecontaining grapes, tomatoes, and orange. Recently, 2
large studies demonstrated behavioural sensitivity to
AFCs and benzoate in children both with and without
ADHD.”
The Lancet, 2011
Effects of a restricted elimination diet on the
behaviour of children with ADHD : RCT, 377
• Findings:
– Restricted elimination diet had a beneficial effect
on ADHD symptoms in 64% of children
– Reintroducing foods led to a significant
behavioural relapse
– The mechanisms and effects of food need to be
investigated—e.g., at a functional and structural
brain level and in relation to genetic factors that
increase the susceptibility to ADHD
Diet
The Basics
Macronutrients:
Carbohydrates, Proteins & Fats
A Healthy Diet
• Provide a nutrient dense diet that
nourishes the body.
• Healthy foods include:
– Fresh, plant-ripened, local, organic & inseason produce
– Grass-fed animal foods including organs and
bones
– Unprocessed
– Good fats
Carbohydrates
• Add complex carbohydrates: whole grains,
vegetables, fruit, starchy vegetables
• Reduce refined carbohydrates: flour
products (bread, crackers, chips), cookies,
pasta
• Avoid Sugars: Refined sugar, honey, juices
Sugar cravings - Yeast overgrowth, stress/anxiety (sensory
sensitivity), and blood sugar imbalances
©Julie Matthews, CNC 2007
Protein
• Protein (essential amino acids) building
blocks for:
– Muscle and tissue growth and repair,
neurotransmitters, immune responses,
enzymes, detoxification
• Bio individuality - amounts vary.
Signs of protein deficiency: Stunted growth, lack of
appetite, suppressed immune system, muscle wasting,
anxiety, sparse hair, dry skin
Fats
•
•
•
•
Brain development & brain function
Hormone balance & mood
Formation/fluidity of cell membrane
Reduce inflammation
©Julie Matthews, CNC 2007
Vital Roles of Saturated Fat
• Brain—Saturated fats are
important for development of the
brain
• Bones – Saturated fats help the
body put calcium in the bones
• Liver – Saturated fats protect the
liver from poisons
• Lungs – Can’t function without
saturated fats—protects against
asthma
• Immune System – Enhanced by
saturated fats—fights infection
• Essential Fatty Acids – Work
together with saturated fats
Coconut Oil:
• Contains many antifungal and
antiviral components
• Anti-inflammatory effects
• More easily digested and
absorbed
• Used immediately to create
energy
• Enhances absorption of
minerals
©Julie Matthews, CNC 2007
Benefits of Cholesterol
•
•
•
•
•
•
•
•
•
Brain development & function
Boosts mental performance
Aids digestion
Builds strong bones
Builds muscle
Building block for hormones
Regulates your blood sugar
Repairs damaged tissue
Protects against infectious diseases
©Julie Matthews, CNC 2007
Key Nutrients for Brain
Development
• Vitamin A - Cod liver oil; liver, butter
& egg yolks from grass-fed animals
• Vitamin D - Cod liver oil; butter
& egg yolks from grass-fed animals
• Choline - Cod liver oil, egg yolks
• DHA - Cod liver oil; liver, butter, egg yolks from
grass-fed animals
• Zinc - Red meat of grass-fed animals, shellfish
• Tryptophan - Meat of grass-fed animals
• Cholesterol - Dairy foods, eggs, seafood,
meat of grass-fed animals
Why Special Diets May Help
Your Child
Leaky gut
Protein Digestion
Malnutrition & Malabsorption
Yeast
Detoxification
Leaky Gut Syndrome
• Most children with ASDs have digestive
issues
• Critical part of a healthy digestive system
is the lining of the intestine
• When lining is damaged, harmful large
food molecules enter the bloodstream
Trouble with protein digestion
• Protein that is not completely broken down is
called a peptide.
• Body views peptide as an ‘intruder’ – IgE
antibodies to expel it out.
