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  • Dolske M. et al.  A preliminary trial of ascorbic acid as supplemental therapy for autism.  Progress in Neuropsycho-pharmacology and Biological Psychiatry.  17(2):765-774, 1993.
  • Earnest, C., et al. Complex Multivitamin Supplementation Improves Homocysteine and Resistance to LDL-C Oxidation. Journal of the American College of Nutrition. 22: 400-407, 2003.
  • Engler, M. M., et al. Antioxidant Vitamins C and E Improve Endothelial Function in Children With Hyperlipidemia: Endothelial Assessment of Risk from Lipids in Youth (EARLY) Trial. Circulation. 108: 1059 – 1063, 2003.
  • Etten, E., et al. 1,25-Dihydroxycholecalciferol: Endocrinology Meets the Immune System.  Proceedings of the Nutrition Society.  61: 375-380, 2002.
  • Fernandez-Robredo, P., et al. Vitamins C and E Reduce Retinal Oxidative Stress and Nitric Oxide Metabolites and Prevent Ultrastructural Alterations in Porcine Hyperscholesterolemia. Investigative Ophthalmology and Visual Science. 46 (4): 1140-1146, 2005.
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  • Hall, S. and Greendale, G.  The Relation of Dietary Vitamin C Intake to Bone Mineral Density: Results from the PEPI Study.  Calcified Tissue International. 63: 183-189, 1998.
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  • Holick, M. Resurrection of Vitamin D Deficiency and Rickets. Journal of Clinical Investigation. 116: 2062-2072, 2006.
  • Holick, M. Vitamin D: Importance in the Prevention of Cancers, Type 1 Diabetes, Heart Disease, and Osteoporosis. American Journal of Clinical Nutrition. 79: 362 – 371, 2004.
  • James S et al. Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in children with autism. American Journal of Clinical Nutrition. 80(6):1611-7, 2004.
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  • Kelly G. Folates: supplemental forms and therapeutic applications. Alternative Medicine Review. 3:208-20, 1998. Review.
  • Kidd P. Autism, an extreme challenge to integrative medicine.  Part II: medical management. Alternative Medicine Review. 7(6):472-499, 2002.
  • Kimura,  M., et al.  Methylenetetrahydrofolate Reductase C677T Polymorphism, Folic Acid and Riboflavin are Important Determinants of Genome Stability in Cultured Human Lymphocytes. Journal of  Nutrition. 134(1):48-56, 2004.
  • Kirsch M et al. Ascorbate is a potent antioxidant against peroxynitrite-induced oxidation reactions. Evidence that ascorbate acts by re-reducing substrate radicals produced by peroxynitrite.  J Biol Chem.  275(22):16702-16708, 2000.
  • Kleijnen J and Knipschild P. Niacin and vitamin B6 in mental functioning: a review of controlled trials in humans. Biological Psychiatry. 29(9):931-41, 1991.
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  • Kraus, A., et al. Supplementation with Vitamin C, Vitamin E or ß-Carotene Influences Osmotic Fragility and Oxidative Damage of Erythrocytes of Zinc-Deficient Rats. Journal of Nutrition. 127: 1290-1296, 1997.
  • Kuo C et al.  Ascorbic acid, an endogenous factor required for acetylcholine release from the synaptic vesicles.  Japan Journal of Pharmacology.  30(4):481-492, 1980.
  • Leggott, P., et al. Effects of Ascorbic Acid Depletion and Supplementation on Periodontal Health and Subgingival Microflora in Humans. Journal of Dental Research. 70: 1531-1536, 1991.
  • Lelord G et al.  Effects of pyridoxine and magnesium on autistic symptoms:  initial observations.  Journal of Autism Developmental Disorders.  11(2):219-229, 1981.
  • Lenton, Kevin J., et al.  Vitamin C Augments Lymphocyte Glutathione in Subjects with Ascorbate Deficiency. American Journal of Clinical Nutrition. 77: 189 – 195, 2003.
  • Levy A and Hyman S. Use of complementary and alternative treatments for children with autistic spectrum disorders is increasing. Pediatric Annals. 32:685-91, 2003.
  • Levy S et al. Novel treatments for autistic spectrum disorders. Mental Retardation and Developmental Disabilities Research Reviews. 11(2):131-42, 2005. Review.
  • LimeBack, H., et al.  The effects of Hypocalcemia/Hypophosphatemia on Porcine Bone and Dental Hard tissues in an Inherited Form of Type 1 Pseudo-Vitamin D Deficiency Rickets. Journal of Dental Research. 71:346-352, 1992.
  • Lonsdale D et al. Treatment of autism spectrum children with thiamine tetrahydrofurfuryl disulfide: A pilot study.  Neuroendocrinology Letters. 23(4):303-308, 2002.
