Celiac Disease Presenting as Autism

The Journal of Child Neurology published a special article online June 29, 2009 (published ahead of printing) entitled “Celiac Disease Presenting as Autism.” The article is a case study of a 5-year-old boy diagnosed with autism and celiac disease.

The boy was described as “an increasingly picky eater and would reject food on the basis of taste, smell, or appearance.”  He had severe language problems, as well as gastrointestinal symptoms including bloating, belching, abdominal pain, nausea, vomiting, and diarrhea.  He had deficiencies in fat-soluble vitamins (vitamins A, D, and E) and fatty acids (omega 3, omega 6, saturated fat), as well as low coenzyme Q10 and folate.

Upon being assessed and diagnosed with celiac, the boy was put on a gluten-free diet and nutritional supplementation based on deficiencies.  "Fruits and vegetables were juiced to make nutrients easier to absorb, and fat-soluble vitamins, omega 3 fatty acids (in the form of cod liver oil), omega 6 fatty aids, and folic acid were given as supplements.”  According to the published article, "The patient's gastrointestinal symptoms rapidly resolved, and signs and symptoms suggestive of autism progressively abated." 

“Within 1 month, the boy’s gastrointestinal symptoms were relieved and his behavior had changed dramatically.  The mother excitedly reported that for the first time, her 5-year-old boy became progressively more communicative and told her that he loved her.  Within 3 months, his functioning had improve so much that he no longer required an individualized leaning program and was able to enter a normal classroom with no aide.”

The authors of the article postulate that nutrient deficiencies caused by malabsorption from celiac disease caused the symptoms of autism, as they stated, “This case is an example of a common malabsorption syndrome associated with central nervous system dysfunction and suggests that in some contexts, nutritional deficiency may be a determinant of developmental delay.  It is recommended that all children with neurodevelopmental problems be assessed for nutritional deficiency and malabsorption syndromes.”

Genuis SJ, Bouchard TP. Celiac Disease Presenting as Autism. J Child Neurology Online First. Published on June 29, 2009 as doi:10.1177/0883073809336127

Conference discusses whether diet can ‘heal’ autism

by Diane Rusignola
ORIGINAL POSTING

For the parents of children with autism, social and communicative symptoms are complicated with physical problems like constipation, diarrhea, digestive pain and gas. Can putting a child on a special diet really reduce or even eliminate autism though?

“We know that kids with autism have nutrient deficiencies,” said San Francisco-based Julie Matthews, a certified nutrition consultant and author of “Nourishing Hope for Autism,” at international nonprofit Autism One’s conference at the Westin O’Hare last weekend. “When we [develop] an autism diet, we want to focus on getting good nutrition in.”

Matthews recommends adding “foods that heal” and have probiotics to the diet of an autistic child, as well as removing foods that cause inflammation. As digestion improves, autistic children can “focus better when they’re feeling better,” and therefore language and sleeping irregularities can improve.

“The whole body works together,” agreed Chicago dietician Karen Benzinger, who did not attend the conference. “If one thing’s off, unfortunately it can throw something completely else off. The two are always going to be somewhat related, but you have to find the cause in order to help the effect.”

Benzinger suggests that parents have a dietician as a part of their therapy team, in addition to their primary care doctor, psychologist and any other specialists, in order to really evaluate a complete nutrition picture.

“Until you really get that full assessment of exactly what [your child is] eating and making sure that there are no other intestinal issues going on,” she said, “Then you really can’t start to eliminate things.”

Benzinger said keeping a complete food journal and having allergy testing done could be good initial steps as well.

Once parents have established their child’s individual needs, there are a variety of diets they can try out. Matthews said the gluten (wheat) free, casein (dairy) free diet is one of the most popular, as the reduction of these things in diet can help with impulsive behaviors, lack of focus and even speech problems, she said. Soy blocks the absorption of calcium, magnesium and zinc, so she recommends making it a soy-free diet as well.

Parents can learn more about each through Matthews’ Facebook group, which has over 1,200 members and 100 discussion topics.

“What does a good diet look like?” Matthews asked during her presentation. “It’s going to be whole [foods], unprocessed [and] organic whenever we can.”

One easy step parents can take to include necessary veggies in the diets of picky eaters is to puree them and add to sauces or muffin, pancake and meatball mixes, she said. For children with texture issues, she suggests starting them out eating carrot chips if they are only eating potato chips now.

