Nutrition and Behavior in Youngsters with Autism & ADHD

It’s common sense (and research proven): If our bodies receive optimal nutrition, they function at their best. However, what do we know about the connection between nutrition and behavior? Right now, not much.

Right off the bat, let me say that the research evidence regarding the effects of nutritional supplements on behavior is not yet solid. (That was the data-based professional part of me speaking in the previous sentence.) As a professional who is also a parent, I hear and read testimonials of other parents who found improvements in behavior when their child followed a regimen of nutritional supplementation (certain vitamins, minerals, enzymes, etc.). It appears as if this approach does work with some kids to some extent. I offer the information below with scientific cautions and parental enthusiasm.

Suggestive evidence is emerging that nutritional supplements and restrictive diets have a beneficial effect on the well-being and actions of kids with behavioral challenges and disorders. Many parents and professionals are reporting the results of their own nutritional interventions with children who display undesirable behaviors. They tell us that their children’s behavior is directly connected to the foods eaten. In their personal nutritional research, they have found that the avoidance of some substances (food dyes, preservatives, gluten, soy, yeast, starch, etc.), and the taking of certain supplements helps to prevent or reduce worrisome behaviors. Combined with therapeutic help for behavior disorders, more impressive outcomes would be expected.

If you are leery of prescription drugs due to the side effects and other concerns, you might want to give natural supplements a try. However, before engaging in a regimen of adding vitamins, minerals, and/or other supplements to your child's diet, it is best to obtain a clinical and laboratory (especially blood) assessment of his/her nutritional status (vitamin & mineral levels). It is also a good idea to consult your child's pediatrician and work with someone who is knowledgeable in nutrition.

Remember that some vitamins and minerals are “water soluble” (If you ingest too much, you pee them out). Others are “fat soluble” (excess get stored in the body fat and can cause health concerns). Large doses of vitamins, minerals, and other substances need to be administered knowledgeably. Changes in diet bring about adjustments (not always positive) within the body.

Here's an excerpt from a long article at: wholefoodsmagazine

Nutritional Support for ADD/ADHD and Autism
Recent studies indicate that many children with autism and ADD have certain nutritional deficiencies in common. “Specialized laboratory testing often demonstrates sub-optimal levels of vitamins, minerals, amino acids and fatty acids in people with autism, which can be addressed with nutritional supplements,” Tomlinson says. Again, while dietary supplements cannot cure these disorders, it is important to ensure affected children have adequate amounts of the following nutrients in their diet.

Magnesium and other minerals. Magnesium, an important mineral on numerous fronts, is one of the most deficient nutrients in most American’s diets, says naturopath Jones. This is noteworthy because magnesium deficiency can exacerbate many developmental/neurological problems as well as emotional and mental stress, he says. “This combination of issues is often present in children and families dealing with autism, so I recommend magnesium in appropriate dosages for children,” Jones advises.

Ochel seconds the notion that magnesium has distinct benefits for autistic children. “Magnesium plays a huge role in the proper functioning of the nervous system and has been linked to alleviating anxiety, stress, tension, spasms, panic attacks and promoting proper sleep, just to name a few. All of these can be a regular occurrence in autistic children,” she says.

These are important points. After all, magnesium is said to have a calming effect. Says Rachel West, D.O., an osteopath in Santa Monica, CA, who frequently treats children with autism and ADD, “It is great to take in higher doses to help with relaxation, sleep and vasodilation. The va-sodilation is like making the pump wider so more blood can flow…It is also great for muscle tension, nervous tension and headaches, which many children have. [This] makes them have sensory issues.”

And, since many autistic children also have digestive problems, magnesium may offer some benefits in terms of proper food metabolism. More than 300 digestive enzymes need magnesium to function, says Ochel. “As children with autism suffer various intestinal damage and may actually be deficient in magnesium, higher doses than just those provided in food are needed to address these problems and ensure adequate supplies, she states.”

Given the benefits of magnesium for children with autism and ADD, it’s striking that studies show they are often deficient in this mineral. In one trial, 116 children with ADHD were evaluated and 95% had magnesium deficiency (7). In another, Dugoua states, “A study demonstrated that when you give magnesium-deficient ADHD children 200 mg of magnesium daily, their hyperactive behavior appears to improve.”

Other minerals such as iron, zinc, calcium and trace minerals are important, too, says Michael T. Murray, N.D., of Natural Factors, Everett, WA, in an essay published last month in WholeFoods Magazine. He states, “It is a well-known fact that children with iron deficiency demonstrate impaired intellectual performance.”

