Autism is one disease where there is a very high ‘inherited’ component. In studies with genetically identical twins, if one twin has it, the odds of another having a diagnosis is about 60%. But not all this is ‘in the genes’ since we share the same ‘environment’ as our siblings.
Perhaps the more interesting question is why the number of children diagnosed with Attention-deficit /hyperactivity disorder (ADHD), autism and other neurodevelopmental disorders classifying them as ‘neurodivergent’, has rocketed in both the UK and US. One in six children is ‘neurodivergent’ as autism numbers quadruple. The graph below shows US figures. These parallel UK figures (see here) which show that just under 1.5 million pupils in England have special educational needs which is one in six children. Autism is the biggest part of this, has been steadily rising in both the Uk and US.
“Now, one in six children in the US are classified as neurodivergent and one in 36 as autistic – a fourfold increase in 20 years.” says pediatric Professor Alessio Fasano from Massachusetts General Hospital for Children, Harvard Medical School.
According to Dr Rona Tutt OBE, past president of the UK’s National Association of Head teachers “There has been a dramatic increase in the number of people being diagnosed with ASD. Although some of this is due to a broader definition of autism as well as better diagnosis, it raises the question of whether it may also be the result of environmental changes, which have also been dramatic.”
Some UK schools are reporting as many as one in four children having problems.
Since the genes cannot have changed this rapidly, the increase points to the influence of environmental factors of which there are many candidates. The main suspects are:
World-renowned pediatric gastroenterologist, and research scientist Professor Alessio Fasano, MD, directs the Center for Celiac Research and Treatment at Massachusetts General for Children thinks something is going wrong in the gut, with many ASD children reporting gut problems including diarrhoea, constipation, belching and excessive flatulence and ‘dysbiosis’ – abnormal patterns of gut bacteria. In some children, wheat and milk may contribute to these symptoms. His research finds that neurodivergent children show high levels of ‘zonulin’, a family of proteins that regulate the barrier between intestinal cells in the digestive tract that can lead to “leaky gut.” ASD children are often found to have opioid-like wheat and milk proteins in their urine, making these foods especially ‘addictive’.
Professor Michael Crawford, who heads the Institute of Brain Chemistry and Human Nutrition at the Chelsea & Westminster Hospital says “We can predict which babies are going to have developmental problems from the fats in the mother’s blood. When omega-3 levels are low, the mother produces a non-functional ‘brain fat substitute’ to build their baby’s brain during pregnancy, high levels of which predict problems. The brain is 50% fat, and omega-3 DHA should make up most of the structural fat in brain cells.” Less than 5 per cent of children in the UK achieve the basic dietary recommendations for omega-3 and fish.
Vitamins may help. ‘A high level of homocysteine, a marker for B vitamin deficiency, predicts ASD and studies have shown that giving homocysteine-lowering vitamin B6, B12 and folate help reduce symptoms.” says Patrick Holford from the Food for the Brain Foundation, which is hosting the masterclass. “Vitamin A improves eye coordination and vision, helping those with autism who don’t look you in the eye and have visual problems.”
A 12-month randomised controlled trial giving omega-3, vitamins, digestive enzymes and a healthy gluten-free, casein-free diet showed major improvement in both autistic symptoms and raising IQ.
Nutrition and functional medicine therapist Anne Pemberton, who specialises in helping those with ASD, is also speaking at the conference, reports considerable success, not just by improving nutrition but by addressing the psychological and social circumstances of neurodivergent children. “It is critical to work with both mother and child, and not only address critical nutritional issues, stress triggers including early life traumas, and suppressed emotions as a result of their condition and conditioning, and to help them develop a sense of self and mindset. I have seen hundreds of children and adults who usually have major improvements. Peter, age 8, is a case in point. He was diagnosed with ASD and classified as needing special education. 15 months later he’s no longer even classified as ASD.”
So, as you can see, there are many layers to Autism and Neurodivergence. This is why we are running an in-depth Masterclass with some of the aforementioned experts so that you can learn how to support your own brain or those around you who experience this.