“Get creative with the flavor and the texture and the presentation,” Matthews said. “It will really go a long way.”

Although it might be overwhelming to begin, parents can take solace in simple steps like soaking their seeds in water overnight, and other shared tips from experts like Matthews.

“Do one thing at a time,” she recommends. “Chart your progress and remember to get some support if you need it.”

Autism Diet Newsletter

Click the image to view Julie's recent Newsletter....

Autism Diets Overview: GFCF, SCD, Body Ecology, Weston A. Price, and more

Significant scientific data and overwhelming anecdotal analysis by thousands of parents indicate a link between Autism symptoms and diet. Gluten- (wheat) and Casein- (dairy) free has shown a 65% improvement rating as reported by Autism Research Institute (ARI) in a survey of thousands of parents; Specific Carbohydrate Diet (while a small sample of hundreds) has shown a 66% improvement.

The conclusions demonstrate that diet can have a significant effect on behavior, cognition, and autism/ADHD and their symptoms. DAN! (Defeat Autism Now!) practitioners believe that diet is the most important place to begin biomedical autism intervention.

The common symptoms reported to improved by diet are: stimming, language, attention, hyperactivity, learning, fatigue, aggression, self-injurious behavior, rashes, digestion, diarrhea, constipation, gas, and more. According to the parents polled by ARI, after mercury/heavy metal chelation, diet is the most effective intervention for children on the autistic spectrum – - more that any drug, nutrient, or other biomedical therapy.

Several dietary options exist for children and adults on the autistic spectrum. The best for a particular individual depends on many factors such as digestive capacity, bioindividuality, family history, symptoms and more. This section provides an introduction to each diet and has some specifics to assist you in choosing the best one for you.

For further information on choosing, implementing, or customizing a diet, pick up a copy of Nourishing Hope. Julie assists families from around the world by telephone and e-mail. Please e-mail for more information. DOWNLOAD a copy of a Daily Food/Mood Record and Daily Supplement Record sheet.

• GFCF: Gluten Free/Casein Free (Wheat/Dairy Free)

• Specific Carbohydrate Diet

• Feingold Diet/Phenols

• Body Ecology Diet

• Weston A. Price Diet

NIH Underscores Nutrition for Autism

Last week, The National Institutes of Health announced "Thin Bones Seen in Boys with Autism and Autis m Spectrum Disorder." They reference a new study and suggest that dairy-free diets may put boys with Autism Spectum Disorder (ASD) at "higher than normal risk" for thinner bones, and say a possible explanation is the lack of calcium and vitamin D in their diets. The study found that boys with ASD had thinner bones than boys without autism, and that ASD boys on a casein-free diet had the thinnest of all.

The researchers believe that there are several contributing factors, including lack of exercise, a reluctance to eat a varied diet, lack of vitamin D, digestive problems, and diets that exclude casein. This is true. Many children with autism have nutrient deficiencies, when parents do special diets with restrictions, such as dairy-free, parents need to account for any shortfalls.

However, I was disappointed that the NIH called casein-diets "a controversial treatment thought by some to lessen the symptoms of autism." Eliminating casein from the diets of children with autism has been proven 65% effective in reducing symptoms, as reported by thousands of parents (Autism Research Institute). I'd like to see the NIH pay more attention to parents' "front line" experience with autism diets, and fund more diet research.

Ultimately, the NIH news release underscores Nourishing Hope for autism, quoting Dr. Hediger who says it "would probably help if parents of children with autism consult with a dietitian during their children's routine medical care to make sure that their diets are balanced."  I certainly agree!  Proper nutrition is essential for children with ASD, and for those applying special diets, the advice of a practiced nutrition professional is helpful to ensure proper dietary balance including calcium, vitamin D, and other vital nutrients.

At a deeper level the article revealed more. It's encouraging that the NIH has finally acknowledged the issue of gut health in ASD children by saying, "...children with autism may have digestive problems which interfere with the absorption of nutrients." Further, they mentioned that because more outdoor supervision is needed, ASD kids don't spend as much time getting exposure to the sun and vitamin D.  These statements support the emerging understanding that ASD is more than a "psychiatric disorder" - it includes biochemical and physiological imbalances that can be addressed.

The path of recovery is encouraging.

Julie Matthews
Certified Nutrition Consultant