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Dairy deficit

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Laura Geggel
8 October 2013

Children with autism often have different eating habits than their peers, whether because they are picky eaters or because their families restrict their diets in a bid to manage their symptoms. Some families drop dairy or gluten from their child’s menu in hopes of improving his or her behavior or digestion, although evidence for any benefit is spotty at best.

These selective eating practices are not without harm, either. Some studies have found that children with autism who have particular eating habits get fewer vitamins and minerals than their typically developing peers do.

A new study suggests that these deficiencies may broadly accompany the disorder: It found that many children with autism — and not just those on dairy- or gluten-free diets — don't get enough calcium or vitamin D, nutrients important to bone health. Given this finding, parents should be wary of putting their children on a diet that further restricts their dairy intake. 

In the study, published in the September issue of the Journal of Developmental and Behavioral Pediatrics, parents logged the diets of their children, aged 1 to 6 years, for three days. In all, researchers collected food journals for 37 typical children, 14 children with developmental delays and 69 children with autism.

A third of the individuals with autism were on restricted diets and did not eat the milk protein casein, the wheat protein gluten, soy products or a combination of the three.

Overall, all of the children in the study needed to eat more fiber, vitamin D and vegetables, the study found. The food records from the children with autism raised additional concerns — they ate less vitamin A, vitamin D, calcium, and riboflavin and folate, vitamins responsible for making red blood cells, than the controls did. However, only their calcium intake was considered too low for children their age.

When the researchers removed the children with autism on special diets from the analysis, the autism group still ingested lower levels of vitamin D and calcium than the control group did. Vitamin D helps the body absorb calcium, and is typically added to dairy products.

Within the autism group, the 23 children eating a special diet were more likely to have inadequate levels of folate compared with children not on diets. People often get much of their folate from fortified wheat products — a food group that children on gluten-free diets don't eat.

A sensory test indicated that the children's responses to smell and taste had no bearing on their nutritional intake. It's possible, however, that another sensory problem affects their eating habits.

It's important that families and doctors ensure that children with autism eat foods with enough calcium, vitamin D and folate, the researchers say. Interestingly, the parent reports suggest that the children with autism take more vitamins and other supplements than the other groups do. But the researchers lacked information on the doses of these supplements, so they had to leave this information out of their analysis.

News and Opinion articles on SFARI.org are editorially independent of the Simons Foundation.

Comments

Name: Paul Whiteley
8 October 2013 - 8:36PM

Thanks for the post about this work.

Admitting that I have an obvious bias towards this area of work - http://www.ncbi.nlm.nih.gov/pubmed/20406576
the study by Graf-Myles et al paints an interesting picture of nutritional intake in autism both on and off special dietary measures.

I could quote from the study: "Children in the AUT group NOT following a restricted diet received significantly worse Healthy Eating Index-2005 scores than those following a restricted diet and typical controls".

But rather the issue of vitamin D and autism might actually turn out to be the important factor... http://www.ncbi.nlm.nih.gov/pubmed/22898564 something certainly mentioned when it comes to bone health too: http://www.ncbi.nlm.nih.gov/pubmed/23124396

What this study adds is that professional nutritional support is an absolute must when embarking on any dietary change.

Thanks!

Name: Seth Bittker
4 December 2013 - 4:28PM

Paul,

There are data that point to the opposite conclusion: namely that significant supplementation with vitamin D early in life induces autism.

Some interesting data on this:
1) Williams syndrome (50% comorbidity with autism) seems to be associated with abnormal regulation of 25-hydroxyvitamin D (http://www.ncbi.nlm.nih.gov/pubmed/6977721). (comment: we do quite a bit of mucking around with vitamin D by supplementation with baby drops and fortification of formula)
2) You supplement with vitamin D early in life and you get more cases of asthma, rhinitis, and dermatitis later. (http://www.ncbi.nlm.nih.gov/pubmed/15699498). (comment: I don’t think it is a big stretch to say you get more cases of autism later especially since autism is intimately tied to calcium channels and feature Th2 immune skew)
3) Vitamin D is tasteless. If you eat enough it can kill you. (comment: this shows we are not genetically designed for signficant oral supplementation)
4) Whenever supplementation and fortification of vitamin D for the very young increase, we see higher rates of autism. This explains increases in the US during the 1990s and additional increases during the 2000s. It also explains why there are very few cases of autism in Cuba and among the Amish.
I have a book about this on amazon and would gladly converse with you further about this.

Name: Seth Bittker
26 February 2014 - 2:44PM

I have found some additional data suggesting that vitamin D supplementation is a risk factor for autism. I wrote up this hypothesis, and it now a journal article that is available here: http://www.omicsgroup.org/journals/infant-exposure-to-excessive-vitamin-d-a-risk-factor-for-autism-2165-7890.1000125.pdf.

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