Transcript Nutrition & Diet for Autism

Nourishing Hope
Nutrition Intervention for
Autism Spectrum Disorders
Parent’s Listen Speaker Series
Ryerson University - Toronto, Ontario
December 1st, 2007
Julie Matthews
Certified Nutrition Consultant
©Julie Matthews, CNC 2007
Trudy Scott - Research Assistant
The food we feed a child
has significant impact
 Background and Biochemistry
 Nutrition Basics
 Diet Options
 Nutrition Boosters
 Beginning & Evolving a Diet
©Julie Matthews, CNC 2007
What is Autism and
Autism Spectrum Disorder (ASD)?
Autism, PDD, Asperger’s Syndrome, ADHD
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Social: Not playful, avoids eye contact
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Communication: Not use gestures, receptive and
expressive language poor
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Unusual interests and behaviors: Repetitive
actions, hand flapping, picky eating, “stimming”

Physical: Constipation, diarrhea, hyperactivity,
fatigue, aches and pains, digestive pain and gas,
difficulty sleeping, anxiety
©Julie Matthews, CNC 2007
Underlying Causes and Contributors

Genetics: MTHFR, GST, COMT. Involving the
systems of methylation, sulfation, detoxification,
digestion, gut/brain barrier, inflammation, immune
function.

Environmental: Toxins, vaccinations, nutrient
deficiencies, antibiotics and dysbiosis, endogenous
toxins (opiates from food, microbial toxins)
©Julie Matthews, CNC 2007
Biochemistry
©Julie Matthews, CNC 2007
Affects of Faulty Sulfation
©Julie Matthews, CNC 2007
Complex and Interrelated
Whole Body Disorder
Brain is Downstream
Yeast toxins
Undermethylated
neurotransmitters
Brain inflammation
Increased toxicity
Nutrient deficiencies
Opiates
©Julie Matthews, CNC 2007
Why the GI System is So Important
• Physical barrier of defense against bacteria, viruses, etc.
• The largest part of the immune system is contained
within the gut (70%)
• Vitamins/minerals cofactors for enzymatic reactions and
metabolism, etc.
• Nutrients are precursors for neurotransmitters
• The greatest concentration of serotonin, 90%, is found in
the GI tract
The Health of the GI System Determines
Function of Body
From Lisa Lewis, Ph.D.
©Julie Matthews, CNC 2007
How Diet Can Help Support Digestion & Biochemistry
•
Leaky Gut and Gut Inflammation
– Remove foods that inflame gut
– Add foods that heal the gut
– Add foods that supply beneficial bacteria
•
Nutrient Deficiencies
– Increase the quality of food and digestibility
•
Yeast Overgrowth
– Remove sugars
– Remove starches
– Add probiotic-rich foods
•
Toxicity and Poor Detoxification
– Avoid food additives
– Avoid toxins in food supply and meal preparation
•
Faulty Methylation and Sulfation
– Remove phenolic foods
– Improve methylation and sulfation through supplementation
©Julie Matthews, CNC 2007
Symptoms Diet May Improve
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Ability to focus
Eye contact
Aggression
Gastrointestinal problems
Language
Sleep difficulties
Toilet training
Rash or eczema may improve
Behavior
From Lisa Lewis, Ph.D
©Julie Matthews, CNC 2007
Autistic Spectrum Disorders
are caused by
genetic predispositions combined
with environmental factors
that create
disordered biochemistry and
damaged organs & systems.
©Julie Matthews, CNC 2007
INITIAL STEPS
Holistic Nutrition Approach
#1
Cleaning up
the Diet
#2
Cleaning up
the Home
#3
Supplement
Basics
#4
Diet Basics
#5
Beginning an
ASD Diet
#6
Removing Food
Intolerances
Q uickTim e™ and a
decom pr essor
ar e needed t o see t his pict ur e.
MOVING FORWARD
Q uickTim e™ and a
decom pr essor
ar e needed t o see t his pict ur e.
