Vitamin D and Autism Spectrum Disorders

Vitamin D and Autism

Vitamin D has become popular in the last few years due to its role in cancer prevention. More recently, doctors in Sweden have pointed to a possible link between vitamin D deficiency and autism. The idea that vitamin D deficiency may have a link to autism isn’t that big of a stretch considering that vitamin D deficiency is emerging in scientific literature as a possible culprit in a wide range of diseases.

In fact, Dr. John Cannell, an American doctor and Executive Director of the Vitamin D Council, connects vitamin D deficiency not only to autism, but depression, mental illness and a variety of other problems that plague our modern society.

Vitamin D and Autism

A unique aspect of vitamin D is that it is a nutrient that can be synthesized by the human body from our skin through the action of sunlight. Dr. Cannell contends that autism rates have skyrocketed since the late 1980s when in the interest of public health, medical experts advised us to avoid continued exposure to bright sunshine. It was then that sun avoidance and/or application of sunscreen was promoted to prevent skin cancer. However, that advice may have had the unintended consequence of making a large segment of the population vitamin D deficient.

Why We Need Vitamin D
Vitamin D helps the gut absorb calcium, which most people know is needed by bones and teeth need to grow and stay strong. But Vitamin D also has a role in various biological processes within the nervous, muscular and immune systems. Since sensory processing disorders, low muscle tone, brain inflammation and other immunity problems are common in many children with autism, it is worth investing research dollars into understanding  vitamin D’s role and its association to neurobehavioral disorders.

There are three main areas of human growth and development where vitamin D could have a direct impact on the development of Autism Spectrum Disorders: (1) the brain (2) immune system and (3) gene expression.

The Brain
Vitamin D receptors are present in the central nervous system, which is composed of the brain and spinal cord. Studies show that vitamin D protects nerves against toxic damage and has a positive effect on neurotransmitters, brain chemicals that communicate information throughout our brain and body. This relationship may play a role in brain development, sensory processing and mood regulation.

The Immune System
The healthy human body is equipped with a powerful set of tools for resisting the onslaught of invading microorganisms (such as viruses, bacteria, and parasites). Unfortunately, this set of biological tools, known as the immune system, sometimes goes awry and attacks the body instead of its invaders. This misdirected immune response is referred to as autoimmunity. Studies suggest that immune abnormalities, mainly autoimmunity to brain tissue, may also have a role in the development of autism in a subgroup of patients.

Vitamin D deficiency has also been implicated as an environmental factor that may trigger immune-related conditions, including allergies, food sensitivities and autoimmunity.  This may explain why many children with neurobehavorial disorders have various food sensitivities (i.e. reactions to gluten and casein).

Vitamin D has been shown to strengthen the body’s innate immune system by inducing a production of proteins with natural antibiotic actions that can combat bacterial and viral infections and thereby reduce inflammation throughout the body.

Gene Expression
Another biological action of vitamin D involves regulating the expression of more than 200 genes as a child grows in the womb. Studies have found adverse effects on fetal brain development during the third trimester of pregnancy related to vitamin D deficiency, including increased risk of schizophrenia and language difficulties. Proper levels of Vitamin D might reduce the risk of autism by diminishing the occurrence of random mutations of DNA thus keeping these mutations from influencing the development of the fetus.

Low maternal vitamin D level is a risk factor for premature delivery and statistics show that the risk of autism increases with each week a baby is born early. One paper suggests that Vitamin D deficiency–either during pregnancy or early childhood– may allow the genetic tendency for autism to express itself.

Several recent studies show that vitamin D deficiency is common among children with autism. However, the “vitamin D theory” of autism does not diminish other genetic and environmental contributions to autism occurrence. While current findings do not prove that taking vitamin D reduces the risk of autism, the theory is strong enough that further research is warranted to determine if symptoms may be reduced by treating a deficiency.

 

Read the next post in this series “Maintaining Vitamin D Levels in Autism“.

 

If you have enjoyed this article, please share it on your social media networks and forums. Parents of special needs kids are always looking for valuable info. Thanks!

 

This post is an excerpt from the ebook: E.A.T. An Italian Mother’s Guide to Going Casein-free in Autism Spectrum Disorders now available on Amazon.