Vitamins B and C. Certain basic vitamins are also key for this population of children. Vitamin B6, for example, is essential for normal brain function. Says Marissa McMillin, C.H.H.C., a nutritional counselor and speaker based in Omaha, NE, “The enzyme that is used to break down B6 into pyridoxal-5-phosphate (PLP) may not work in children with autism; PLP is needed for the brain to produce dopamine and if autistic children are not producing enough PLP, supplementing their diets with vitamin B6 may help boost levels of PLP for proper dopamine production, a neurotransmitter essential for normal behavior.” In a nutshell, having healthy neurotransmitters is important for those with ADHD and autism, “and if we don’t have enough B6, we can’t make them,” as Bowden puts it.

In fact, author Janet Zand, L.Ac., OMD, Dipl. Ac., Dipl. CH, says it’s not uncommon for autistic children to lack other B-vitamins like B12, B5, B3 and folic acid in their systems. “An easily absorbed B-complex can begin to improve a multitude of symptoms including energy, mood and attention span,” she advises.

Autistic children may also benefit from extra vitamin C—an important free radical figher—whether or not they are deficient in the nutrient. Says Ochel, “Children with autism can be more prone to improperly managing free radicals, which can cause extensive damage in the body, especially the brain, thereby worsening the condition. As vitamin C plays a large role in the proper functioning of neurotransmitters, and offers a calming effect, it can prove to be very beneficial for autistic children.” DHA. Few experts debate the importance of the omega-3 DHA for those with ADHD and autism. With respect to the former, this nutrient has been studied to improve concentration. Says Bowden, “Studies clearly show that animals who are deficient in omega-3 fatty acids are most distractible and take longer to reach goals. A ton of research—notably by John Burgess and his team at Purdue University—has shown a connection between lower levels of omega-3s (specifically EPA and DHA) and ADHD. Burgess also found that those with low levels of omega-3s in their blood were far more likely to have the characteristic behavior problems of ADHD whether or not they were diagnosed with the disorder.”

Sheila Gautier, R.D., in scientific affairs at Martek, Columbia, MD, offers some insight into the connection between this omega-3 and the brain: “DHA plays a central role in the normal development and function of the brain and nervous system throughout life. Perhaps not surprising, as it is a major structural fat in the brain and represents about 97% of all omega-3 fatty acids in this organ.” And, DHA is concentrated at synapses, where it contributes to cell signaling and neurotransmission, she adds.

Research shows those with neurocognitive disorders such as ADHD and autism are deficient in omega-3s. In this month’s Research News section, we report one recent study in which many autistic children were found to lack polyunsaturated fats (PUFAs) in their systems. And in a 2008 article, researchers found “adolescents with ADHD continue to display abnormal essential fatty acid profiles that are often observed in younger children and distinctly different from normal controls of similar age” (8).

The reason for the deficiency, Gautier speculates citing other research, is that kids with ADHD may have an impaired ability to metabolize PUFAs. “The significance of which may be that they may have higher requirements for long-chain polyunsaturated fatty acids such as DHA,” she says. “Unfortunately, DHA intake in the United States is dramatically below recommended levels, particularly during pregnancy, nursing and childhood; thus compromising optimal nutritional status during a very important time of brain development and function.”

There’s some hope in supplementation, however. Even modest intake of DHA via diet or supplementation may improve symptoms in children with autism and ADHD. Of note, West of Nordic Naturals, points out “both language and learning skills improve with EPA and DHA supplementation.” And, according to Gautier, other benefits include the following:

Digestive enzymes. It bears repeating that many children with autism have trouble with digestion, and therefore may not be able to absorb all the nutrients they need for proper brain function. Says Gonzalez of Enzymedica, “Many of our children are enzyme deficient and are not manufacturing enough of their own enzymes.” Therapeutic enzymes may help offer digestive support and improve nutrient absorption.

Amino acids. Amino acids, especially those in powdered form, may also be suitable for children that have problems with concentration. According to Murray, “Amino acids from protein are very important to brain function as they can be used as neurotransmitters (i.e., compounds that transmit nerve impulses). The proper amount and ratio of neurotransmitters are essential for attentiveness, task completion and the ability to remain calm when appropriate.”

