There is no doubt that gastrointestinal pain can alter a child’s behavior in many ways. In addition to the direct emotional responses a child can display in reaction to discomfort, the brain—and hence behavior—can be affected chemically by food intolerance reactions. Regardless of the initial cause of food sensitivities, whether purely genetic, early antibiotic drug exposure, or other source, chronic reactions over time can lead to autoimmune symptom complexes such as asthma or autism.
As originally published in Natural Mother Magazine
Gastrointestinal complaints are known to be very common among children who are diagnosed with autism spectrum disorders (ASDs) as well as with ADHD. I demonstrated in last month’s article that such symptoms as diarrhea and constipation are not just behavioral results of the brain alterations attributed to ASDs. GI conditions are recognized to be part of the cause of autistic and ADHD behaviors in a large subset of these children. At times, they may even be part of a whole systemic autoimmune process that leads to such brain alterations.
Efforts to heal a child’s gut are worthy if they may reduce problematic behaviors and increase a child’s social and learning abilities. Many parents have found just that. The condition is generally 3-pronged: poor gut flora, damaged intestinal linings, and intolerance reactions to foods. Each component needs to be addressed, and improvement of each will lead to improvement of the others, hopefully then leading to behavioral improvements. In addition, this gut healing can lead to reduced risks for other autoimmune disorders down the line, such as diabetes, arthritis, and inflammatory bowel disease.
Do Milk and Gluten Cause Autism?
Powerful correlations between active intestinal food reactions and altered child behavior have been documented by many researchers for decades and have been observed thousands of times over by families of food sensitive children. Many parents report that their ASD children’s behavioral symptoms and functioning improve through dietary interventions and other gut healing measures. The same is true for those labeled with ADHD.
Reactions to various food proteins are often at the base of an ASD child’s gut troubles and behavioral responses. In turn, food reactions may cause or be caused by poor flora and damaged gut linings. Other flora-nurturing and gut-healing steps are important components of an effort to improve a child’s behavioral symptoms, but as long as a child’s system is being riled up by food reactions, greater healing is unlikely.
A preponderance of milk and gluten antibodies has been found in ASD children compared to those not on the spectrum, meaning that many more ASD children are reacting to these foods than are typical children. Although parents have found milk and gluten to be the most common offenders, it’s quite common for various other foods to be problematic for any given child.
Numerous studies and several study reviews have been performed with diets free of milk and gluten in attempt to reduce symptoms in autistic children. Both of these foods have peculiar properties that can be specifically linked to gut damage and potential brain effects. However, when researchers look at ASD children avoiding these two food ingredients, consistent improvements are not being measured. These studies are then paraded as “proof” that autism is never related to diet. These studies do make it clear that random exclusion of milk and gluten—and only milk and gluten—is not an across-the-board autism cure.
Diets need to be tailored to each child’s specific food reactions. Improvements are not going to be exhibited from any food eliminations if a child is still reacting to some other foods or additives. Some children are not reacting to milk or gluten and have entirely different foods offending them. Likely, a portion of ASD children are not reacting to any foods.
Although the random milk and gluten avoidance analyses come up short, other studies and reviews do reveal that a considerable subset of ASD children suffer from GI conditions related to food reactions. When high quality elimination diets are performed to discover exactly what foods a child reacts to, significant results are measured with strict avoidance of these foods. The behavioral links are so strong in many ADHD children that it’s quite possible that without their consumption of offending foods they have no ADHD.
Foods and the Brain
Intestinal food reactions lead to intestinal inflammation or more serious intestinal membrane degradation (villous atrophy). This kind of damage allows proteins to leak across the intestinal membranes, leading to inflammatory immune reactions in the blood. Researchers have discovered various manners by which such inflammation in the body can lead to slight interruptions of the blood-brain barrier. An impaired blood-brain barrier may allow various inflammatory factors to pass directly into the brain, altering function and behavior.
Other researchers describe routes by which inflammatory factors can have influence over brain pathways without directly crossing the blood-brain barrier. In addition to these mechanisms, scientists have mapped out direct brain responses to stress. They have found that stress, which can result from the pain of a food reaction, can cause the activation of brain mast cells and the release of histamines directly inside the brain. Various kinds of hormone releases are also documented to occur in some food sensitivity reactions. These too are seen to have direct effects in the brain.
Via any of these routes, food reactions can lead directly to behavior-modifying brain responses. Affected children can display easily triggered moods, hyperactivity, reduced attention, withdrawal, tantrum-throwing, and even bouts of laughing or euphoria. Besides these short-term reactions that occur hours or days after an offending food exposure, chronic reactions and gut flora interruptions can lead to more prolonged autoimmune processes such as those which often lead to an autism diagnosis.
