Special Autism Research and News Edition

Recent advances in the understanding and treatment of autism
Dietary and therapeutic strategies for inflammation in autism spectrum disorders
Specific biomarkers could facilitate ASD diagnosis

Fighting back with fat: the modified ketogenic diet and MCT oil for autism
PANDAS and PANS: The inflammatory aspect of autism
Picky eating: The relationship between sensitivity to touch and mouthfeel

Recent advances in the understanding and treatment of autism

Autism spectrum disorders are one of the biggest challenges of modern medicine and several theories have been proposed to explain how these conditions develop and how they can be treated.

In this new review, researchers from Tehran University highlight the following modern theories of ASD development:

• Impaired connection between the neurons – this could affect language function
• Misplacement of neurons during the antenatal period – this may disable further brain development
• Genetic mutation of the methyl CpG binding protein 2 gene – this could lead to impaired maturation of the synapses
• An excitation-inhibition imbalance which is essential for representation of sensory information and cognitive processes
• Alterations in the immune system, or increased intestinal permeability, causing oxidative stress and inflammation in the brain
• Maternal infection that can cause early immune dysregulation and contribute to ASD development

The researchers also highlighted the following evidence-based natural therapies and lifestyle recommendations:

• A gluten free casein free diet
• A modified ketogenic diet
• Vitamin B6, methylcobalamin, and folate
• Omega-3 fatty acids
• Exercise and animal assisted therapy
• Digestive enzymes

Dietary and therapeutic strategies for inflammation in autism spectrum disorders.

Brain development and function can be influenced by the environment, gut health, and diet in utero and after the child is born.

For instance, lab studies indicate that offspring of mothers who were obese during pregnancy were more likely to develop social communication impairment and repetitive behavior. Scientists explain that the low-grade inflammation caused by obesity could impair the brain’s neuronal circuit which controls behavior in the offspring.

Moreover, anything that adversely influences the development of the gut microbiome (such as the mode of delivery, stress, antibiotics, and diet) will also affect the gut-brain axis. Since gut microbes produce neurochemicals that play a role in social cognition, emotion, and behavior, improving the gut’s health during pregnancy could decrease risks of ASD in the offspring.

As such, this paper highlights promising adjuvant therapies for ASD include:

• A gluten-free and casein free diet – this free step-by-step guide can help you get started
• The specific carbohydrate diet
• A diet low in oxalates
• Adequate intake of micronutrients such as carnitine, zinc, selenium, vitamins A, D, E, and B-complex and omega-3s and omega-6s from real foods and/or high-quality supplements
• Prebiotics and probiotics from the Lactobacillus and Bifidobacterium genus
• Fecal transplants which involve transferring fecal microbiota from healthy donors to an unhealthy individual

Specific biomarkers could facilitate ASD diagnosis

Current methods to diagnose and evaluate ASD rely mainly on observing the patient’s behavior using tools that involve great variability.

Numerous studies indicate that abnormalities in the folate-related metabolism pathway could increase likelihood of both genetic and environmental predisposition to ASD.

In a new study, Chinese researchers investigated the following biomarkers in a group of 89 autistic patients and 89 healthy controls aged 3 to 12 years old:

• Folic acid
• Vitamin B12
• Tetrahydrofolate (THF)
• 5-methylenetetrahydrofolate (5-MTHF)
• Methionine
• S-adenoslymethionine (SAM)
• S-adenosylhomocysteine (SAH)
• SAM/SAH
• Homocysteine
• Methionine synthase
• Folate receptor alpha
• Transcobalamin II
• Cystathionine-β-synthase (CBS)

Each participant was given a standardized dietary guidelines and exercised moderately about a week before fasting blood samples were collected.

The researchers reported that, compared to healthy controls, children with ASD were more likely to have:

• Reduced methionine and SAM/SAH levels – these are associated with methylation potential and influence key developmental periods.
• Low levels of folic acid, vitamin B12, 5-MTHF, and SAM.
• Higher homocysteine and lower transcobalamin II levels – this could indicate vitamin B12 deficiency in the ASD population.

