Nourishing Hope Nutrition Intervention for Autism Spectrum Disorders Parent’s Listen Speaker Series Ryerson University - Toronto, Ontario December 1st, 2007 Julie Matthews Certified Nutrition Consultant ©Julie Matthews, CNC 2007 Trudy Scott - Research Assistant The food we feed a child has significant impact Background and Biochemistry Nutrition Basics Diet Options Nutrition Boosters Beginning & Evolving a Diet ©Julie Matthews, CNC 2007 What is Autism and Autism Spectrum Disorder (ASD)? Autism, PDD, Asperger’s Syndrome, ADHD Social: Not playful, avoids eye contact Communication: Not use gestures, receptive and expressive language poor Unusual interests and behaviors: Repetitive actions, hand flapping, picky eating, “stimming” Physical: Constipation, diarrhea, hyperactivity, fatigue, aches and pains, digestive pain and gas, difficulty sleeping, anxiety ©Julie Matthews, CNC 2007 Underlying Causes and Contributors Genetics: MTHFR, GST, COMT. Involving the systems of methylation, sulfation, detoxification, digestion, gut/brain barrier, inflammation, immune function. Environmental: Toxins, vaccinations, nutrient deficiencies, antibiotics and dysbiosis, endogenous toxins (opiates from food, microbial toxins) ©Julie Matthews, CNC 2007 Biochemistry ©Julie Matthews, CNC 2007 Affects of Faulty Sulfation ©Julie Matthews, CNC 2007 Complex and Interrelated Whole Body Disorder Brain is Downstream Yeast toxins Undermethylated neurotransmitters Brain inflammation Increased toxicity Nutrient deficiencies Opiates ©Julie Matthews, CNC 2007 Why the GI System is So Important • Physical barrier of defense against bacteria, viruses, etc. • The largest part of the immune system is contained within the gut (70%) • Vitamins/minerals cofactors for enzymatic reactions and metabolism, etc. • Nutrients are precursors for neurotransmitters • The greatest concentration of serotonin, 90%, is found in the GI tract The Health of the GI System Determines Function of Body From Lisa Lewis, Ph.D. ©Julie Matthews, CNC 2007 How Diet Can Help Support Digestion & Biochemistry • Leaky Gut and Gut Inflammation – Remove foods that inflame gut – Add foods that heal the gut – Add foods that supply beneficial bacteria • Nutrient Deficiencies – Increase the quality of food and digestibility • Yeast Overgrowth – Remove sugars – Remove starches – Add probiotic-rich foods • Toxicity and Poor Detoxification – Avoid food additives – Avoid toxins in food supply and meal preparation • Faulty Methylation and Sulfation – Remove phenolic foods – Improve methylation and sulfation through supplementation ©Julie Matthews, CNC 2007 Symptoms Diet May Improve • • • • • • • • • Ability to focus Eye contact Aggression Gastrointestinal problems Language Sleep difficulties Toilet training Rash or eczema may improve Behavior From Lisa Lewis, Ph.D ©Julie Matthews, CNC 2007 Autistic Spectrum Disorders are caused by genetic predispositions combined with environmental factors that create disordered biochemistry and damaged organs & systems. ©Julie Matthews, CNC 2007 INITIAL STEPS Holistic Nutrition Approach #1 Cleaning up the Diet #2 Cleaning up the Home #3 Supplement Basics #4 Diet Basics #5 Beginning an ASD Diet #6 Removing Food Intolerances Q uickTim e™ and a decom pr essor ar e needed t o see t his pict ur e. MOVING FORWARD Q uickTim e™ and a decom pr essor ar e needed t o see t his pict ur e. ©Julie Matthews, CNC 2007 #7 Evolving the diet: Nutrition Boosters #8 Refining the ASD Diet #9 Cleaning up the Gut #10 Supplement Specifics #11 Immune Support #12 Detox From Nourishing Hope Nutrition Basics Macronutrients: Fats, Protein,and Carbohydrates ©Julie Matthews, CNC 2007 Unhealthy Ingredients to Avoid • Artificial colors/flavors and preservatives • MSG (hydrolyzed protein, yeast extracts) • Pesticides • Aspartame and other artificial sweeteners • Trans fats (hydrogenated fat) • Excessive/Refined Sugar • Nitrates/nitrites (bacon, hotdogs, lunch meat) ©Julie Matthews, CNC 2007 A Healthy Diet • Whole foods • Unprocessed • Organic • Fermented foods: rich in probiotics • Grass-fed/pastured meat and eggs • Good fats • Free of food intolerances ©Julie Matthews, CNC 2007 Fats • Brain development and brain function • Hormone balance and mood • Formation/fluidity of cell membrane • Creating energy in cell and helps burns fat • Reduces inflammation Supplement with vitamin E to prevent oxidation of fats. Omega 3 Omega 6 Omega 9 Saturated Fat Borage oil (GLA) Evening primrose oil (GLA) Olive oil Fish oil or Black currant oil (GLA) cod liver oil Avocado Nuts/seeds and their oil Flax seed oil Nuts/seeds Hemp seeds/oil (GLA) DHA and EPA Grapeseed oil supplements AVOID Vegetable oil: canola, safflower, corn, soy oils ©Julie Matthews, CNC 2007 Coconut oil Palm/Red Palm oil Animal fats Р ghee/dairy, bacon Fats • 30+% Many children - 40% or more. – Breast milk is 53% fat (25% saturated). • Proceed slowly - not everyone can digest fats well. Problematic for those with: – High oxalates – Gallbladder/bile imbalances – Enzyme insufficiency • Signs of poor fat digestion – Stool light tan or gray in color, large in volume. Sometimes stool will float. Malodorous flatulence. ©Julie Matthews, CNC 2007 Vital Roles of Saturated Fat Brain—Saturated fats are important for development of the brain Bones – Saturated fats help the body put calcium in the bones Liver – Saturated fats protect the liver from poisons Lungs – Can’t function without saturated fats—protects against asthma Immune System – Enhanced by saturated fats—fights infection Essential Fatty Acids – Work together with saturated fats ©Julie Matthews, CNC 2007 Coconut Oil: • Contains many antifungal and antiviral components • Anti-inflammatory effects • More easily digested and absorbed • Used immediately to create energy • Enhances absorption of minerals Benefits of Cholesterol • Brain development and function • Boosts mental performance • Aids digestion • Builds strong bones • Builds muscle • Building block for hormones • Regulates your blood sugar • Repairs damaged tissue • Protects against infectious diseases ©Julie Matthews, CNC 2007 Key Nutrients for Brain Development • Vitamin A - Cod liver oil; liver, butter and egg yolks from grass-fed animals • Vitamin D - Cod liver oil; lard, butter and egg yolks from grass-fed animals • Choline - Cod liver oil, egg yolks • DHA - Cod liver oil; liver, butter, egg yolks from grass-fed animals • Zinc - Red meat of grass-fed animals, shellfish • Tryptophan - Meat of grass-fed animals • Cholesterol - Dairy foods, eggs, seafood, meat of grass-fed animals ©Julie Matthews, CNC 2007 Variety and quality are the keys to fat intake ©Julie Matthews, CNC 2007 Animal Fat (Grass-fed) is High in Vitamins A and D Vitamin A • Protein assimilation • Calcium absorption • Proper growth and healing • Speech/language • Vision • Proper function of the glands • Thyroid function • Immune system function • Production of stress and sex hormones ©Julie Matthews, CNC 2007 Vitamin D • Healthy bones • Proper growth • Mineral absorption • Muscle tone • Immune system function • Healthy nervous system • Cell function • Insulin production • Reproduction Animal Products - Quality is essential Grass-fed/pastured •Rich in DHA (brain development) •Rich in Vitamin A •Rich in Vitamin D •Higher in CLA •Higher in Tryptophan (sleep and mood) *Organic is not necessarily grass-fed ©Julie Matthews, CNC 2007 Commercial •Unhealthy animals unhealthy food •Inflammatory grains create inflammatory food •Low in Vitamins A and D •Low in anti-inflammatory fats •Higher in arachidonic acid (inflammatory) Consider RAW Dairy • PASTEURIZED Dairy - Inflammation and gut reaction – Casein molecule altered – Lectins (grain-fed milk) • Raw dairy is not for everyone - however some who cannot tolerate pasteurized dairy can consume raw dairy • Use with SCD - homemade 24-hour raw milk yogurt • Raw butter - very little casein • Fatty acids (such as butyric acid) – Nourish brain and intestinal lining – Antimicrobial properties • • • • Phosphatase - calcium absorption Enzymes for digestion Natural probiotics Milk fat reduces asthma ©Julie Matthews, CNC 2007 See RealMilk.com Information & Sources Protein • Protein (essential amino acids) building blocks for: – Muscle and tissue growth and repair, neurotransmitters, immune responses, enzymes, detoxification • Bio