Nutrition Intervention for Autism Spectrum Disorders

1. Nourishing Hope Nutrition Intervention for Autism Spectrum Disorders Parent’s Listen Speaker Series Ryerson University - Toronto, Ontario December 1st, 2007 Julie MatthewsCertified Nutrition Consultant Trudy Scott - Research Assistant

2. The food we feed a child has significant impact • Background and Biochemistry • Nutrition Basics • Diet Options • Nutrition Boosters • Beginning & Evolving a Diet

3. What is Autism and Autism Spectrum Disorder (ASD)? Autism, PDD, Asperger’s Syndrome, ADHD • Social: Not playful, avoids eye contact • Communication: Not use gestures, receptive and expressive language poor • 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

4. 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)

5. Biochemistry ©Julie Matthews, CNC 2007

6. Affects of Faulty Sulfation ©Julie Matthews, CNC 2007

7. Brain is Downstream Yeast toxins Undermethylated neurotransmitters Brain inflammation Increased toxicity Nutrient deficiencies Opiates Complex and InterrelatedWhole Body Disorder

8. 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.

9. 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 Feeling Better >>> Learning Better

10. Symptoms Diet May Improve • Ability to focus • Eye contact • Aggression • Gastrointestinal problems • Language • Sleep difficulties • Toilet training • Rash or eczema may improve • Behavior From Lisa Lewis, Ph.D

11. Autistic Spectrum Disordersare caused by genetic predispositions combined with environmental factorsthat create disordered biochemistry and damaged organs & systems. Nutrition affects this chemistry and the body

12. Holistic Nutrition Approach From Nourishing Hope

13. Nutrition BasicsMacronutrients: Fats, Protein,and Carbohydrates

14. 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)

15. A Healthy Diet • Whole foods • Unprocessed • Organic • Fermented foods: rich in probiotics • Grass-fed/pastured meat and eggs • Good fats • Free of food intolerances Quality is Key! ©Julie Matthews, CNC 2007

16. 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.

17. 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.

18. Vital Roles of Saturated Fat • 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 • 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

19. 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

20. Key Nutrients for Brain Development • Vitamin A - Cod liver oil; liver, butterand 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

21. Variety and quality are the keys to fat intake

22. Animal Fat (Grass-fed) is High in Vitamins A and D • Vitamin D • Healthy bones • Proper growth • Mineral absorption • Muscle tone • Immune system function • Healthy nervous system • Cell function • Insulin production • Reproduction • 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

23. Animal Products - Quality is essential ©Julie Matthews, CNC 2007

24. 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 • Phosphatase - calcium absorption • Enzymes for digestion • Natural probiotics • Milk fat reduces asthma See RealMilk.com Information & Sources

25. Signs of protein deficiency: Stunted growth,lack of appetite, edema, suppressed immune system, muscle wasting, anxiety, sparse hair, dry skin 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

26. 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

27. 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)

28. 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)

29. Diet Options

30. Diet Options to Choose From ©Julie Matthews, CNC 2007

31. Selecting a DietFoundational Diets • GFCF – Start here. 65% improved. • Specific Carbohydrate Diet – For bowel inflammation, diarrhea, gut dysbiosis that is not improving. 66% improved. • Body Ecology Diet – For yeast overgrowth • Weston A. Price - Not ready to eliminate foods yet. Focus on nourishment.

32. Additional Diets • Food Sensitivities. Elimination and Rotation Diets. • Feingold/Phenols – For red cheeks, red ears, hyperactivity/fatigue, irritability, aggression • 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

33. Nutrition BoostersFoods and preparation methods that increase nutrient density and digestibility Grandma knew best

34. Nutrients Needed for Pathways

35. Helpful Supplements • Digestive Enzymes • Probiotics • Cod liver oil/fish oil/EFAs • Magnesium • Calcium • Zinc • B6 • Vitamins A, C, and E • CoQ10 • Glutathione/NAC • Methylation: B12, folinic or 5MTHF, TMG/DMG • Transfer factor • Amino acids

36. 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

37. 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

38. Preparation tip • 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) Juicing • Higher concentration of nutrients • Chlorophyll and phytonutrients • Get nutrients without needing to eat/chew vegetables • Children that like liquids, juices and smoothies

39. 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) Preparation tip Beans - Soak in water for 8-24 hours with hearty pinch of baking soda. Drain and cook with fresh water. Soaking “seeds” – easy to doGrains,nuts, seeds, beans • Increases digestibility • Reduces inflammatory response • Breaks down phytic acid and oxalates • Fermenting grains breaks down lectins

40. 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!

41. 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

42. Preparation tip Cook grains, soups, and/or pasta in broths - nutrients will absorb into food HomemadeBone & Vegetable Broths Grandma knew best • 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

43. 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

44. 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 • 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

45. Beginning and Evolving a Diet

46. 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

47. 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)

48. Avoiding Toxins in the Kitchen ©Julie Matthews, CNC 2007

49. For Picky Eaters • 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 it fun!

50. Evolving the Diet • 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