Many Different Diets Were Shown to Be Effective for Autism Symptoms

Nutrition continues to top the list of tools that help families manage symptoms of autism, in spite of contradicting and confusing information.

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Many Different Diets Were Shown to Be Effective for Autism Symptoms — (Oksana Kuzmina/Shutterstock)

By Amy Denney

5/9/2024

Updated:

5/17/2024

0:00

When Matthew Hirning was diagnosed with autism, specialists told Terri Hirning that her 4-year-old son had a genetic condition, there was nothing she could do about it, and that he’d need to live in a group home as an adult because he’d never be independent.

“I remember thinking, ‘I don’t know how, but that’s not going to be his story. That’s not an answer for what’s going on here,’” Ms. Hirning told The Epoch Times.

She’d already noticed when he ate certain foods he’d have trouble sleeping, intense sensory meltdowns, and virtually no eye contact. He also suffered from limited vocabulary and chronic constipation—at times he wouldn’t even respond to his name.

Both intuition and critical reasoning pointed to diet as an easy entry point to symptom resolution.

“We had a dear friend who was an occupational therapist specializing in autism and she mentioned red dye and MSG [monosodium glutamate, a flavor enhancer] … I started to just kind of dip my toe in the world that was biomedical intervention,” Ms. Hirning said.

The Hirnings learned that Matthew had a disrupted gut microbiome—the community of bacteria, viruses, and fungi that work synergistically to create metabolites that modulate neurotransmitters. That gut-brain connection can explain mood, behavior, and overall functionality changes that come through diet.

Success Through Diet

Earning an Eagle rank in Boy Scouts and attending college are among Mr. Hirning’s more recent accomplishments. Mother and son credit his diet and keeping his carbohydrates low as key to unlocking his healing.

However, there are no formal studies on whether a paleo diet might work for autism. The Paleo diet emphasizes eating whole foods and avoiding simple carbohydrates, sugar, grains, dairy, and legumes. In fact, only a few diets have been thoroughly researched in conjunction with autism spectrum disorders (ASD), which cause communication and social developmental problems.

While the variety of diets is complex to study, particularly in children with developmental difficulties, sharing wisdom on nutritional observations is common—especially among caregivers of families with ASD. Researchers took advantage of that sharing with an extensive survey of caregivers, many of whom have used nutrition to address symptoms common in autism.

A 2023 observational study involving more than 800 participants compared those using supplements and pharmaceuticals to those who used specialized nutrition—including the paleo and 12 other diets—to manage symptoms of autism.

“There are a lot of good reasons these diets are helpful. The underlying mechanisms for why they work relates to what we see happening in symptoms related to autism,” Julie Matthews, co-author of the study and certified nutrition consultant, told The Epoch Times. She’s founder of Nourishing Hope, personalized nutrition for autism and ADHD.

Rating the Effectiveness of Specific Diets

As a whole, therapeutic diets were shown to be safe and cost-effective tools that improved some symptoms with far fewer adverse effects than some pharmaceutical and supplemental options.

Results were published in the September 2023 Journal of Personalized Medicine, with even more details published in a free iPhone app called ANRC (autism nutrition research center) treatment radar. The study itself includes a summary of research that supports each diet for related symptoms.

On a benefit scale of zero to three, diet averaged 2.36 for symptom management, compared to 1.59 for nutraceuticals, and 1.39 for pharmaceuticals, which consisted of seizure and psychiatric medications.

“They helped and there was very little downside. I feel like that’s a double positive,” Ms. Matthews.

The diets selected were those that participants in the national survey were already following. Any diet that had at least 20 respondents was included in the statistical analysis. Of the 818 participants, 486 used dietary intervention. The most popular diets were a “healthy diet” and gluten/casein-free at 221 and 179 respectively. At the low end, the ketogenic and paleo diets were used by only 21 participants each.

The top-rated diets were defined as:

Healthy diet—rich in vegetables, fruit, and protein and low in junk food and sugars.
The Feingold diet—a whole food diet with no artificial colors, flavors, or preservatives, as well as being low in naturally occurring salicylates, or toxins produced by some plants.
Food avoidance diet based on allergy testing—an individual approach based on foods that produced elevated allergy responses in participants. Other studies have shown children with ASD tend to have high testing sensitivity to eggs, milk, and wheat.
Low sugar diet—used to balance blood sugars and lower inflammation.
Gluten-free/casein-free diet—avoidance of all gluten and casein, a milk protein.

Symptom Improvement

In addition to ranking diets by the net health improvements, the study charted 23 specific symptoms—including anxiety, attention, cognition, skin problems, language/communication, seizures, sensory sensitivity, sleep issues, social interaction, tics, and others—and matched each of them to the top five diets.

“Which diet did best depends on who you are as a person. If you are a person struggling with particular symptoms, you might be more interested in how diets perform with specific symptoms rather than overall,” Ms. Matthews said. “Some diets with a lower net benefit had some of the best symptom improvement.”

Even though the “healthy diet” had the highest overall score, it only ranked as the top diet in one symptom category, which was general health. On the other hand, the ketogenic diet took the top spot for nine symptom improvements, even though it was second to last for overall improvements.