individuality - amounts vary. • Some children cannot process protein well: – High ammonia, low HCl, low zinc, B6, or iron Signs of protein deficiency: Stunted growth, lack of appetite, edema, suppressed immune system, muscle wasting, anxiety, sparse hair, dry skin ©Julie Matthews, CNC 2007 Avoid Soy • Not good substitute for dairy • Very difficult to digest • Irritate the gastrointestinal tract • Blocks absorption - calcium, magnesium, iron, copper and especially zinc - due to phytic acid and oxalates • Blocks thyroid function • Endocrine disruption in the reproductive hormones of both males and females ©Julie Matthews, CNC 2007 Note on Vegetarian Diets • When eggs (and dairy) are not tolerated, protein becomes limited • When nuts and beans are not tolerated, protein intake becomes even more limited • Grains, nuts, beans, and other starches - inflammatory to the gut. • Difficult to be vegetarian with some diets, as meat is relied upon with SCD and other diets. • Can be difficult to get enough protein –Eat eggs if tolerated –Free form amino acids (5 grams amino acids = 30 grams dietary protein) ©Julie Matthews, CNC 2007 Carbohydrates • Add complex carbohydrates: whole grains, vegetables, fruit, starchy vegetables • Reduce refined carbohydrates: flour products (bread, crackers, chips), cookies, pasta • Avoid Sugars: Refined sugar, honey, juices – 4-5 grams per serving (1 teaspoon “sugars”) = 2 oz fruit juice, 2 tsp dried fruit, 1 TBSP ketchup – Keep to 4 servings/day • Sugar cravings - Yeast overgrowth, stress/anxiety (sensory sensitivity), and blood sugar imbalances All grains problematic for some • All starches & sugars (except monosaccharides) problematic for some (SCD) ©Julie Matthews, CNC 2007 Diet Options ©Julie Matthews, CNC 2007 Diet Options to Choose From ASD Diet Options ARI Survey Results parents’ reporting noticeable symptomatic improvement GFCF (Gluten-free and Casein-free) No gluten (wheat, rye, barley, spelt, kamut, and oats) or casein (dairy) GFCF - 65% improved No Dairy - 50% improved No Wheat - 49% improved Food Sensitivity Elimination Eliminating all other food sensitivities: Soy, corn, eggs, citrus, peanuts, chocolate, cane sugar No Eggs – 49% improved No Chocolate – 49% improved No Sugar – 48% improved Rotation Diet – 49% improved Feingold Diet/Low Phenols Restricts high phenolic foods, including all artificial ingredients and high salicylate fruits 54% - improved SCD (Specific Carbohydrate Diet) Restricts carbohydrates to only fruits, non-starchy vegetables, and honey. No grains, starchy vegetables, or mucilaginous fibers SCD - 66% improved Candida Diet – 54% improved Body Ecology Diet Anti-yeast diet combining principles of anti-yeast diets including no sugar, acid/alkaline, fermented foods Nourishing Traditions/ Weston A. Price Good quality fats, soaking and fermenting for digestion Low Oxalate Diet Restricts high oxalate foods (nuts, beans, greens) ©Julie Matthews, CNC 2007 Selecting a Diet Foundational Diets • GFCF – Start here. 65% improved. • Specific Carbohydrate Diet – For bowel inflammation, diarrhea, gut dysbiosis that is not improving. 66% improved. • Body Ecology Diet – For yeast overgrowth • Weston A. Price - Not ready to eliminate foods yet. Focus on nourishment. ©Julie Matthews, CNC 2007 Additional Diets • Food Sensitivities. Elimination and Rotation Diets. • Feingold/Phenols – For red cheeks, red ears, hyperactivity/fatigue, irritability, aggression • Low Oxalate Diet – For pain (body or GI), urinary incontinence, pain, or irritation, constipation or diarrhea not relieve by SCD, continued stimming after meals, poor growth ©Julie Matthews, CNC 2007 Nutrition Boosters Grandma knew best Foods and preparation methods that increase nutrient density and digestibility ©Julie Matthews, CNC 2007 Nutrients Needed for Pathways ©Julie Matthews, CNC 2007 Helpful Supplements Digestive Enzymes Probiotics Cod liver oil/fish oil/EFAs Magnesium Calcium Zinc B6 Vitamins A, C, and E CoQ10 Glutathione/NAC Methylation: B12, folinic or 5MTHF, TMG/DMG Transfer factor Amino acids ©Julie Matthews, CNC 2007 Nutrient-dense Foods • Sweet potatoes: beta carotene, vitamin C, magnesium, fiber • Leafy