Sahley of the Pain & Stress center agrees, noting that glutamine can be helpful for this application. “Good nutrition is vital and supplementing with amino acids that create neurotransmitters is more than vital. The neurotransmitters help the brain make connections between the cells so communication can take place,” she says, and explains that children with ADD/ADHD and autism tend to burn neurotransmitters quickly."

Many parents report improvement in the behavioral symptoms of autism when nutritional supplements are used. The thought is that there may be nutrient absorption problems that create nutritional deficiencies. A few studies suggest that persistent intestinal and gastrointestinal problems may reduce the absorption of essential nutrients, causing disorders in immunity and general metabolic functions. Other investigations have shown that some kids with autism may have low levels of vitamins A, B1, B3, B5, as well as nutrients such as biotin, magnesium, selenium, and zinc

Others may have an out-of-balance serum copper to plasma zinc ratios, which suggest that taking extra zinc might boost their immune system. Some studies have indicated a that increase calcium intake might help.

Vitamin B is probably the most common supplement, because it plays an essential role in creating enzymes utilized by the brain. The general consensus in a score of studies pertaining to vitamin B (and magnesium, which promotes the effectiveness of vitamin B) nearly half of autistic individuals improved. Improved how? Benefits were found in reduction of undesirable behaviors, improved eye contact, greater attention, and enhancement in learning.

Other research-based outcomes show that fish oil (a good source of vitamins A and D) has improved eye contact and behavior in kids on the autistic spectrum. Vitamin C appears to help brain function and decrease confusion and depressive symptoms. Vitamin C supplementation was shown in one clinical trial to decrease the severity of symptoms in youngsters with autism. A small (16 youngsters with autism) pilot study that utilized a multivitamin & mineral combination found improvements in sleep patterns, gastrointestinal issues, language, eye contact, and behavior.

“Probiotics” and essential fatty acids also have some evidence pointing to improved behavior.

Some kids with autism have low tolerance for, or allergies due to certain foods or chemicals. They don’t cause autism, but they may very well contribute to behavioral issues. Many parents and professionals have reported significant changes when certain substances have been eliminated from their child's diet.

Gluten and casein are commonly reported culprits. Gluten is found in grains such as oats, wheat, and rye. Casein is in dairy products. If there is an incomplete breakdown of the substances, and/or an excessive absorption of peptides, certain biochemical and neurological processes in the brain can be disrupted. Parents who want to implement a gluten-free or casein-free diet should consult a gastroenterologist or certified nutritionist, who can help ensure proper nutrition.

Some sources hypothesize that kids with autism have "leaky gut" syndrome; tiny perforations in the intestines caused by uncontrolled growth of yeast. They believe that this overgrowth contributes to behavioral and medical problems in many individuals with autism. Some of the identified symptoms are hyperactivity, confusion, fatigue, and stomach problems. Nutritional supplements and a yeast-free diet may reduce the behavioral problems.

Click here to read a summary of a study regarding Gluten-free and Casein-Free Diets with Youngsters who have ASD

A clinical study on 100 children with Attention Deficit Hyperactive Disorder (ADHD) demonstrated that those with lower levels of omega-3 fatty acids had more learning and behavioral problems such as tantrums. Fish (salmon, sardine, or tuna) and nut oils are the main source of omega-3 fatty acids.

Iron
There may be a connection between low iron levels and low dopramine levels in the brain. In one study, 84% of children with ADHD possessed abnormally low levels of iron compared to only 18% of children without Attention Deficit Hyperactivity Disorder. "Iron and Your Child,"(published in KidsHealth, Author: Konofal), states that children 1 to 12 years old need 10 milligrams of iron per day, while adolescent boys need 11 milligrams, and adolescent girls need 15 milligrams per day. Fish, red meat, leafy greens, and cereals are good sources of iron. Many multi-vitamins contain iron. Be cautious about iron pills are sold in stores. It may be too much, to quickly. Your trusted source for quality nutritional supplements.

Vitamin B6 and Magnesium
An article titled "Vitamin B6 and Magnesium" (Autism Research Institute), states that vitamin B6 and magnesium help to reduce behavioral problems in youngsters with autism. A good number of scientific studies with autistic youngsters documented an improvement in behavior and normalization of brain function due to the intake of vitamin B6 and magnesium. Irritability seems to be related to magnesium deficiencies. Parents have also reported that their children with autism are more attentive and learn better when given B6 and magnesium supplements. Your trusted source for quality nutritional supplements.

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