©Julie Matthews, CNC 2007
#7
Evolving the diet:
Nutrition Boosters
#8
Refining the
ASD Diet
#9
Cleaning up
the Gut
#10
Supplement
Specifics
#11
Immune
Support
#12
Detox
From Nourishing Hope
Nutrition Basics
Macronutrients:
Fats, Protein,and Carbohydrates
©Julie Matthews, CNC 2007
Unhealthy Ingredients to Avoid
• Artificial colors/flavors and preservatives
• MSG (hydrolyzed protein, yeast extracts)
• Pesticides
• Aspartame and other artificial sweeteners
• Trans fats (hydrogenated fat)
• Excessive/Refined Sugar
• Nitrates/nitrites (bacon, hotdogs, lunch meat)
©Julie Matthews, CNC 2007
A Healthy Diet
• Whole foods
• Unprocessed
• Organic
• Fermented foods: rich in probiotics
• Grass-fed/pastured meat and eggs
• Good fats
• Free of food intolerances
©Julie Matthews, CNC 2007
Fats
• Brain development and brain function
• Hormone balance and mood
• Formation/fluidity of cell membrane
• Creating energy in cell and helps burns fat
• Reduces inflammation
Supplement with vitamin E to prevent oxidation of fats.
Omega 3
Omega 6
Omega 9 Saturated Fat
Borage oil (GLA)
Evening
primrose oil (GLA) Olive oil
Fish oil or
Black currant oil (GLA)
cod liver oil
Avocado
Nuts/seeds
and
their
oil
Flax seed oil
Nuts/seeds
Hemp seeds/oil (GLA)
DHA and EPA
Grapeseed oil
supplements
AVOID Vegetable oil:
canola, safflower, corn,
soy oils
©Julie Matthews, CNC 2007
Coconut oil
Palm/Red Palm
oil
Animal fats Р
ghee/dairy,
bacon
Fats
• 30+% Many children - 40% or more.
– Breast milk is 53% fat (25% saturated).
• Proceed slowly - not everyone can digest fats well.
Problematic for those with:
– High oxalates
– Gallbladder/bile imbalances
– Enzyme insufficiency
• Signs of poor fat digestion
– Stool light tan or gray in color, large in volume.
Sometimes stool will float. Malodorous flatulence.
©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
©Julie Matthews, CNC 2007
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
Benefits of Cholesterol
• Brain development and 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
and egg yolks from grass-fed animals
• Vitamin D - Cod liver oil; lard, butter
and 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
©Julie Matthews, CNC 2007
Variety and quality
are the keys to
fat intake
©Julie Matthews, CNC 2007
Animal Fat (Grass-fed)
is High in Vitamins A and D
Vitamin A
• Protein assimilation
• Calcium absorption
• Proper growth and healing
• Speech/language
• Vision
• Proper function of the glands
• Thyroid function
• Immune system function
• Production of stress and sex
hormones
©Julie Matthews, CNC 2007
Vitamin D
• Healthy bones
• Proper growth
• Mineral absorption
• Muscle tone
• Immune system function
• Healthy nervous system
• Cell function
• Insulin production
• Reproduction
Animal Products
- Quality is essential
Grass-fed/pastured
•Rich in DHA (brain
development)
•Rich in Vitamin A
•Rich in Vitamin D
•Higher in CLA
•Higher in Tryptophan (sleep
and mood)
*Organic is not necessarily
grass-fed
©Julie Matthews, CNC 2007
Commercial
•Unhealthy animals unhealthy food
•Inflammatory grains create inflammatory food
•Low in Vitamins A and D
•Low in anti-inflammatory
fats
•Higher in arachidonic
acid (inflammatory)
Consider RAW Dairy
• PASTEURIZED Dairy - Inflammation and gut reaction
– Casein molecule altered
– Lectins (grain-fed milk)
• Raw dairy is not for everyone - however some who cannot tolerate
pasteurized dairy can consume raw dairy
• Use with SCD - homemade 24-hour raw milk yogurt
• Raw butter - very little casein
• Fatty acids (such as butyric acid)
– Nourish brain and intestinal lining
– Antimicrobial properties
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Phosphatase - calcium absorption
Enzymes for digestion
Natural probiotics
Milk fat reduces asthma
©Julie Matthews, CNC 2007
See RealMilk.com
Information & Sources
Protein
• Protein (essential amino acids) building blocks for:
– Muscle and tissue growth and repair, neurotransmitters,
immune responses, enzymes, detoxification
• Bio individuality - amounts vary.
