Impact on the physical, cognitive and emotional development of the person with autism

Autism is a neurodevelopmental disorder that affects communication, social interaction, and behavior in individuals with autism. While the exact cause of autism is not yet fully understood, it is believed that genetic, immunological, metabolic, and environmental factors may play a significant role in its development. Furthermore, it has been observed that nutritional deficiencies may be present in individuals with autism, which can affect their overall health and well-being.

Nutritional deficiencies in people with autism can be the result of several factors, such as:

• Food selectivity.
• Sensitivity to certain foods.
• Difficulty chewing or swallowing.
• Gastrointestinal problems.
• Enzyme deficiencies.
• Amino acid deficiencies.

FOOD SELECTIVITY

It is a common problem in people with neurodevelopmental disorders, and is characterized by a preference for certain foods and a rejection of others. This selectivity can be due to a variety of factors, such as sensory sensitivities, difficulties in communication and social interaction, rigidity in routines and repetitive behavior patterns, among others.

It can present itself in different ways, such as preference for foods with specific textures, colors, flavors or particular brands, as well as resistance to trying new foods or limiting the variety of foods consumed. This selectivity can have negative consequences on the health and well-being of the person, as it can lead to nutritional deficiencies, gastrointestinal problems, difficulties in growth and development, among others.

To address food selectivity in individuals with autism, it is important to work with a multidisciplinary team that includes health professionals such as physicians, dietitians, occupational therapists, speech therapists, and behavioral therapists. Some strategies that can be used to manage food selectivity in individuals with autism include:

1. Evaluate the underlying cause: It is important to identify the possible causes of food selectivity, such as sensory sensitivities, gastrointestinal problems, rigidity in routines or anxiety, food intolerances, allergies in order to effectively address them. There are many tests that can help us
2. Create a supportive environment: Creating a calm, distraction-free environment during meals can help reduce anxiety and improve a person's willingness to try new foods.
3. Introduce new foods gradually: It is important to introduce new foods gradually, starting with small amounts and combining them with familiar foods to increase acceptance.
4. Involve the person in food preparation: Involving the person in food preparation can increase their interest and willingness to try new foods.
5. Offer healthy options: Offering healthy and varied options can help ensure a balanced intake of nutrients and encourage exploration of new foods.
6. Consulting with a dietitian: Working with an autism-trained dietitian can help develop a personalized eating plan that meets the individual's nutritional needs and addresses their food preferences.

SENSITIVITY, ALLERGIES OR INTOLERANCES

Food sensitivities and intolerances to certain foods are very common in patients with neurodevelopmental conditions, and can contribute to a variety of symptoms and health problems. These sensitivities can manifest in different ways and can be due to a variety of factors: intestinal dysfunction (intestinal permeability), imbalances in the intestinal flora (intestinal dysbiosis), inflammatory responses, among others.

Some of the most common food sensitivities in people with autism include:

1. Gluten: They may be sensitive to gluten, a protein found in wheat, barley and rye. Gluten sensitivity can cause gastrointestinal symptoms, behavioral problems, difficulties with concentration and attention, among others.
2. Casein: Casein is a protein found in dairy products that some people with autism may have difficulty digesting. Sensitivity to casein can cause gastrointestinal problems, behavioral issues, difficulties with communication and social interaction, among others.
3. Additives and colorants: They may be sensitive to certain food additives, such as artificial colors, preservatives, and flavorings. These additives can trigger adverse reactions in some people, such as hyperactivity, irritability, sleep problems, and difficulty concentrating.
4. Sugar: Excessive sugar consumption can have a negative impact on anyone's health, and it also affects the behavior of some people with autism. Sugar can contribute to attention problems, hyperactivity, irritability, and difficulties in emotional regulation.

To identify and address food sensitivities, intolerances, or allergies to certain foods in individuals with autism, it is important to work with a health care professional, such as an autism dietitian or nutritional therapist, who will develop a personalized meal plan that meets the individual's specific nutritional needs and effectively addresses their food sensitivities.

Some strategies that can be used to manage food sensitivities in people with autism include:

1. Conduct food sensitivity testing: Food sensitivity testing can be performed to identify possible triggers for symptoms and health problems in the person with autism, so that they can determine what they are intolerant to or allergic to.
2. Following an elimination diet: In some cases, following an elimination diet that excludes foods to which the person is sensitive may help relieve symptoms and improve overall health.
3. Keeping a food diary: Keeping a food diary can help identify patterns between food intake and symptoms experienced, which can help healthcare providers identify potential food sensitivities.
4. Implement dietary changes: Making dietary changes, such as reducing gluten, casein, sugar and food additives, can help improve the health and well-being of a person with autism.

DIFFICULTY SWALLOWING OR CHEWING

Also known as dysphagia, it is a problem that can occur and may be related to a variety of factors, such as motor coordination problems, oral hypersensitivity, and sensory processing problems.