 

Vitamin D Supplements

I love these because they are free of: Yeast, Wheat, Milk, Egg, Soy, Salt, Tree Nuts, Peanuts, Shellfish, Gluten, Artificial Colors and Flavors, Salicylates and Preservatives and they are GMO Free!

 

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Sources:

Doctors eye vitamin D link to autism http://goo.gl/aqP3C3

Researcher sees link between vitamin D, autism http://www.autismtoday.com/articles/Researcher%20sees%20link.asp

Vitamin D and Autism http://www.vitamindcouncil.org/health-conditions/autism/

Vitamin D and Autism http://www.treatingautism.com/useful-documents/

Etiopathogenesis of autism spectrum disorders: fitting the pieces of the puzzle together http://www.ncbi.nlm.nih.gov/pubmed/23622947

Kočovská E, Fernell E, Billstedt E, Minnis H, Gillberg C. Vitamin D and autism: clinical review. Res Dev Disabil. 2012 Sep-Oct;33(5):1541-50. doi: 10.1016/j.ridd.2012.02.015. Epub 2012 Apr 21. PubMed PMID: 22522213.

Holick, M. F. “Vitamin D: A Millenium Perspective,” Journal of Cellular Biochemistry, 2003; 88: 296-307.

Vitamin D http://www.nlm.nih.gov/medlineplus/vitamind.html

Eyles DW, Burne TH, McGrath JJ: Vitamin D, effects on brain development, adult brain function and the links between low levels of vitamin D and neuropsychiatric disease. Front Neuroendocrinol 2012

Mechanisms of Neuroprotective Action of Vitamin D3
http://www.direct-ms.org/pdf/VitDImmunology/Tuohimaa.pdf

Vitamin D and Inflammation http://www.ncbi.nlm.nih.gov/m/pubmed/21067953/

Clues to Immune System’s Role in Autism
http://www.autismspeaks.org/science/science-news/clues-immune-system%E2%80%99s-role-autism

Reduced serum concentrations of 25-hydroxy vitamin D in children with autism: Relation to Autoimmunity    http://www.jneuroinflammation.com/content/9/1/201

Croen LA, Grether JK, Yoshida CK, Odouli R, Van de Water J: Maternal autoimmune diseases, asthma and allergies, and childhood autism spectrum disorders: a case–control study. Arch Pediatr Adolesc Med 2005, 159:151-157.

Cohly HH, Panja A: Immunological findings in autism. Int Rev Neurobiol 2005, 1:317-341.

Grant WB, Soles CM: Epidemiologic evidence supporting the role of maternal vitamin D deficiency as a risk factor for the development of infantile autism. Dermatoendocrinol 2009, 1:223-228.

 

Replacing Calcium in the Casein-free Diet

Calcium | Casein-free Diet

Before embarking on a casein-free diet, consult your child’s doctor. Because dairy products are one of the main sources of calcium in children, you’ll need to make sure the child’s diet has other good sources of calcium, and vitamin D, in order to meet their nutritional needs.  Talk with your child’s doctor about whole foods, fortified foods (ie. calcium-enriched rice milk or coconut yogurt) and/or supplementation to avoid any nutritional deficiencies.

Calcium | Casein-free Diet

Calcium is the most abundant mineral in the body. Over 99 percent of the body’s calcium is found in bones and teeth. The skeleton serves as a reservoir of calcium for fundamental calcium-dependent functions throughout the body.

Apart from maintaining strong teeth and bones, calcium is essential for sending messages between cells and supporting tissues throughout the body. Calcium plays a major role in proper muscle function, nerve transmission and hormonal secretion. Since children with autism spectrum disorders commonly have low muscle tone, sensory integration issues and varying levels of anxiety, maintaining the proper level of circulating calcium is critical for the body to function at its best.

The body’s endocrine system—a system of glands that secrete hormones and provides a series of feedback mechanisms to the body, is charged with keeping calcium levels in check. The endocrine system includes a major role for calcitriol, the hormonal form of vitamin D, which is required for absorption of calcium in the small intestine. (Vitamin D post coming soon – learn about the importance of Vitamin D in this system and its link to Autism.)

