Nutrition and Autism

I had been planning on writing a(nother) “meat and mental health” article for some time and had a few studies cited, and today I saw that Frontiers published an article titled Nutritional Status of Pre-school Children and Determinant Factors of Autism: A Case-Control Study. Now, as you might imagine, I have a never ending queue of podcasts, journals, lectures, videos, etc to keep up with; but this got my attention pretty quick.

Granted, the study is correlational, but as is the case, this can inform later interventional trials. This is particularly relevant to me as I’ve seen a recent increase in Autism in my caseload. Now, I am not an Autism specialist, so typically within the realm of mental health I focus (as expected) on the affective states or distress of the person (trauma, depression, anxiety, etc…); and as it turns out the principles of distress tolerance, emotional regulation, and understanding your perception of yourself and others’ perception of you is quite helpful to … well… just about everyone (myself included).

Anyway, getting into the nutritional component of the article, the authors write:

“Micronutrient intake was analyzed to complete the assessment of the children’s nutritional status. Gender differences among our study population between both ASD and TD groups were studied for inadequate intake of vitamins (Table 7) and minerals (Table 8). ASD boys exhibit significantly higher percentages of inadequacy of vitamin E (94.4 vs. 73.1%, P = 0.015) and vitamin K (86.1 vs. 61.5%, P = 0.026) than do TD boys. The results showed higher rates of inadequacy of vitamin B2 and vitamin B6 intake among ASD boys compared to TD boys, while more ASD girls failed to meet the daily needs of pantothenic acid, and biotin compared to TD girls. All children, ASD and TD, fell short of the requirements for vitamin A, vitamin D, vitamin B12, and folate.”

Now, I should specify that the study used “standard American” dietary recommendations; which then it comes as no surprise ( spoiler alert) that both categories of children had notable vitamin and mineral deficiencies. At any rate, these are some of the most common nutrient deficiencies on a vegan diet ( 1, 2, 3). Once again, I’ll throw the cliff-note in there that supplementation is far inferior in terms of bioavailability compared to whole foods ( 4).

The original article continues…

“Previous studies agreed that most children failed to meet vitamin E requirements (21), and that vitamin K intake was inadequate among ASD children (58). But, in Spain, most children had an adequate intake of vitamin E and vitamin K, with ASD children having a higher intake (11). ASD boys in our study had lower intake of vitamin B2 and B6. Our results align with previous studies among ASD children in the United States and Spain (11, 21, 64). ASD girls in our study had a lower intake of biotin, which is consistent with observations of a previous study in Spain (11). Girls also had a lower intake of vitamin B6 In contrast with a previous study that reported a higher intake of vitamin B6 among ASD children (11). All children had an inadequate intake of vitamin A in this study.”

So, we’ve got major deficits in:

• B Vitamins
• Vitamin K
• Vitamin E
• Vitamin A
• Folate
• Iron

Interestingly enough, what one meal would give you all of those?

• Butter
• Steak
• Beef Liver

It’s a bit outside the scope of this article, but let it be said again that the types of iron (in red meat) and Vitamin K(2) in butter are also more bioavailable in their animal forms than they are when obtained from plants. Let’s continue though…

“Nearly all children in our study presented with vitamin D3 deficiency, serum levels being lower than 30 mg/ml. This is a higher percentage compared to previous studies in the United States and Egypt in which 62 and 57% of children (respectively), had vitamin D deficiency (54, 70). There was no significant difference in the severity of vitamin D3 deficiency between ASD and TD children, but the incidence was higher among the TD girls compared to ASD girls. Conversely, studies reported a lower serum level of vitamin D3 among ASD children compared with TD children (59). Notably, Saad and colleagues reported that the level of vitamin D deficiency is associated with the severity of ASD symptoms (70). Vitamin deficiency among ASD children might be caused by inadequate dietary vitamin D intake due to the picky eating behavior among ASD children (59).”

So, we also have a deficiency in Vitamin D. I find it interesting that the authors make reference to dietary intake of Vitamin D (I suppose since it’s in the dietary section of the article); but this pales in comparison to the Vitamin D from the sun (also shown to be more efficacious than a supplement) which could meet your dietary requirement in less than 15 minutes depending on the time of day ( 5).

Now, don’t get crazy on me, I’m not trying to say that eating plants causes Autism. Quite the opposite. I’m saying that eating more meat and organs should be considered as a plausible conjunctive treatment. This is a very interesting axis in the healthcare system. I’ve written before about ADHD and you will find a multitude of reports of improvements in sleep, depression, and anxiety with dietary change (of pretty much any way of eating other than the Standard American Diet).

This food-affect axis seems particularly relevant when it comes to neurologically related / developmental disorders (ADHD, Autism, etc…). It’s also the case for many “severe” mental health disorders that have a genetic component (schizophrenia, bipolar)( 6).

Sticking to this article’s specifics though, I recently came across some publications that highlighted the importance of protein (meat specifically) in the development of (prenatal) children ( 7).

“This study considers adequate evidence that low levels of total iron and meat consumption during pregnancy will determine an increased risk of latent iron deficiency and lower levels of ferritin in newborns, and therefore, greater risk of long-term adverse effects on myelination and neurocognitive development.”

And just recently (February 2021)( 8):

“In a cohort of school aged children born very preterm, greater protein intake during the first week and the first month of life were positively associated with more robust functional connectivity strength between thalamic networks and anterior DMN essential for higher order cognitive functioning. “

In terms of general mental health we have:

“The majority of studies, and especially the higher quality studies, showed that those who avoided meat consumption had significantly higher rates or risk of depression, anxiety, and/or self-harm behaviors….Our study does not support meat avoidance as a strategy to benefit psychological health.” ( 9)

Bottom line: Not much has changed.

• Eat meat
• Eat organs
• Play in the sun

Live well, and die hard my friends!