  • Marlow M et al.  Decreased magnesium in the hair of autistic children.  Journal of Orthomolecular Psychiatry.  13(2):117-122, 1984.
  • Martineau J et al.  Vitamin B6, magnesium, and combined B6-Mg:  therapeutic effects in childhood autism.  Biological Psychiatry.  20(5):467-478, 1985.
  • Martineau J et al. Brief report: an open middle-term study of combined vitamin B6-magnesium in a subgroup of autistic children selected on their sensitivity to this treatment.  Journal of Autism and Developmental Disorders. 18:435-447, 1988.
  • Martineau J et al. Effects of vitamin B6 on averaged evoked potential in infantile autism.  Biological Psychiatry.  16(7):627-641, 1981.
  • Martineau J et al. Electrophysiological effects of fenfluramine or combined vitamin B6 and magnesium on children with autistic behavior. Developmental Medicine and Child Neurology. 31:728-736, 1989.
    Matkovic, V., et al.  Calcium Supplementation and Bone Mineral Density in Females from Childhood to Young Adulthood: A Randomized
    Controlled Trial. American Journal of Clinical Nutrition. 81: 175 – 188, 2005.
  • Matsuda, T. and Toda, T. Effects of Vitamin B6 on Dental Caries in Rats.  Journal of Dental Research.  46(6): 1460-1464, 1967.
  • McGinnis W. Oxidative stress in autism. Alternative Therapies in Health and Medicine. 10(6):22-36, 2004. Review.
  • Megson M. Is autism a G-alpha protein defect reversible with natural vitamin A?  Medical Hypotheses.  54(6):979-983, 2000.
  • Meisel, P., et al. Magnesium Deficiency is Associated with Periodontal Disease. Journal of Dental Research. 84(10): 937-941, 2005.
  • Methylcobalamin. Alternative Medicine Review. 3:461-3, 1998.
  • Meydani M.  Protective role of dietary vitamin E on oxidative stress in ageing.  Age.  15:89-93, 1992.
  • Misner, D., et al. Vitamin A Deprivation Results in Reversible Loss of Hippocampal Long-term Synaptic Plasticity. Proceedings of the National Academy of Sciences. 98(20): 11714-11719, 2001.
  • Moretti P et al. Cerebral folate deficiency with developmental delay, autism, and response to folinic acid. Neurology. 64(6):1088-90, 2005.
  • Mousain-Bosc M et al. Improvement of neurobehavioral disorders in children supplemented with magnesium-vitamin B6. Magnesium Research. 19(1):53-62, 2006.
  • Mousain-Bosc, M., et al. Magnesium, Vitamin B6 Intake Reduces Central Nervous System Hyperexcitability in Children. Journal of the American College of Nutrition.  23: 545S-548S, 2004.
  • Nanci, A., et al. Morphological and Immunocytochemical Analyses on the Effects of Diet-induced Hypocalcemia on Enamel Maturation in the Rat Incisor.  Journal of Histochemistry and Cytochemistry. 48(8): 1043-1057, 2000.
  • Numakawa Y et al.  Vitamin E protected cultured cortical neurons from oxidative stress-induced cell death through the activation of mitogen-activated protein kinase and phosphatidylinositol 3-kinase.  Journal of Neurochemistry.  97(4):1191-1202, 2006.
  • Osendarp S et al. Effect of a 12-mo micronutrient intervention on learning and memory in well-nourished and marginally nourished school-aged children: 2 parallel, randomized, placebo-controlled studies in Australia and Indonesia. American Journal of Clinical Nutrition. 86(4):1082-93, 2007.
  • Outila, T., et al.  Vitamin D Status Affects Serum Parathyroid Hormone Concentrations during Winter in Female Adolescents: Associations with Forearm Bone Mineral Density.  American Journal of Clinical Nutrition. 74: 206 – 210, 2001.
  • Paleologos M et al. Cohort Study of Vitamin C Intake and Cognitive Impairment. American Journal of Epidemiology. 148(1):45-50, 1998.
  • Pfeiffer S et al. Efficacy of vitamin B6 and magnesium in the treatment of autism: a methodology review and summary of outcomes. Journal of Autism and Developmental Disorders. 25(5):481-93, 1995.
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  • Rahman, J., et al. Effects of Zinc Supplementation as Adjunct Therapy on the Systemic Immune Responses in Shigellosis. American Journal of Clinical Nutrition. 81:  495 – 502, 2005.
  • Raslova K., et al.  Effect of Diet and 677 C-->T 5, 10-Methylenetetrahydrofolate Reductase Genotypes on Plasma Homocyst(e)ine Concentrations in Slovak Adolescent Population. Physiological Research. 49(6): 651-8, 2000.
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Nutrition and Your Autistic Child
Rosanne Rust 