Deciding to Explore Dietary Connections
Interestingly, many medical studies of dietary links summarize that if medication treatments for a child’s autism or ADHD symptoms fail, elimination dieting is worth a try. Wouldn’t it make more sense to try it the other way around? It seems more reasonable to determine how much, if any, progress can be made by exploring whether a child exhibits actual intestinal, behavioral, or other reactions to milk or gluten, other foods, or to food colorings or additives. In these cases, the opportunity may exist for improved behavioral symptoms with avoidance of potentially offending foods, possibly reducing or eliminating the question of medication and creating a healthier child.
Immediate-type food reactions that occur within minutes of exposure fit into the strict definition of food allergies. These are typically measurable through blood tests for IgE antibodies, or through skin scratch tests. Food reactions among ASD children are typically delayed and not IgE antibody related. Intestinal delayed reactions, often referred to as intolerance reactions or food sensitivity reactions, start some 2 to 72 hours after exposure to the food and possibly last for a few days. IgG antibody blood tests are intended to diagnose delayed-type food reactions but their sensitivity and accuracy are not great. Additionally, standard celiac disease tests for that specific kind of gluten intolerance are also often negative in children on the spectrum who are clearly reacting to gluten. Any negative test results mean nothing. It’s entirely possible that the child is reacting to foods that do not show up in any standard blood or skin tests.
Although today’s mainstream blood tests are only weakly helpful in determining the presence of food reactions and which foods are being reacted to, extensive blood and biopsy tests in research laboratories are able to document the various bodily reactions. Some of the immune system components found to be involved include T cells, mast cells, several interleukins and other inflammatory cytokines, as well as IgG, IgA, and IgM antibodies and platelet-activating factors.
Elimination dieting is the key to discovering what foods are affecting a child, and what effects they have. The goal is to eliminate any potentially offending foods so that the child’s digestive system recovers from inflammation and damage, and hopefully behavioral improvements begin to occur. For a condition as complicated as autism, it’s best to perform a highly extensive elimination diet from the start, whereby only a handful of nutritionally complimentary, very low allergen foods are fed. If a child is breastfeeding, the mother needs to remove the foods from her diet as well.
Typically, food reactions are thought of as occurring in response to food proteins, but reactions to various chemicals in foods are common as well. The most common food chemical sensitivities are to added sulfite preservatives, benzoates, various food colorings, and to high levels of salicylates or histamines found naturally in certain foods. These are found to present statistically significant results in many studies and reviews, more so with ADHD but also in some autism studies.
The use of probiotic supplements, cartilage factors (such as in bone stock), omega-3 fatty acids, and other gut-healing supplements can greatly help to support the process. This diet is maintained while the child’s gut hopefully heals. During this time, parents are watching for any GI symptoms to go away and observing any changes in the child’s behavior. The child is then “challenged” with each of the eliminated foods over time, one at a time, and watched for the return of symptoms.
In a mildly affected child, one may find a much more comfortable child within several days after removal of potential allergens from the diet. In the case of a child with moderate to severe symptoms, extensive tissue damage and flora imbalance can preclude observable symptom improvements for weeks.
It’s Not Lactose
There is a highly common misconception that even many doctors still get wrong. Do not confuse milk protein allergy or intolerance with lactose intolerance. Lactose intolerance does not involve any kind of immune system factors and the only symptoms revolve around gas and diarrhea. Lactose intolerance tends to develop with age and is simply an insufficiency of the enzyme needed to digest this milk sugar. Any rashes, itching, breathing difficulties, or constipation in response to milk consumption are reactions to proteins. Both milk protein reactions and lactose intolerance can cause abdominal pain, diarrhea, and gas, but most children who develop symptoms from milk ingredients are actually reacting to milk proteins, not to lactose. Intestinal damage, such as that which occurs in sensitivity reactions to milk proteins, can result in temporary reductions in available lactase enzyme. Once some healing occurs, good lactose digestion should return.
Only strict avoidance of problematic foods will maintain a healthy gut and behavior improvements. After a long period of gut healing, some children are able to regain tolerance to some foods. It’s common, however, for reactions to re-develop over time. Any re-introduction process needs to be carried out gingerly.
If extensive and precise food eliminations do not bring about improvements in your child, and blood IgE and IgG tests give no clues, be sure you’ve also examined other exposures your child encounters, such as fragrances, animals, body care products, and cleaning products in the home. In chemically sensitive children, such agents can intensify food reactions. Finally, you may resolve that the source of child’s symptoms is not a product of determinable food or other environmental exposure. Depending upon the severity of symptoms, you may wish to return to your integrative care practitioner for other kinds of testing, including in-depth stool tests. Other gut healing efforts may still bring on some positive results over time.
References and further information can be found in the author’s book: Baby Poop
See other Autism articles on this site.