Written by: Kevin Cann
Autism seems to always be at the forefront of debate. Whether it be vaccines leading to autism, or the modern diet, or genetics, or a combination of all of these, people are always debating on the cause and proper treatment for it. We can’t deny that autism is on the rise. It is now estimated that one out of 68 children in the United States has autism. This is a 30% increase from just two years ago.
The drastic rise in autism leads me to believe that our modern lifestyle definitely plays a role in the development of the disorder. Recent research looked at ketogenic diets and their potential benefits to treating autism. This paper looked at 8 studies, 5 of which were human studies and 3 of which were studies performed on animals.
The study concluded by stating “The limited number of reports of improvements after treatment with the KD is insufficient to attest to the practicability of the KD as a treatment for ASD, but it is still a good indicator that this diet is a promising therapeutic option for this disorder” (1). What could be happening during a ketogenic diet that is having this potential positive effect on the disorder?
When nutrition is used as an intervention and it has an impact, either positive or negative, we need to look at the gut microbiome to get more answers. Our diet influences our gut microbiome and 90% of children diagnosed with autism have some form of eating concern such as being “picky” eaters (2). Children with autism have a strong liking of sweet and starchy processed foods.
Our gut microbiome can influence behavior. One way in which our gut microbiome influences behavior is by making us crave certain foods. This has a survival benefit to the specific bacteria that thrives off of that given food. At the same time the bacteria makes us crave sweet and starchy processed foods, it can suppress our appeal to eat foods such as fruits and vegetables. This gives the species of bacteria a hand up in colonizing our body. They get plenty of food and suppress the food of competing bacteria.
A ketogenic diet would extremely limit the sweet and starchy processed foods. This deprives certain gut bacteria of the food they need and may be a way to help restore balance in the microbiome. To further the argument of the role that the gut microbiota play on autism, the Journal of Ecology in Health and Disease, published an article referencing one child’s autism symptoms improving on a course of antibiotics (3).
Dr. Natasha Campbell-McBride developed the Gut and Psychology Syndrome Diet (GAPS) and has had large success in treating disorders such as autism. This diet has some similarities with a ketogenic diet and removes processed foods entirely. I agree that more research needs to be done to know for sure the role the gut microbiome plays in disorders such as autism, but it is hard to ignore all of the positive stories you see on this site, the GAPS site, and many others.
One connection that seems to link the gut microbiome to autism is the fermentation of propionic acid. When injected into rats, propionic acid shows a large change neurologically that is similar to autism. Some of the changes seen are neuroinflammation, increased oxidative stress, and glutathione depletion (probably due to the increased oxidative stress and inflammation). Common antibiotics are known to impair the bacteria responsible for producing propionic acid (4). This could explain the success the antibiotics had on the one child mentioned in the previous study.
Not only is nutrition important, but so is exercise. A meta-analysis looked into the role exercise plays in autism and the authors concluded by stating that physical activity has a positive effect on the symptoms associated with the disorder (5). Exercise also promotes a balanced gut microbiome (6). Big surprise, diet and exercise have a positive effect.
The gut microbiome might not be the only area in which a ketogenic diet may improve symptoms of autism. Autism, like many other disorders, has a spectrum of symptoms associated with it. Some children with autism exhibit behavioral symptoms and fall victim to seizures. Ketogenic diets have been used to treat epilepsy and the seizures associated with it.
The therapeutic use of ketogenic diets in helping with epileptic seizures has led researchers to look at ketogenic diets and their affects on seizures and behavioral problems associated with autism. The ketogenic diet may be beneficial to those suffering from seizures and behavioral problems due to its effects on the glucose sensitivity in the brain as well as with pyruvate dehydrogenase deficiencies (7).
Caution should be taken before placing an autistic child on a ketogenic diet. Labs should be drawn to check for metabolic deficiencies. The reason the ketogenic diet is so effective at treating seizures is its effects on the glucose transporter GLUT1. GLUT1 is responsible for transporting glucose into the cells from the blood or from other cells. It is also responsible for transporting glucose across the blood brain barrier.
A lack of the GLUT1 transporter leaves the brain cells starving for energy. A ketogenic diet starves the body of glucose and forces it to produce an alternative fuel source known as ketones. The brain cells that can’t utilize glucose due to the GLUT1 deficiency can now get fuel from the ketones and function more normally.
A ketogenic diet should always be administered from a qualified health professional. It is a low carb, moderate protein, and high fat diet. Ketones in the body can actually be measured through the urine using ketone testing kits that can be purchased right at your local pharmacy. Calories can be calculated using an equation such as the Mifflin-St Jeor. Utilizing MCT oil you can actually keep carb intake a bit higher and negate some of the negative effects of going too low carb. MCT (medium chain triglycerides) are converted in the liver to ketones and are readily available for cells. Usually 6-8 tablespoons of MCT oil daily is effective or double that for coconut oil since 50% of the fats in coconut oil are MCT.
With the MCT oil supplementation carbs can begin around 50g per day. Protein should start around 100g per day to 150g per day as the body needs roughly 600-800 calories of glucose daily. The rest of the calories should come from fats. These numbers may be adjusted after the start of the ketogenic diet with the use of the ketone testing strips. Again, be sure to check with your healthcare provider before implementing a ketogenic diet.
Hopefully research continues to look at the gut microbiome-brain connection to find more productive treatment plans for disorders such as autism. The current research looks promising in this realm. Perhaps one day we will be able to pinpoint the exact bacterial species responsible for symptoms and be able to use targeted antibiotics and probiotics to help correct the disorder. Until then, living a healthy lifestyle of minimized processed foods, exercising, sleeping, and having strong family and friend relationships can go a long way to minimizing symptoms.