This masterclass is perfect for practitioner, parent, caregivers or anyone who wants to understand more about this area.
Attention Deficit and Hyperactivity Disorder (ADHD) is a condition that relates to a collection of behavioural symptoms such as hyperactivity, impulsiveness and inattentiveness. It is most commonly diagnosed in childhood between the ages of 6 and 12 when disruptive behaviour begins to show, however, due to a growing awareness of the condition, it is also becoming common among adults. According to the thinktank Demos, the cost of undiagnosed ADHD in adults in the UK, who are unable to work or hold down a full-time job, are estimated to cost billions of pounds to the nation. They warn that too many may be going through life struggling, unable to access the support or diagnosis they need, which means there could be a huge amount of wasted talent.
The most common front-line of treatment for ADHD is medication and cognitive behavioural therapy (CBT). Prescriptions for ADHD drugs such as Ritalin, have doubled to 922,000 a year in the last decade, and whilst it offers symptom management for many, it has also been found to have significant negative side effects such as weight loss, liver toxicity, and suicidal thoughts, and in the short term may suppress pubertal growth. The aetiology of ADHD is multifactorial, meaning that there are varying influencing factors that drive the symptoms. This is perhaps why this condition has been hard to study and find effective treatment for.
A key area that has been widely researched is the link between the microbiome (bacteria) in the gut and the brain. The hypothesis is that alterations in bacteria due to changes in our environment such as increased hygiene, increased exposure to antibiotics, refined and processed foods and stress, have led to disturbances in short-chain fatty acids (SFCAs), which are byproducts of fermentation in the gut when bacteria come into contact with indigestible fibre found in food.
One SCFA in particular, called propionic acid, has been identified as a driver for abnormal behaviour that is related to both ADHD and the autism spectrum. This SCFA can alter metabolic and immune pathways, as well as gene expression, which can affect the functionality of the brain cells and their receptivity to neurotransmitters, as well as their ability to regenerate and regulate inflammatory responses. Certain strains of pathogenic bacteria, such as clostridia, have been implicated in producing large amounts of propionic acid. This strain of bacteria is naturally present in the gut, however, an overgrowth can occur when good bacteria levels are compromised and/or there is an acute infection. In addition, processed wheat and dairy products often contain propionic acid as a food preservative in the form of calcium propionate.
Other SCFAs such as butyrate, are well known for having health-promoting properties, such as producing anti-inflammatory effects by being able to regulate T-cells (immune cells) in the colon, as well as helping to maintain a healthy gut barrier function. In order to increase the favourable, health-promoting SCFAs, such as butyrate, it’s important to increase the intake of vegetables, fruits and good fats such as grass-fed butter, coconut oil, nuts and seeds, olive oil and avocado. These provide food for gut bacteria to feed on, also known as prebiotic fibres. Foods such as those listed above, contain the right nourishment for gut bacteria to produce SCFAs that support health. Eating traditional foods such as fermented cabbage and other vegetables, as well as bone broth, are also rich in prebiotics and nutrients that support a healthy microbiome and digestive system.
Exposure to toxins and heavy metals has also been implicated in the aetiology of ADHD. Research shows that significant childhood exposure to heavy metals and chemical compounds promotes neurodevelopmental toxicity and may be one of the underlying drivers of behavioural disorders among children.
For example, prenatal exposure to phthalates, which are chemical compounds that are commonly added to plastics to increase their durability and flexibility, have been linked to behavioural abnormalities, characterised by shortened attention span and impaired social interaction. Phthalates are an extensive group of chemicals, and whilst not all of them have been studied, several have shown to have negative health impacts. This class of chemicals is found abundantly and can find their way into food packaging, cosmetics and household cleaners – making them virtually impossible to avoid. However, a growing awareness about the potential negative impact on health has led to the production of phthalate-free cosmetic and personal care products, as well as cleaning products. It may, therefore, be a significant step to try to avoid these chemicals by choosing products wisely, as well as trying to buy vegetables, fruit etc that haven’t been wrapped in plastic.