• Histamine reaction
• Inflammation of gut lining
• Opioid-like substances
• Dairy, wheat, soy, corn, egg, sugar, peanuts,
beans & nuts
Malnutrition & Malabsorption
(Nutrient Deficiencies)
• First signs of malnutrition are mental and
emotional
• Malnutrition contributes to pickiness,
pickiness contributes to malnutrition
• 85% of children on the spectrum have
malabsorption
• Increase the quality of food
• Improve digestibility of food
Yeast Overgrowth
• Exacerbates symptoms and places stress
on biochemical pathways
• Sugar: feeds yeast, depresses immunity,
contributes to inflammation
• Remove sugars
• Reduce refined carbs
• Add probiotic-rich foods
Poor Detoxification
• Nutrition is vital to biochemistry of
detoxification
• Avoid additives, preservatives, artificial
colours, MSG
• Improve detoxification pathways
• Avoid toxins in food supply & meal
preparation
Diet Options
Diet Options to Choose From
ASD Diet Option
ARI Survey Results
Parents reporting noticeable symptomatic improvement
GFCF (Gluten-free and Casein-free)
No gluten (wheat, rye, barley, spelt, kamut, oats) or casein (dairy)
GFCF - 66% improved
No Dairy - 50% improved
No Wheat - 49% improved
Food Sensitivity Elimination
Eliminating all other food sensitivities: Soy, corn, eggs, citrus,
peanuts, chocolate, cane sugar
No Eggs – 41% improved
No Chocolate – 49% improved
No Sugar – 50% improved
Rotation Diet – 51% improved
Feingold Diet/Low Phenols
Restricts high phenolic foods, including all artificial ingredients
and high salicylate fruits
56% - improved
SCD (Specific Carbohydrate Diet)
Restricts carbohydrates to only fruits, non-starchy vegetables, and
honey.
SCD – 69% improved
Body Ecology Diet
Anti-yeast diet, acid/alkaline, fermented foods
Candida diet – 54% improved
Nourishing Traditions/ Weston A. Price
Good quality fats, soaking and fermenting for digestion
Low Oxalate Diet
Restricts high oxalate foods (nuts, beans, greens)
Symptoms Diet May Improve
•
•
•
•
•
•
•
•
•
Ability to focus
Eye contact
Aggression
Gastrointestinal problems
Language
Sleep difficulties
Toilet training
Rash or eczema may improve
Behaviour
Gluten & Casein Free
“It’s not the food you avoid that
makes you sick. It’s the food you
crave and eat every day!”
Gluten-free, Casein-free (GFCF)
• What is it?
– No gluten (wheat, rye, oats, barley, spelt, kamut)
– Wheat-free is not gluten free
– No casein (dairy)
• When to use it?
–
–
–
–
–
–
Cravings
Constipation, diarrhoea
Poor focus & eye contact
OCD, self injury
High pain tolerance
Sensory, stims
Gluten-free substitutes
available in South Africa
Grains
Flours
Thickeners
Rice
Nut flours
Arrowroot
Millet
Coconut flour
Cornstarch
Quinoa
Gluten-free grain flours
Gelatin
Amaranth
Guar gum
Buckwheat
Tapioca
Wild rice
Xantham gum
Corn
Tapioca
Casein-free substitutes
available in South Africa
Milk & Yoghurt
Oil / Butter
Rice milk
Extra virgin coconut oil
Coconut milk
Ghee
Nut milks
Lard
What about Soy?
• Not a good alternative
• 50% of children cross-react between
casein and soy
• 90% genetically modified
• Endocrine disruption
• Blocks thyroid function
• Blocks absorption
Is GFCF safe?
• Gluten and casein are not essential food
groups
• Calories, protein and nutrients must be
maintained
• Replace missing nutrients like calcium
Replacing calcium…when milk is
eliminated
Calcium
RDA (mg)
Substitutes for 300mg Calcium
in 1 cup of milk
0-6 months
400
85g sardines, with bones
6- 12 months
600
100g pilchards (in tomato sauce)
1-10 years
800
½ cup tofu
11-24 years
1200
150g can salmon
Adults (premenopausal)
800
1 cup rhubarb
Pregnant & Lactating
1200-1500
200g prawns
1 cup spinach
2 tbsp molasses
100g almonds
Fortified rice milk
GFCFSF Menu Plan
• Breakfast:
– Bacon, eggs
– Millet porridge, chicken/turkey sausage
• Lunch / Dinner:
– GF pasta with meatballs, pureed veg in sauce
– Meat patties, butternut squash fries
– Gluten-free fish fingers, tomato sauce, potato
• Snacks:
– Apple/pear with nut butter
– Hummus with vegetables
Healthy lunch box
• Chicken or other protein with:
– Fruit
– Raw veggie sticks with dipping sauce (hummus, nut
butter)
– Healthy snacks
• Slice lunch meat roll ups with shredded veg
• Sandwich on GF bread with sunflower seed butter
• Use a thermos for hot food
–
–
–
–
Dinner leftovers
Soup, stew
GF pasta
GF chicken nuggets, burgers
Food Elimination
Allergies
Sensitivities
Intolerances
Food Allergies
• The antibodies that result in traditional
allergies are called immunoglobulin E (IgE)
antibodies.