When we talk about sensory sensitivities, a person may reject certain foods due to a certain sensitivity to textures, flavors, or temperatures, which can lead to refusing to swallow or chew the food. With respect to sensory processing, the person's ability to perceive and respond to stimuli or certain sensations is affected, so certain sensations, such as having food in the mouth, are not perceived as a stimulus for eating, making chewing or swallowing difficult.

Oral hypersensitivity is characterized by increased sensitivity in the mouth and throat, and swallowing or chewing solid foods or even liquids may be a cause of discomfort and irritation.

To address swallowing or chewing difficulties in people with autism, it is important to work collaboratively with a team of health professionals, such as an occupational therapist, speech therapist, autism nutritionist, and a developmental disorders physician. They will help us develop personalized strategies to improve nutrition and promote healthy eating in people with autism.

Some strategies that can be used to help people with autism overcome difficulties with swallowing or chewing include:

1. Modification of food texture: Adapt the texture of foods (for example, crush, mix or soften them) to make them easier to chew and/or swallow. Emulsifiers are used when foods are very liquid and thus we avoid risks in patients who are unable to swallow, such as bronchial aspiration.
2. Provide support and supervision during meals: Provide support and supervision during meals to help the person chew and swallow properly.
3. Swallowing exercises and therapy: Perform swallowing exercises and therapy to improve the coordination and strength of the muscles used in chewing and swallowing.
4. Use sensory strategies: Implement sensory strategies, such as providing eating utensils with specific textures or using aromatherapy, to help the person feel more comfortable during meals.
5. Offer favorite foods: Offering foods that the person enjoys and that are easier to chew and swallow can motivate eating more effectively.

These deficiencies can affect the absorption of essential nutrients, which in turn can impact the physical, cognitive and emotional development of the person with autism.

One of the most common nutritional deficiencies in people with autism is a deficiency of certain essential nutrients, such as vitamins and minerals.

For example, many individuals with autism have been found to have low levels of vitamin D, vitamin B12, iron, zinc, and omega-3 fatty acids. These deficiencies may be related to poor diet, lack of sun exposure, intestinal absorption problems, or the use of certain medications.

HOW TO CORRECT DEFICIENCIES IN A PATIENT WITH AUTISM?

The most important thing is to carry out the appropriate tests to begin correcting any possible deficiencies. When you go to the doctor or nutritionist, they will indicate a series of examinations or tests that we must carry out to understand how our body is functioning:

• Exome: With this test we can observe if there is any genetic variant that prevents the production of metabolites based on those obtained in the daily diet, absorption and/or metabolism of any of the nutrients we obtain daily.
• Gut microbiota: With this we evaluate not only intestinal health but also the gut-brain axis, a microbiota allows:
  • Digesting some food components that the body cannot digest and metabolize on its own. For example, foods that generate unsaturated short-chain fatty acids, which are powerful antioxidants and help balance cholesterol and triglyceride levels.
  • Production of vitamins: some are essential for maintaining health, such as vitamin K and B12. 
  • Regulate the secretion of intestinal neurotransmitters, insulin and peptides essential for vital processes. 
  • Regulation of metabolism and energy balance.
  • Protection from pathogenic bacteria that can cause disease.
  • Maintaining the immune system: There are studies that suggest that up to 70% of the immune system depends on the microbiota. It helps the defense system to function properly. 

SUPPLEMENTS FOR TEA

• Vitamins: Studies show common deficiencies in vitamins D, B6, B12, calcium, potassium, and choline in children with ASD, which are not always corrected with supplements.
• Folinic acid: Research indicates that high-dose folinic acid may improve communication and repetitive behaviors in individuals with ASD, especially those with folate receptor alpha autoantibodies.
• Probiotics: While probiotics may help improve gastrointestinal symptoms such as constipation and abdominal pain in ASD, their impact on core ASD symptoms is not well established.
• N-acetylcysteine: N-acetylcysteine has shown mild improvement in irritability but mixed results in repetitive behaviors in children with ASD, with some studies reporting benefit and others showing no improvement.
• Omega-3 fatty acidsMeta-analyses have shown mixed results regarding the benefits of omega-3 fatty acid supplementation in ASD, with some trials showing no significant improvement in symptoms.

WATER SOLUBLE VITAMINS

Water-soluble vitamins are easily absorbed, and excess water-soluble vitamins are excreted in urine, so they are the most abundant in the daily diet.

• The thiamine plays an important role in the metabolism of fats, carbohydrates and proteins. It is therefore important for mitochondrial function. The bioavailable forms of B1 are alliathiamine, lipothiamine and benfontiamine.
• The riboflavin It is also important for the metabolism of carbohydrates, fats and proteins. It is also necessary to activate B6 and B9.
• The niacin is important for cellular metabolism and is the only vitamin that releases growth hormones. It also stimulates hydrochloric acid in the stomach to ensure proper digestion. Niacin is known as “Nature's Valium"because it is very calming.
• The B5 or also known as pantothenic acid It is called the anti-stress vitamin because it activates the adrenal glands to produce cortisol. The bioavailable form of B5 is coenzyme A.