Food Sources of Calcium

In the United States, an estimated 72 percent of calcium comes from milk, cheese and yogurt and from foods to which dairy products have been added (e.g., pizza, lasagna, dairy desserts). The remaining calcium comes from vegetables (7%); grains (5%); legumes (4 %); fruit (3%); meat, poultry, and fish (3%); eggs (2%); and miscellaneous foods (3%).

Since the casein-free diet requires removal of the foods that supply most of your child’s ingested calcium, I recommend you consult a licensed dietitian or nutritionist who can help tailor a menu to your child’s taste preferences as well as ensure that your child’s nutritional needs are being met.

Not all consumed calcium is absorbed once it enters the gut. Studies show that our intestines absorb about 30 percent of the calcium present in foods, and this varies with the type of food consumed. Therefore, to promote the best absorption, it is best to avoid processed foods and obtain vitamins and minerals from natural, whole foods.

The recommended daily allowance for children ages 1-3 is 700mg of calcium per day. Children 4-8 years old should take in 1000mg per day and children ages 9-18 should consume at least 1300mg per day. Based on those numbers, try to tailor your menu to include calcium-rich foods. Below are some examples foods high in calcium.

Vegetables
Kale (1 cup contains 180 mg)
Collard Greens (1 cup contains over 350 mg)
Turnip Greens (1 cup contains 250 mg)
Broccoli (1 cup contains 95 mg)
Raw fennel (1 medium bulb contains 115 mg)
Artichoke (1 medium artichoke contains 55 mg)

Fruits
Blackberries (1 cup contains 40 mg)
Black Currants (1 cup contains 62 mg)
Oranges (1 orange contains between 50 and 60 mg)
Dried apricots (1/2 cup contains 35 mg)
Figs (1/2 cup contains 120 mg)
Dates (1/2 cup contains 35 mg)

Grains
Tempeh (1 cup contains 215 mg)
Amaranth (1 cup contains 275 mg)

Legumes
Great northern beans (1 cup contains 120 mg)
Soybeans (1 cup contains 175 mg)
Adzuki beans (1 cup contains 65 mg)
Navy beans (1 cup contains 125 mg)

Other
Blackstrap Molasses (2 tablespoons contains 400 mg)
Fortified non-dairy milk (ie. Almond, Soy, or Rice) (1 cup contains 200-300 mg)
Hemp milk (1 cup contains 460 mg)
Fortified orange juice (1 cup contains 300 mg)
Tahini (2 tablespoons contains 130 mg)
Almond butter (2 tablespoons contains 85 mg)
Roasted sesame seeds (1 oz. contains 35 mg)

Calcium Supplements
If you don’t think your child is getting enough calcium from food sources, consider adding a calcium supplement. While excess intake of calcium is almost never due to calcium intake from foods, the use of calcium supplements could lead to excessive calcium intake as a result of improper dosing.

Because calcium plays a major role in virtually every cell in the body and interacts with a large number of other nutrients, too much calcium may give rise to a variety of adverse effects. That is why it is recommended that you consult your physician before implementing any supplementation for your child.

The most common forms of supplemental calcium are calcium carbonate and calcium citrate. Generally fewer tablets of calcium carbonate are required to achieve the desired dose, thus, costs tend to be lower with calcium carbonate than with calcium citrate.  However, calcium carbonate is more often associated with side effects including constipation, flatulence, and bloating . If you choose calcium carbonate (which is also available as a chewable) monitor your child for those side effects.

When choosing supplements, make sure it is a casein-free formula. It should say so on the label. Select a form suited to your child’s age and abilities. Is it better to find a liquid, chewable tablet, capsule or powder?

Check the label to find out what kind of calcium the supplement contains. If the supplement contains calcium citrate, you can take it with or without food. If the supplement contains calcium carbonate, take it with food. Stomach acid produced while eating helps the absorption of calcium carbonate. It is also better to take calcium not at the same time as a multi-vitamin since some other minerals can interfere with calcium absorption.

Whatever supplement you choose, incorporate it into a schedule. For example, in our house, we take calcium in the evening after dinner. The routine helps us to remember to take it. Also, since calcium has been shown to help the brain use the amino acid tryptophan to manufacture the sleep-inducing substance melatonin, taking it in the evening hours helps prepare the body for a restful sleep.

 

This post is an excerpt from the ebook: E.A.T. An Italian Mother’s Guide to Going Casein-free in Autism Spectrum Disorders now available on Amazon.  