greens: calcium, vitamin C, folic acid, beta carotene, magnesium, iron • Whole grains: selenium, vitamin E, magnesium, B6 • Nuts and seeds: calcium, magnesium, iron, zinc, B6, vitamin E, folic acid • Beans and legumes: folic acid, B6, zinc, iron • Blackstrap molasses: iron, magnesium • Organic liver: iron, vitamin C, B12, folic acid, beta carotene, vitamin A • Hemp seeds: GLA, omega-3, vitamin E, L-arginine. All essential amino acid. • Nettles (can make a tea ): calcium, magnesium, potassium, iron, antioxidants • Kombu and seaweed: calcium, magnesium, iron • Eggs, from pastured hens (if not sensitive): B12, vitamin A, B-vitamins, vitamin D, vitamin E, selenium, calcium, iodine, zinc, iron, choline • Animal protein and fats (grass-fed): Vitamin A, vitamin D, DHA, tryptophan ©Julie Matthews, CNC 2007 Good ways to Boost Nutrient Levels • Cook and puree orange vegetables (or any). Freeze in ice cube trays and add to smoothies • Cook and puree any vegetables and add to meatballs, meat patties, meatloaf, or pasta sauce • Cook allowable grains or gluten-free pasta in homemade broth • Nettles can be consumed as a tea, or added to a homemade broth • Seaweed - Add kombu or other sea vegetable to cooking grains, soups, tomato sauce, even boiling pasta ©Julie Matthews, CNC 2007 Juicing • Higher concentration of nutrients – Chlorophyll and phytonutrients • Get nutrients without needing to eat/chew vegetables • Children that like liquids, juices and smoothies Start with Add as you evolve taste Go cautiously (high sugar) •Cucumber •Celery •Fennel •Ginger •Lemon •Green apples •Parsley, cilantro •Kale or other greens •Cabbage (ulcers) •Cranberries •Carrot •Beet •Fruit: Apple, pear Add vegetable juice to smoothies. Add a bit of fruit to vegetable juice for flavor or added sweetness Add supplements to vegetable juice (instead of fruit juices) ©Julie Matthews, CNC 2007 Soaking “seeds” – easy to do Grains, nuts, seeds, beans • Increases digestibility • Reduces inflammatory response • Breaks down phytic acid and oxalates • Fermenting grains breaks down lectins Grains - Soak in water for 8-24 hours with 2 TBSP lemon juice or vinegar. Drain and cook with fresh water. Nuts - Soak in water (with or w/o salt) for 7-12 hours. Drain and refrigerate, use to make nut milk, or drain and dehydrate (eat or make nut butter) Beans - Soak in water for 8-24 hours with hearty pinch of baking soda. Drain and cook with fresh water. ©Julie Matthews, CNC 2007 Fermented Foods – Rich in Probiotics Functions of good bacteria – Regulate peristalsis and bowel movements – Break down bacterial toxins – Make vitamins needed and utilize: B1, B2, B3, B5, B6, B12, A and K – Digest protein into amino acids (for use by the body) – Produce antibiotics and antifungals – Help breakdown sugars, lactose, and oxalates – Support immune system and increase number of immune cells – Balance intestinal pH – Protect against environmental toxins: mercury, pesticides, pollution Raw fermented foods contain billions of bacteria/serving! ©Julie Matthews, CNC 2007 Fermented Foods – Rich in Probiotics Dairy-free: • Raw sauerkraut • Beverages (contain yeast that kills candida): • Kombucha • Coconut juice kefir • “Sodas” (hibiscus/rosehip tea with kefir starter) • Nut milk yogurt Dairy: Milk-based yogurt/kefir ©Julie Matthews, CNC 2007 Homemade Bone & Vegetable Broths • Grass-fed/pastured chickens or beef bones – Add 2 Tablespoons of vinegar - increases the calcium and magnesium • Vegetables, seaweed, greens, nettles • Nutrient dense, easy to assimilate nutrients – trace minerals, amino acids, calcium, magnesium, potassium, iron Cook grains, soups, and/or pasta in broths nutrients will absorb into food ©Julie Matthews, CNC 2007 Grandma knew best Bone Broths and Gelatin Bone broth contains gelatin: • Gelatin’s colloidal properties aid digestion of all foods • Glycine: Sleep, detox environmental toxins, component of glutathione, improves gastic acid secretions and protein digestion • Proline: Formation of connective tissue: skin, gut, ligaments • Broken down by DPPIV • Free glutamate - potentially problematic for glutamate sensitive children ©Julie Matthews, CNC 2007 Water and