• Some children cannot process protein well:
– High ammonia, low HCl, low zinc, B6, or iron
Signs of protein deficiency: Stunted growth,
lack of appetite, edema, suppressed
immune system, muscle wasting,
anxiety, sparse hair, dry skin
©Julie Matthews, CNC 2007
Avoid Soy
• Not good substitute for dairy
• Very difficult to digest
• Irritate the gastrointestinal tract
• Blocks absorption - calcium, magnesium, iron, copper
and especially zinc - due to phytic acid and oxalates
• Blocks thyroid function
• Endocrine disruption in the reproductive hormones of
both males and females
©Julie Matthews, CNC 2007
Note on Vegetarian Diets
• When eggs (and dairy) are not tolerated, protein
becomes limited
• When nuts and beans are not tolerated, protein intake
becomes even more limited
• Grains, nuts, beans, and other starches - inflammatory
to the gut.
• Difficult to be vegetarian with some diets, as meat is
relied upon with SCD and other diets.
• Can be difficult to get enough protein
–Eat eggs if tolerated
–Free form amino acids (5 grams amino acids = 30
grams dietary protein)
©Julie Matthews, CNC 2007
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
– 4-5 grams per serving (1 teaspoon “sugars”) = 2 oz fruit juice, 2 tsp
dried fruit, 1 TBSP ketchup
– Keep to 4 servings/day
• Sugar cravings - Yeast overgrowth, stress/anxiety
(sensory sensitivity), and blood sugar imbalances All
grains problematic for some
• All starches & sugars (except monosaccharides)
problematic for some (SCD)
©Julie Matthews, CNC 2007
Diet Options
©Julie Matthews, CNC 2007
Diet Options to Choose From
ASD Diet Options
ARI Survey Results
parents’ reporting noticeable symptomatic improvement
GFCF (Gluten-free and Casein-free)
No gluten (wheat, rye, barley, spelt, kamut, and oats)
or casein (dairy)
GFCF - 65% 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 – 49% improved
No Chocolate – 49% improved
No Sugar – 48% improved
Rotation Diet – 49% improved
Feingold Diet/Low Phenols
Restricts high phenolic foods, including all artificial
ingredients and high salicylate fruits
54% - improved
SCD (Specific Carbohydrate Diet)
Restricts carbohydrates to only fruits, non-starchy
vegetables, and honey. No grains, starchy
vegetables, or mucilaginous fibers
SCD - 66% improved
Candida Diet – 54% improved
Body Ecology Diet
Anti-yeast diet combining principles of anti-yeast diets
including no sugar, acid/alkaline, fermented foods
Nourishing Traditions/ Weston A. Price
Good quality fats, soaking and fermenting for digestion
Low Oxalate Diet
Restricts high oxalate foods (nuts, beans, greens)
©Julie Matthews, CNC 2007
Selecting a Diet
Foundational Diets
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GFCF – Start here. 65% improved.
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Specific Carbohydrate Diet – For bowel
inflammation, diarrhea, gut dysbiosis that is not
improving. 66% improved.
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Body Ecology Diet – For yeast overgrowth
•
Weston A. Price - Not ready to eliminate foods
yet. Focus on nourishment.
©Julie Matthews, CNC 2007
Additional Diets
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Food Sensitivities. Elimination and Rotation
Diets.
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Feingold/Phenols – For red cheeks, red ears,
hyperactivity/fatigue, irritability, aggression
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Low Oxalate Diet – For pain (body or GI),
urinary incontinence, pain, or irritation,
constipation or diarrhea not relieve by SCD,
continued stimming after meals, poor growth
©Julie Matthews, CNC 2007
Nutrition Boosters
Grandma
knew best
Foods and preparation methods that
increase nutrient density and digestibility
©Julie Matthews, CNC 2007
Nutrients Needed for Pathways
©Julie Matthews, CNC 2007
Helpful Supplements
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Digestive Enzymes
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Probiotics
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Cod liver oil/fish oil/EFAs
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Magnesium
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Calcium
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Zinc
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B6
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Vitamins A, C, and E
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CoQ10
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Glutathione/NAC
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Methylation: B12, folinic or 5MTHF, TMG/DMG
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Transfer factor
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Amino acids
©Julie Matthews, CNC 2007
Nutrient-dense Foods
• Sweet potatoes: beta carotene, vitamin C, magnesium, fiber
• Leafy greens: calcium, vitamin C, folic acid, beta carotene, magnesium, iron
• Whole grains: selenium, vitamin E, magnesium, B6
• Nuts and seeds: calcium, magnesium, iron, zinc, B6, vitamin E, folic acid
• Beans and legumes: folic acid, B6, zinc, iron
• Blackstrap molasses: iron, magnesium
• Organic liver: iron, vitamin C, B12, folic acid, beta carotene, vitamin A
• Hemp seeds: GLA, omega-3, vitamin E, L-arginine. All essential amino acid.