Results from this study suggest that, using Fisher Discriminant Analysis, the following six metabolites could help identify – with great accuracy –  84.3% of patients with ASD:

• 5-MTHF
• SAM/SAH
• Methionine
• Vitamin B12
• Transcobalamin II
• Methionine synthase

Fighting back with fat: the modified ketogenic diet and MCT oil for autism

Low in carbohydrate, moderate in protein, and high in fat, the ketogenic diet has shown promises in the treatment of ASD.

In this study, 15 children aged 2 to 17 were prescribed a modified ketogenic diet with supplemental medium-chain triglycerides (MCT) oil for 3 months.

Individuals with ASD suffer from mitochondrial dysfunction –mitochondria act like the cell’s “engine” and helps produce energy. The scientists wanted to see if adding MCT to the modified ketogenic diet could improve ketone and fatty acid production which would optimize mitochondrial efficiency.

The children’s caregivers received 2 hours of training on the modified ketogenic, gluten free diet and MCT protocol. This diet consisted of:

• 20 – 25g of carbohydrates per day
• Protein, twice the RDA requirements, based on the child’s weight and height
• Various types of fats including 20% of pure MCT oil or coconut oil

At the end of the study, 50% of the children showed moderate to considerable improvement in ADOS-2 scores for the social affect component. No significant difference was observed in restricted and repetitive behavior scores.

Furthermore, 50% showed improvement on CARS-2 scores in the areas of imitation, body use, and fear or nervousness.

Findings from this study suggest that this modified diet could improve inflammation levels, gut health, and cellular health in ASD patients.

PANDAS and PANS: The inflammatory aspect of autism

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) are both autoimmune conditions induced by infections.

Both PANS and PANDAS disrupt normal neurologic function since they affect basal ganglia nuclei, a cluster of nerve cells at the base of the brain. As such, PANS and PANDAS can trigger acute and dramatic onset of neuropsychiatric symptoms in children.

The difference between PANS and PANDAS is that, unlike PANDAS which is associated only with streptococcal infections, specifically group A streptococcal infection, PANS can be caused by various types of infections.

Unfortunately, due to the abrupt onset of symptoms, children with PANS and PANDAs are often misdiagnosed as having a psychiatric illness and treated only with psychotropic drugs.

This does not address the root of the problem since, in some individuals, exposure to certain bacteria, viruses, or germs can disturb the immune system which can start producing autoantibodies.

These antibodies attack both the invaders and the brain, causing inflammation in the brain and leading to a sudden onset of neurological symptoms. Therefore, a safer alternative would be to try an anti-inflammatory protocol combined with an anti-infective treatment.

Picky eating: The relationship between sensitivity to touch and mouthfeel

When talking about foods, what do taste, smell, appearance, and texture have in common?

Well, “love-hate relationships” with foods are often based on these characteristics. For instance, kids are more likely to dislike bits and pieces of foods in a homogenous texture. The same goes for tough, gummy or slimy foods vs. foods that are crispy or crunchy.

And in an interesting new study, scientists have found that tactile sensitivity – a person’s emotional response to textures and the touch of objects – could promote picky eating even into adulthood.

The study involved 89 undergraduate students aged 18 to 25 enrolled at Maastricht University. The students were requested to fill in a self-report questionnaire that measured:

1. 1. Picky eating – On a scale of 1 to 5, participants were asked to rate how much they liked 30 food items prepared differently.
2. 2. Subjective tactile sensitivity – The students were blindfolded and asked to feel nine different objects with various textures. They then rated how much they liked the feel of these objects on a 1 to 5 scale.
3. 3. Evaluation of mouthfeel – Using the same 1 to 5 scale, the students rated how much they liked the texture of nine foods. They were blindfolded and wore a nose clip to reduce influence of sight of the food and its flavor.

It turns out that “participants who disliked textures more when feeling them by hand, also disliked the mouthfeel of different foods more and in turn liked fewer foods.”
Take home-message: Match the food’s texture to your child’s preferences. For instance, if your child doesn’t like pureed meats, try minced meat or slow-cooked meat. These are easier to digest than beef strips and don’t look like a paste.  Additionally, if your child doesn’t like the texture of mushy vegetables make them crispy and crunchy.

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