Salt • Purified Water – Avoid tap water, fluoridated and chlorinated water – Get a water filter (point of entry, reverse osmosis, carbon block or ionic - not Brita). Avoid bottled water (plastic and transportation). • Nutritive Salt – – – – Salt cravings - sign of nutrient deficiencies Avoid stripped white “table salt” - may contain aluminum Choose nutritive salt with trace minerals Celtic Sea Salt or Himalayan crystal salt • Sole - water and salt combine to make minerals ionic – They are highly absorbable, alkalizing, and help with elimination – Add 1 tsp to 8 oz glass of water – See Water and Salt, by Handel and Ferreira ©Julie Matthews, CNC 2007 Beginning and Evolving a Diet ©Julie Matthews, CNC 2007 Begin by Removing Artificial Ingredients Avoid trans fats (hydrogenated oil, fried foods, margarine, mayo, commercial peanut butter) Avoid artificial sweetener & high fructose corn syrup Avoid artificial ingredients (artificial colors, flavors, and preservatives) Avoid MSG (hydrolyzed vegetable/soy protein, autolyzed yeast, yeast extract, natural flavors) Avoid Nitrates/nitrites ©Julie Matthews, CNC 2007 Eliminate Foods, Additives and Factors that Irritate the GI Tract Food intolerances (IgG test and LEAP test) MSG Carageenan Olestra Lectins, oxalates and phytates from “seeds”(grains even non-gluten, bean, nuts, seeds) Yeast, antibiotics, and some medications (NSAIDS) ©Julie Matthews, CNC 2007 Avoiding Toxins in the Kitchen Toxins Around the Kitchen Safer Cooking Alternatives Avoid aluminum cans Buy in glass Avoid storing in plastic Store in glass w/metal or plastic lid Avoid Teflon, copper, and aluminum pans Use stainless steel (attracts a magnet), cast iron or enameled cast iron Avoid the microwave, do not reheat in plastic Heat in oven or on stove Avoid plastic wrap & aluminum foil Use wax paper or glass with lid ©Julie Matthews, CNC 2007 For Picky Eaters • • • • • • • • • • Always provide food child likes in addition to "new" food. Only offer one new food at a time. Include small portion of new food and serve everyone at the table. Involve your children in food preparation of "new" food. Small taste ~ 1/2 teaspoon. Let child determine amount. Inform them. Let child know whether it is sweet, salty or sour. Let them spit it out. If at First You Don't Succeed, Try and Try Again! At least 15 times! Try new food in a texture they prefer - crunchy, smooth, etc. Avoid being emotionally “attached” - children sense anxiety. – Keep mealtime calm. Visualize child eating/enjoying new foods. • Avoid forcing or pushing - maintain trust. • Choose rewards or other encouragement. • Make sure the whole family participates. • Make ©Julie Matthews, CNC 2007 it fun! Evolving the Diet • • • • • Involve the family as much as possible Remove known food allergens: peanuts, etc. Begin to add nutrient dense whole foods Add fermented foods Introduce new GFCF substitutes before removing familiar gluten/casein foods • Implement GFCF (or other foundational diet) for 3-6 months – Regardless of test results – Begin with casein-free, then gluten-free • Determine other food sensitivities – Based on dietary challenge testing (and/or lab results) – Be careful not to substitute soy (for dairy) and corn (for gluten) – often equally problematic ©Julie Matthews, CNC 2007 Chart Progress and Further Refine • • • • Correlations not always clear - Keep diet record. Add one food at a time - Take note. Avoid changing foods & supplements simultaneously. Watch for symptoms or regression: – Sometimes a “regression” is actually a sign of healing, i.e. removal of gluten/casein may cause opiate withdrawal – However, sometimes a new food substitution (corn) is problematic and needs to be removed • Look for improvement • See what’s remaining, and consider additional diets/dietary intervention. Changing the diet or layering diets. • Seek help from a nutrition consultant or qualified practitioner/physician ©Julie Matthews, CNC 2007 NourishingHope.com Book • Website • Radio Show • Community For food sources, diet resources, and scientific references Contact Julie at: Julie@HealthfulLiving.org www.NourishingHope.com 415-437-6807 ©Julie Matthews, CNC 2007