• Nettles (can make a tea ): calcium, magnesium, potassium, iron, antioxidants
• Kombu and seaweed: calcium, magnesium, iron
• Eggs, from pastured hens (if not sensitive): B12, vitamin A, B-vitamins,
vitamin D, vitamin E, selenium, calcium, iodine, zinc, iron, choline
• Animal protein and fats (grass-fed): Vitamin A, vitamin D, DHA, tryptophan
©Julie Matthews, CNC 2007
Good ways to Boost Nutrient Levels
• Cook and puree orange vegetables (or any). Freeze in ice
cube trays and add to smoothies
• Cook and puree any vegetables and add to meatballs,
meat patties, meatloaf, or pasta sauce
• Cook allowable grains or gluten-free pasta in homemade
broth
• Nettles can be consumed as a tea, or added to a
homemade broth
• Seaweed - Add kombu or other sea vegetable to cooking
grains, soups, tomato sauce, even boiling pasta
©Julie Matthews, CNC 2007
Juicing
• Higher concentration of nutrients
– Chlorophyll and phytonutrients
• Get nutrients without needing to eat/chew vegetables
• Children that like liquids, juices and smoothies
Start with
Add as you evolve taste
Go cautiously (high sugar)
•Cucumber
•Celery
•Fennel
•Ginger
•Lemon
•Green apples
•Parsley, cilantro
•Kale or other greens
•Cabbage (ulcers)
•Cranberries
•Carrot
•Beet
•Fruit: Apple, pear
 Add vegetable juice to smoothies. Add a bit of fruit to vegetable
juice for flavor or added sweetness
 Add supplements to vegetable juice (instead of fruit juices)
©Julie Matthews, CNC 2007
Soaking “seeds” – easy to do
Grains, nuts, seeds, beans
• Increases digestibility
• Reduces inflammatory response
• Breaks down phytic acid and oxalates
• Fermenting grains breaks down lectins
Grains - Soak in water for 8-24
hours with 2 TBSP lemon juice
or vinegar. Drain and cook
with fresh water.
Nuts - Soak in water (with or w/o
salt) for 7-12 hours. Drain and
refrigerate, use to make nut milk,
or drain and dehydrate
(eat or make nut butter)
Beans - Soak in water for 8-24 hours with hearty pinch
of baking soda. Drain and cook with fresh water.
©Julie Matthews, CNC 2007
Fermented Foods – Rich in Probiotics
Functions of good bacteria
– Regulate peristalsis and bowel movements
– Break down bacterial toxins
– Make vitamins needed and utilize: B1, B2, B3, B5, B6,
B12, A and K
– Digest protein into amino acids (for use by the body)
– Produce antibiotics and antifungals
– Help breakdown sugars, lactose, and oxalates
– Support immune system and increase number of immune
cells
– Balance intestinal pH
– Protect against environmental toxins: mercury, pesticides,
pollution
Raw fermented foods contain billions of bacteria/serving!
©Julie Matthews, CNC 2007
Fermented Foods – Rich in Probiotics
Dairy-free:
• Raw sauerkraut
• Beverages (contain yeast that kills candida):
• Kombucha
• Coconut juice kefir
• “Sodas” (hibiscus/rosehip tea with kefir starter)
• Nut milk yogurt
Dairy: Milk-based yogurt/kefir
©Julie Matthews, CNC 2007
Homemade
Bone & Vegetable Broths
• Grass-fed/pastured chickens or beef bones
– Add 2 Tablespoons of vinegar - increases the
calcium and magnesium
• Vegetables, seaweed, greens, nettles
• Nutrient dense, easy to assimilate nutrients
– trace minerals, amino acids, calcium, magnesium,
potassium, iron
Cook grains, soups, and/or pasta in broths nutrients will absorb into food
©Julie Matthews, CNC 2007
Grandma
knew best
Bone Broths and Gelatin
Bone broth contains gelatin:
• Gelatin’s colloidal properties aid digestion of all foods
• Glycine: Sleep, detox environmental toxins,
component of glutathione, improves gastic acid
secretions and protein digestion
• Proline: Formation of connective tissue: skin, gut,
ligaments
• Broken down by DPPIV
• Free glutamate - potentially problematic for
glutamate sensitive children
©Julie Matthews, CNC 2007
Water and Salt
• Purified Water
– Avoid tap water, fluoridated and chlorinated water
– Get a water filter (point of entry, reverse osmosis, carbon block or
ionic - not Brita). Avoid bottled water (plastic and transportation).