• Obvious and fast
• Cause and effect easy to figure out. e.g.
peanut allergy
• These do not have a direct negative effect on
the brain
• Milk, soy, eggs, peanuts, tree nuts, fish,
shellfish, wheat.
Food Sensitivities
• May result in a range of symptoms
including behavioural or developmental.
• Occur over a longer period of time (1-3
days).
• For those with compromised systems,
number of IgG sensitivities may be high.
Food Intolerances
• Not IgG or IgE
• Include problems with the digestion of
foods due to lack of enzymes (e.g. lactose
intolerance)
• May also include an inability to metabolise
a component of food such as fructose,
phenylalanine, phenols & salicylates
Symptoms of food sensitivities &
intolerances
• General: fatigue, food cravings
• Skin: eczema, allergic shiners, red face
• Digestion: stomach aches, loose stools,
constipation
• Respiratory: mucus production, congestion
• Neurologic: headaches, tinnitus, dizziness,
tics
• Psychological: depression, anxiety,
aggression, sleep disorders
• Behaviour: ADHD symptoms, mood swings
Elimination Diet
• The gold standard for food reactions is an
elimination diet & challenge
• Give up all possible food sensitivities for
10 days
– Gluten, dairy, eggs, soy, sugar, chocolate,
corn, citrus, peanuts
• Add back one at a time
• Wait for 3 days and record symptoms
• Proceed to next item
Sensitivity test
• At bedtime, take a drop of the food in
question (if solid, mash and mix with a little
water) and place on inside wrist.
• Let it dry and let patient go to sleep
• In the morning check the spot, if there is
an angry red reaction, avoid food for a few
weeks and try again.
Feingold Diet / Low Phenol
What is Feingold/Low Phenol Diet
• Restricts food additives along with natural
food chemicals called salicylates
• Impaired sulfation (natural detox process)
• Phenol Sulfotransferase Deficiency (PST)
• Symptoms:
–
–
–
–
–
Disrupted sleep
Regressive behaviour after eating food
High consumption of apple juice
Hyperactivity
Unexplained red cheeks /flushing
Affects of Faulty Sulfation
©Julie Matthews, CNC 2007
©Julie Matthews, CNC 2007
Stages
• Stage 1:
– Eliminate artificial colours, flavours,
preservatives, aspartame, salicylate foods
• Stage 2:
– Salicylates reintroduced and tested for
tolerance
– Artificial colours, flavours, preservatives never
reintroduced
Feingold – foods eliminated in
phase 1
Salicylates
Almonds
Apples
Apricots
Aspirin
Berries, raspberries, cherries
Chili powder
Cider and cider vinegar
Cloves
Coffee
Cold drinks
Cucumbers and pickles
Curry powder
Endive
Grapes, raisins, currants
Honey
Nectarines and peaches
Oranges
Paprika
Peppers (Bell and chili)
Pineapple
Plums and prunes
Radishes
Tea
Tomatoes
Wine and wine vinegar
Phenols & other additives
BHA, BHT – synthetic antioxidant
Preservatives
Anticaking agents
Artificial colours
Artificial flavours
Artificial preservatives
Benzoates
Corn syrup
Emulsifiers
Hydrolyzed vegetable protein
Mineral salts
MSG
Nitrates
Nitrites
Perfumes
Sorbates
Sulfites
Feingold – acceptable foods
Fruits
Pears
Lemon/lime
Grapefruit
Mango
Papaya
Pomegranate
Kiwi
Dates
Figs
Melon
Honeydew melon
Watermelon
Cantaloupe
Avocado
Guava
Coconut
Vegetables
Artichokes
Asparagus
Alfalfa
Beans
Beetroot
Broccoli
Cabbage
Carrots
Cauliflower
Celery
Corn
Eggplant
Green beans
Leafy greens
Lettuce
Lentils
Mushrooms
Olives
Parsley
Parsnips
Peas
Potatoes
Radishes
Rhubarb
Spinach
Squash
Sweet potatoes
Watercress
IN CONCLUSION – PART 1
Diet strategy
GFCF
GAPS
BED
or
Low
Oxalate
SCD
Yeast /dysbiosis /inflammation?
SCD
Food
sensitivities
Phenol
s
Glutamates
Histamines
Food intolerances?
Nourishing Diet for Each Child
Thank you!
Hannah Kaye, BSc (hons)
Nutritional Therapist
www.hannahkaye.co.za

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