It seems like common sense that a well nourished child is a happier child. Many parents have noticed moody or cranky behavior in their young children before meal time or after school when they arrive home hungry. For an Autistic child, however, who may not be able to accurately communicate his or her needs, this hunger may go unnoticed. Or they may not want to eat and may have many food aversions. For these reasons, integrating nutrition therapy into treatment for children with autism is critical.

In many cases, nutrition is not an integral part of overall therapy at diagnosis. Yet many parents who eventually seek out this information on their own, are getting nutrition information from questionable sources. Some parents may not take nutrition therapy into consideration at all.

Autism is complex and involves a spectrum of challenging behaviors, so it is natural for both parents and caregivers to initially focus directly on controlling those behaviors. In many cases, the health care team includes a physician, occupational therapist, speech therapist and behavior therapist; but does not include a registered dietitian to provide nutrition therapy. What is interesting is that almost all autistic children have nutritional deficiencies, food intolerance, or gastrointestinal disorders that often are not thoroughly addressed. While studies involving the significance of the effect nutrition status has in the management of autism are preliminary, there is good reason to consider filling this gap in treatment.

The goal of nutrition therapy in autism is to support the structure and function of the child's brain and body to perform at their optimal level and to maximize the child's brain function so that the response to other treatment is enhanced. Proper nutrition therapy should include a comprehensive nutrition assessment and also address feeding problems, any gastrointestinal problems, or need for vitamin and mineral supplementation.

Imagine a child who has difficulty communicating his or her needs, feeling uncomfortable every time he eats due to unknown food sensitivities or intolerance. This sends a negative message to avoid those foods or avoid eating all together. Children with food allergies are at higher risk for nutrition-related problems and decreased growth, but children with autism are more negatively affected due to their problems with sensory integration dysfunction.

Allergy symptoms may include hives, coughing, eczema, nausea, diarrhea, constipation, gastrointestinal reflux, watery eyes, nasal congestion or sneezing. To determine which foods are problematic, an "Elimination/Challenge Diet" is applied. Once problem foods are removed from the diet, the discomfort is resolved, and the child becomes more open to mealtime. A well-nourished child is a better-behaved child. In many cases, children who undergo nutrition assessment and treatment, have a formed bowel movement for the first time in his or her life. Imagine how eliminating this discomfort helps a child!

Many autistic children may also have a subclinical nutrition deficiency. This is a deficiency of a particular vitamin, mineral, or essential fatty acid that is not severe enough to produce a classic deficiency symptom, but rather has more global, subtle effects that result in loss of optimal health and impairment of body processes. These subclinical deficiencies can cause irritability, poor concentration, depression, anxiety, sleep disturbances or loss of appetite. While it is best to determine which vitamin or mineral the child may be deficient in, minimally a standard multi-vitamin and mineral supplement is recommended. Look for supplements that have the USP label on them, and those that are free of colors, allergens or artificial flavors to eliminate any possible food intolerance issues. Using liquid forms that can be mixed into favorite foods (such as applesauce, yogurt, juices, or sherbet) is one strategy for children who have difficulty chewing or swallowing vitamins. Asking a pharmacist to compound a multivitamin and mineral supplement that is age appropriate is another option.

In addition to the multivitamin/mineral, omego-3 fatty acids have been shown to be helpful as well. Numerous studies indicate that Omega-3 fatty acids are deficient in those who have ADHD, Dyslexia and Dyspraxia. Abnormalities in fatty acid metabolism may account for many features common in these conditions. There is some preliminary evidence that it is also deficient in children with autism. For children ages seven and older, 650 milligrams per day of an Omega-3 that provides both EPA and DHA is recommended. For children four to six years of age, 540 milligrams per day is recommended, and for children aged one to three, 390 milligrams per day is needed.

Much more research is needed in the area of nutrition and autism, but clearly nutrition is a key piece of the treatment puzzle that is often missing. Speak with your health care team about a thorough nutrition assessment for your autistic child.

Rosanne Rust, MS, RD, LDN
Registered Dietitian
Nutrition Consulting, Writing, Lectures
Licensed Provider for Real Living Nutrition Services®

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