• Nutritive Salt
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Salt cravings - sign of nutrient deficiencies
Avoid stripped white “table salt” - may contain aluminum
Choose nutritive salt with trace minerals
Celtic Sea Salt or Himalayan crystal salt
• Sole - water and salt combine to make minerals ionic
– They are highly absorbable, alkalizing, and help with elimination
– Add 1 tsp to 8 oz glass of water
– See Water and Salt, by Handel and Ferreira
©Julie Matthews, CNC 2007
Beginning and Evolving a Diet
©Julie Matthews, CNC 2007
Begin by
Removing Artificial Ingredients
 Avoid trans fats (hydrogenated oil, fried foods,
margarine, mayo, commercial peanut butter)
 Avoid artificial sweetener & high fructose corn syrup
 Avoid artificial ingredients (artificial colors, flavors, and
preservatives)
 Avoid MSG (hydrolyzed vegetable/soy protein,
autolyzed yeast, yeast extract, natural flavors)
 Avoid Nitrates/nitrites
©Julie Matthews, CNC 2007
Eliminate Foods, Additives and
Factors that Irritate the GI Tract
 Food intolerances (IgG test and LEAP test)
 MSG
 Carageenan
 Olestra
 Lectins, oxalates and phytates from “seeds”(grains
even non-gluten, bean, nuts, seeds)
 Yeast, antibiotics, and some medications (NSAIDS)
©Julie Matthews, CNC 2007
Avoiding Toxins in the Kitchen
Toxins Around the Kitchen
Safer Cooking Alternatives
Avoid aluminum cans
Buy in glass
Avoid storing in plastic
Store in glass w/metal or plastic lid
Avoid Teflon, copper, and
aluminum pans
Use stainless steel (attracts a
magnet), cast iron or enameled
cast iron
Avoid the microwave, do not
reheat in plastic
Heat in oven or on stove
Avoid plastic wrap & aluminum foil
Use wax paper or glass with lid
©Julie Matthews, CNC 2007
For Picky Eaters
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Always provide food child likes in addition to "new" food.
Only offer one new food at a time.
Include small portion of new food and serve everyone at the table.
Involve your children in food preparation of "new" food.
Small taste ~ 1/2 teaspoon. Let child determine amount.
Inform them. Let child know whether it is sweet, salty or sour.
Let them spit it out.
If at First You Don't Succeed, Try and Try Again! At least 15 times!
Try new food in a texture they prefer - crunchy, smooth, etc.
Avoid being emotionally “attached” - children sense anxiety.
– Keep mealtime calm. Visualize child eating/enjoying new foods.
• Avoid forcing or pushing - maintain trust.
• Choose rewards or other encouragement.
• Make sure the whole family participates.
• Make
©Julie Matthews,
CNC 2007 it fun!
Evolving the Diet
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Involve the family as much as possible
Remove known food allergens: peanuts, etc.
Begin to add nutrient dense whole foods
Add fermented foods
Introduce new GFCF substitutes before removing
familiar gluten/casein foods
• Implement GFCF (or other foundational diet) for 3-6
months
– Regardless of test results
– Begin with casein-free, then gluten-free
• Determine other food sensitivities
– Based on dietary challenge testing (and/or lab results)
– Be careful not to substitute soy (for dairy) and corn (for gluten)
– often equally problematic
©Julie Matthews, CNC 2007
Chart Progress and Further Refine
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Correlations not always clear - Keep diet record.
Add one food at a time - Take note.
Avoid changing foods & supplements simultaneously.
Watch for symptoms or regression:
– Sometimes a “regression” is actually a sign of healing, i.e. removal
of gluten/casein may cause opiate withdrawal
– However, sometimes a new food substitution (corn) is problematic
and needs to be removed
• Look for improvement
• See what’s remaining, and consider additional diets/dietary
intervention. Changing the diet or layering diets.
• Seek help from a nutrition consultant or qualified
practitioner/physician
©Julie Matthews, CNC 2007
NourishingHope.com
Book • Website • Radio Show • Community
For food sources, diet resources, and scientific references
Contact Julie at:
[email protected]
www.NourishingHope.com
415-437-6807
©Julie Matthews, CNC 2007