Mercury exposure is among several other heavy metals, such as lead, aluminium and cadmium, that have been implicated in the aetiology of ADHD. Childhood exposure to mercury is predominantly through the consumption of seafood, dental amalgams and vaccines containing thimerosal. The reason why mercury can be so problematic, as well as other metals, is that it is capable of breaching the blood brain barrier. This is the brain’s ‘high fortress’, an intelligent gateway system that filters through molecules that are needed in the brain such as cells, nutrients and signalling molecules, and filters out pathogens and toxins.
Mercury, as well as other heavy metals such as lead, can accumulate in brain tissue, as well as in the spinal cord, as they are fat-soluble. This means that they can hide themselves in fat tissue, abundant in both the brain and the spine. Once there, they can induce an inflammatory process called oxidative stress, displace important nutrients for brain health, such as zinc and iron, which are essential for neurotransmitter production.
An important dietary step to avoid heavy metal toxicity is choosing seafood and fish that has reduced levels of exposure. The Seafood Watch web page is a fantastic resource that has an extensive list of fish, seafood and sushi products that are safe, as well as those that are best to stay away from. For example, choosing wild pacific caught salmon is safer than Atlantic caught salmon.
The body has its own inherent detoxification pathways that are responsible for packaging and removing heavy metals safely from the system. For example, glutathione is known as the body’s ‘master antioxidant’ and aside from playing an important role in preventing free radicals from causing damage to the body’s cells, it also helps to bind to heavy metals and remove them from the body. Research shows that glutathione levels are lower than normal in those on the autism spectrum, so enhancing levels through the diet may be an effective way to prevent the accumulation of heavy metals. Consuming sulfur-rich foods such as broccoli, cabbage, onions, garlic, kale and cauliflower can boost glutathione levels, as well as milk thistle, which has unique flavonoids that also support glutathione production.
Most water filters on the market only filter out bacteria, parasites and organic compounds. There is a different method to filter out heavy metals, so make sure it explicitly says it does. The reverse osmosis method seems to be the most effective and can be integrated into the kitchen tap.
As mentioned above, eating foods that are rich in indigestible fibre such as vegetables and fruits, as well as eating good fats that are found in grass-fed butter, nuts and seeds, olive oil, coconut oil and avocado, provide bacteria with prebiotics that help to produce the ‘friendly’ short-chain fatty acids, such as butyrate. Avoiding processed foods that contain calcium propionate, which lead to higher levels of propionic acid – the not so friendly short-chain fatty acid – is also another key strategy to support the gut-brain link.
There are many more steps to help support the optimal functioning of the brain and therefore encourage improved learning and development. However, another key strategy to support brain health is to increase intake of omega 3, an essential fatty acid, that is most abundantly found in oily fish such as salmon, mackerel and sardines. Be sure to choose salmon that has had less exposure to polluted water – visit the Seafood Watch web page to find the best sources. Omega 3 is vital for the brain’s function, particularly one of its components called DHA. This is a key building block for the brain and is what keeps neurons (brain cells) working well and supports proper signalling via neurotransmitters.
Lastly, this may seem like a no-brainer, however, avoiding refined sugar and processed foods at all costs is essential for managing ADHD symptoms. These foods have a negative impact on blood sugar levels, which consequently affect mood and concentration.
Sign up to our mailing list
Receive educational articles and latest information on events, campaigns and research
This study investigated omega 3 & ADHD. For the first 15 weeks, 200 children were given either the combination (PS-Omega3) or a placebo in a double-blind fashion (meaning that no-one involved in the trial knew who was getting the active supplement and who was getting the placebo). One-hundred and fifty children continued taking part in the trial for a further 15 weeks which was now open-label (all the children received the active supplement and all involved knew this was the case). At the beginning and at the end of the study period a number of assessments were made of the children’s ADHD symptoms such as restlessness, impulsivity, and hyperactivity using standard, validated questionnaires. These showed improvements in the children on the active supplements compared to those on placebo. Improvements were also noted in the children who were initially taking the placebo when they were switched to the active intervention for the second 15 weeks.