Ms. Matthews pointed out that the ketogenic result may be skewed due to the lower number of participants. Because it’s a stricter diet, it was also likely used specifically for those who wanted to address many symptoms, including potentially severe symptoms like seizures.

“It was interesting to observe some of the things we see in practice and hear from parents and families … results support what we’ve seen to be true,” she said.

Minimizing Side Effects

Though the survey had a narrow focus on limited pharmaceuticals and offered limited details about specific supplements, all of the diets outperformed both in overall benefits. Seven of the diets reported minimal adverse effects (specific details were not included in the study), while six reported zero adverse effects.

Maria Richert Hong, cofounder of Epidemic Answers, interviewed Ms. Matthews recently in an online webinar about diets for the organization’s community of parents. Ms. Matthews has specialized in autism and nutrition since 2001 and wrote the book “Nourishing Hope for Autism,” detailing the way food affects biochemical pathways and how diet can help children heal.

Ms. Hong, who’s also a bestselling author and certified holistic health counselor, noted how various diets appeared effective for specific symptoms with the added benefit of being safe and cost-effective.

“If you go to a pediatrician, they’re going to give medications for those sorts of things, which most or all medications have some sort of side effect to them,” Ms. Hong said. “You can do this without side effects, and it just means changing your child’s diet. That’s really hopeful, too.”

More pediatricians are seeking dietary guidance, according to Ms. Matthews, who offers a course specifically for doctors. However, the vast majority of clinics offer little resources on nutrition, even if they suggest patients should eat differently.

GI Connection Uncertainty

Autism Speaks, a non-profit solutions-based organization that funds research, offers nothing regarding nutrition or diet in its resource guide. A representative from the organization told The Epoch Times in an email that it has funded grants that have led to nutrition studies.

Some of its website articles on nutrition advice for caregivers include how to understand feeding behaviors in autism, which includes picky eaters, as well as how to manage constipation—a common problem for children with autism.

One of its most recently funded studies on diet, published in 2019 in Frontiers in Psychiatry, concluded that dietary variation does not appear to cause gastrointestinal (GI) symptoms, nor do GI symptoms cause dietary variations.

In a statement emailed to The Epoch Times, Autism Speaks chief science officer Andy Shih said it’s beneficial for caregivers to meet with medical professionals to determine if food allergies and intolerances are behind GI symptoms or food aversion, both of which are common in autism.

Mr. Shih said while a healthy and balanced diet is important for the well-being of all children, “Research has not found a causal relationship between gut health and autism. With certain studies leveraging rating systems that produce disparate results, this particular study does not offer groundbreaking insight to counter other findings.”

Mr. Shih went on to note that Autism Speaks is aware of families that noticed improved symptoms after removing gluten and/or casein from their children’s diets.

“However, rigorous clinical research to date does not support the effectiveness of gluten- and casein-free diets as an evidence-based treatment for autism,” he said. “Gluten-free/casein-free diets are not a cure for autism but can potentially help in cases where children have a sensitivity to gluten or casein, and when used alongside other evidence-based behavioral and medical interventions.”

Dangers to Diets?

A 2021 study in Nutrients categorized casein-free and/or gluten-free diets as “dangerous dietary restrictions” that parents adopt on the false myths that such eating could improve behavioral or gastrointestinal symptoms. It acknowledged the preference children with autism have for high carbohydrate and processed foods but stated “there is a lack of sufficiently robust evidence to support specific dietary interventions in children with ASD.”

Ms. Matthews’ study on diets addresses common concerns, which mainly revolve around calcium deficiency in children on a casein-free or gluten/casein-free diet. It says children who are on a regular diet also have lower calcium levels, and that research has shown a multivitamin or mineral formula that includes calcium will increase levels.

Her study also notes that the gluten-free/casein-free diet has been associated in research studies with improvements in autism behaviors as well as cognition. Gluten-free and ketogenic diets have also been studied and found to be safe and effective, though most of the diets in the study haven’t undergone formal evaluation.

“There are many things that go into helping a child with autism,” Ms. Matthews said. “One of those ways is what people naturally do when they have gastrointestinal symptoms—let’s get our diet going in a healthy direction. Kids need good nutrition to grow and thrive.”

Grateful for His Diet

Mr. Hirning said he occasionally struggles with symptoms related to autism, but he’s grateful his mom adjusted his diet. He believes it’s led to his independence. He takes ownership of his diet because small amounts of anything ultra-processed or high in sugar or carbohydrates make his brain feel “fuzzy” He describes it as not functioning at his full capacity.

“I don’t know where I would be without my mom or how I would have ended up,” Mr. Hirning said. “I definitely feel like I have a good grasp on my diet now. Nowadays it’s better, but I notice some of the reactions will come if I eat something that’s not all that great.”

In high school, he took his own lunch, and he’s been able to travel internationally and eat some foods he normally wouldn’t eat without experiencing symptoms.

Ms. Hirning blogs about her and her son’s experiences, offering encouragement and resources for other families with children who have autism.

“It’s frustrating when you have medical professionals telling parents that food doesn’t matter, and yet, parents know. And they need to have those resources and be encouraged to go down that rabbit hole and do a food trial and be empowered to make these changes that can be absolutely transformational,” she said.