B6 is involved in the metabolism of energy, amino acids, carbohydrates, lipids and hormones. In addition, B6 works to produce neurotransmitters and is responsible for nerve function.

Folate is food for the brain. It is needed to produce red blood cells, for energy production, and is important for proper cell division and replication.

Vitamin C

Vitamin C is a powerful antioxidant, therefore it is important for immunity. It is necessary to help heal wounds and promote iron absorption.

The body does not produce or store vitamin C, so sources of vitamin C MUST be consumed regularly to avoid deficiency. It is important to know that vitamin C supplementation is contraindicated in kidney disease, high oxalate levels, and hemochromatosis.

Fat-soluble vitamins

Fat-soluble vitamins must be taken with fat to be absorbed. They can accumulate in the liver, so it is essential to monitor levels through blood tests.

Vitamin A

The retinol-binding protein that transports vitamin A needs zinc. Therefore, if there is a zinc deficiency, the function of vitamin A is often impaired. Zinc converts retinol into retinol, which is the form of vitamin A needed for the rods in the eyes.

Vitamin D

Vitamin D is needed to help the body absorb calcium and fight off illness and infection. Most vitamin D is produced in the skin after sun exposure. However, despite getting plenty of sun, some children may still not be able to effectively convert sunlight into vitamin D.

Vitamin E

Vitamin E is an antioxidant that prevents cell damage by inhibiting fat oxidation. It also supports nerve function, muscle health, and cholesterol metabolism.

Vitamin K

Vitamin K is necessary for blood clotting and bone formation and helps bones absorb calcium.

Minerals

Minerals are important for bones, teeth, hormone production, muscles, and brain and nervous system health.

Magnesium

Magnesium is a critical mineral needed for hundreds of metabolic processes in the body. It is needed for energy production, calcium and potassium absorption, hormone production, and more. This 2020 study showed that children with autism and ADHD had less magnesium in their hair and excreted too much magnesium in their urine.

Iron

Iron is necessary for the production of hemoglobin, which carries oxygen from the lungs to the tissues.

Zinc

Every human cell contains zinc. It is very important for immune function and proper growth. Additionally, zinc is necessary for reproductive health, energy metabolism, proper sense of taste and smell, and to fight the formation of free radicals. Taking zinc is known to cause stomach upset, so be sure to take it with food. Additionally, zinc can lower cortisol levels; therefore, it is best to take it at night as it is ideal for cortisol to be lower before bed.

Lipids

Lipids are fats that control what enters and leaves cells.

The omega 3 They keep cell walls soft and not rigid. Sixty percent of the brain is fat, so healthy fats are extremely important for brain health. The body cannot produce Omega 3 fatty acids, so they are considered “essential.” The most bioavailable forms of Omega 3 are found in fish. For this reason, it is known as fish oil. 

Coenzyme Q10

CoQ10 is essential for energy production. In fact, ubiquinol is the most important nutrient for mitochondrial dysfunction, which is so common in autism. For this reason, it is very important for neurological function, cognition, immune function, and circulation. It also inhibits histamine, so it can be beneficial in case of allergies.

Amino acids

Amino acids are the building blocks of proteins. Data from a study showed that levels of the following amino acids were lower than average:

• Arginine from 28%
• Glutamate 23%
• Histidine 20$
• Leucine 17%
• Lysine 21%
• Phenylalanine 15%
• Serine 21%
• Taurine 24%
• Threonine 19% 
• Tryptophan 22% 

A study showed that serum levels of hydroxyproline and tyrosine in children with ASD were more than 2-fold and 11-fold higher compared to control values, respectively. And a multiple regression analysis showed that decreased serum levels of Leucine and Serine, and elevated levels of hydroxyproline and Tyrosine were significantly associated with ASD.

Amino acids are essential for the growth, development and proper functioning of the body. A deficiency in amino acids can negatively affect protein synthesis, cellular metabolism and the functioning of different systems and organs in the body.

Some consequences of amino acid deficiencies include delayed growth and development, impaired muscle function, weakness, fatigue, skin and hair problems, alterations in the immune system, among others. These are the fundamental reasons for evaluating amino acid levels in the body to detect possible nutritional deficiencies and take the necessary measures to correct them through a balanced diet, nutritional supplements or specific treatments.

At Enevia we offer specialized consulting services and different tests that can guide you in different areas such as neurology, genetics, nutrition and general medicine, as well as help you make the right decisions and analyze medical tests to achieve effective treatment for the pathologies that you may suffer from.

Enter our website through www.eneviacare.com and you will be able to find the services that we can offer you.

At Enevia, we are your ally in health!

We also leave you with a recent article that we published on our blog about the gut-brain axis: https://eneviahealth.com/blog/autismo-y-eje-intestino-cerebro-vinculo/

Bibliography

Nutritional Therapy for Autism | NICHD Español (nih.gov)

Metabolic interventions in Autism Spectrum Disorder – ScienceDirect

Serum amino acid spectrum in children with autism spectrum disorder (ASD) – ScienceDirect