Manor I, Magen A, Keidar D, Rosen S, Tasker H, Cohen T, Richter Y, Zaaroor-Regev D, Manor Y, Weizman A. (2011) The effect of phosphatidylserine containing Omega3 fatty-acids on attention-deficit hyperactivity disorder symptoms in children: A double-blind placebo-controlled trial, followed by an open-label extension. Eur Psychiatry. Jul 30. [Epub ahead of print]
Click here for abstract
Further infoThis study investigated omega 3 & ADHD. This Canadian study compared dietary intake and blood levels of essential fats in adolescents with and without ADHD. They found that despite a similar level of intake, the adolescents with ADHD had lower levels of all omega-3 essential fats and DHA in particular, and higher levels of omega-6 essential fats. Also, those with the lowest levels of omega-3’s scored the worst on behavioural tests.
Colter A L et al. ‘Fatty acid status and behavioural symptoms of attention deficit hyperactivity disorder in adolescents: a case-control study.’ Nutr J. 2008 Feb 14;7:8
Further infoThis study investigated nutrition & ADHD. A recent review of the current evidence for using diet to help manage ADHD in children concluded that a simple, healthy diet which was low in unhealthy fats and high in fruits, vegetables and fibres may work best. They found that ‘junk food’, fizzy drinks and ice-cream are probably the worst for affected children. They also found some evidence for the benefits of omega-3 and omega-6 essential fat supplementation.
Their review considered a range of other dietary interventions but weren’t able to come to any solid conclusions. This is most likely because of a lack of quality studies to review and the complications of studying dietary changes in children – it’s very difficult to study dietary changes in a double-blind, randomised, controlled fashion where the researchers, subjects and their parents don’t know who is eating the modified and diet and who isn’t, thereby making it impossible to rule out the placebo effect.
Millichap JG, Yee MM (2012) The Diet Factor in Attention-Deficit/Hyperactivity Disorder. Pediatrics. Jan 9. [Epub ahead of print]
Click here for the abstract
Further infoThis study investigated fatty acids & ADHD. Two studies were conducted to determine whether physical signs of fatty acid deficiencies such as dry hair and skin, frequent thirst and urination were a good indicator of whether fatty acid supplementation could potentially improve ADHD symptoms in children both with ADHD and those without the disorder. It was found that the physical symptoms of deficiency did not reliably predict which children would have behavioural benefits from supplementation.
Sinn N.’ Physical fatty acid deficiency signs in children with ADHD symptoms’. Prostaglandins Leukot Essent Fatty Acids. 2007 Aug;77(2):109-15
Further infoThis study investigated food intolerance & ADHD. Researchers from Holland’s Radboud University set out to answer this question by placing 100 children between the ages of 4 and 8 on a restricted diet containing only rice, meat, vegetables, pears and water, therefore free of all gluten and casein. ADHD symptoms were reduced in 78 per cent of children placed on the diet. “We think that dietary intervention should be considered in all children with ADHD, provided parents are willing to follow a diagnostic restricted elimination diet for a five-week period, and provided expert supervision is available,” said the authors. An alternative strategy is IgG food intolerance testing.
Further infoThis study investigated fatty acids & ADHD. The study was a double-blind, placebo-controlled, randomised trial involving 132 children with ADHD. Significant medium to strong positive treatment effects were found on parent ratings of core ADHD symptoms, inattention, hyperactivity/impulsivity, on the Conners Parent Rating Scale (CPRS) in both PUFA treatment groups compared with the placebo group; no additional effects were found with the micronutrients. After a one-way crossover to active supplements in all groups for a further 15 weeks, these results were replicated in the placebo group, and the treatment groups continued to show significant improvements on CPRS core symptoms. No significant effects were found on Conners Teacher Rating Scales.
N Sinn, ‘Effect of supplementation with polyunsaturated fatty acids and micronutrients on learning and behavior problems associated with child’ Journal of Developmental & Behavioral Pediatrics, 28(2); 82-91, 2007
Further info