Sources:

National Research Council. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press, 2011. http://www.nap.edu/openbook.php?record_id=13050&page=R1

Vegan Sources of Calcium
http://www.care2.com/greenliving/25-vegan-sources-for-calcium.html?page=2

Insomnia: Studies Confirm Calcium And Magnesium Effective http://www.medicalnewstoday.com/releases/163169.php

 

How to go Casein-free

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If you are considering implementing a casein-free diet for your child, be prepared. Some parents are made to feel that removing cow milk from a child’s food choices is a form of child abuse. Naysayers are unaware that a large percentage of the world’s population does not consume animal milk once childhood has passed. In fact, humans are the only species that drink milk as adults, and the only “animal” to drink the milk of another animal. Cow milk may be the perfect food for baby cows, but it was not meant to sustain humans.

If you are wondering whether a casein-free diet will benefit your child, consider this: children who crave dairy, and who eat a lot of it, are most likely to benefit from going casein-free.

Casein is the most abundant protein in milk. It is also found in dairy products and other foods containing dairy or lactose (including milk, yogurt, cheese and ice cream). Because this milk protein is commonly used in processed foods, even foods proclaiming to be “dairy-free” or “lactose-free” will contain casein.

So why is casein a problem? The most studied theory proposes that children with autism, or other neurobehavioral disorders, process certain proteins (in this case the milk protein casein) differently than typical people do. Incomplete digestion and this difference in processing leads to high levels of protein by-products, called casomorphines, which exacerbate undesirable symptoms commonly associated with these disorders.

Similar to how the brain reacts to gluten in these individuals, it is believed that the brain reads these proteins as if they were opioid-like chemicals, like heroin or morphine. These by-products may then affect behavior like a drug would. They can affect speech, reduce the desire for social interaction, increase confusion, delay cognitive and auditory processing, and decrease the ability to feel pain.

This opioid reaction can also become addictive.  For some, the craving for dairy foods can be so intense that eating a yogurt or ice cream produces a feeling analogous to “getting high”. Removing casein usually produces benefits within a month, and sometimes within a week. In some children there is a worsening of symptoms for a few days (similar to a drug withdrawal) followed by improvement. In fact, one mom said that her child adapted to going gluten-free without skipping a beat but upon removing dairy, he started “raiding the fridge for yogurt and cheese” and became aggressive during his withdrawal period. This subsided as the days passed so don’t be surprised if you have a similar experience.

The idea behind removing casein from the diet is to heal inflammation in the gut caused by casein, reduce the level of casomorphines in the system and remove the opioid messaging to the brain which will lead to a reduction in symptoms and improve social and cognitive behaviors and speech.

Before embarking on a casein-free diet, consult your child’s doctor. Because dairy products are one of the main sources of calcium in children, you’ll need to make sure the child’s diet has other good sources of calcium and vitamin D.  Talk with your child’s doctor about fortified foods (ie. calcium-enriched rice milk or coconut yogurt) and/or supplementation to avoid any nutritional deficiencies. Because it is best to get vitamins and nutrients from natural whole foods, I recommend you consult a licensed dietitian or nutritionist who can educate you about the casein-free diet and help tailor a menu to your child’s health needs and taste preferences.

If you choose a casein-free diet you must become aware of the ingredients of everything in your grocery cart. Read labels carefully, because milk or milk products can be present in surprising places, like non-dairy creamers, soy cheeses and soy yogurt and even sausages. Caseinates, such as calcium caseinate, potassium caseinate and sodium caseinate are derived from casein. If you really want to see if a casein-free diet is going to help your child, avoid purchasing any food whose label lists either casein or caseinates, even if it is not a “dairy” food.

In to avoid casein in your cooking, use olive or grapeseed oils instead of butter, or simply omit the cheese in certain dishes (ie. garnish tacos with avocado instead of cheese).

Source of Casein include (but are not limited to):

Animal Milk (all forms: cow, sheep, goat, etc)

Butter

Butter flavor

Casein

Caseinate

Cheese

Cheese powder

Non-dairy cheese (check the label for caseinate)

Cream

Custard

Flavorings

Half & Half

Ice Creams

Milk fat

Milk hydrolysate

Sour cream

Whey

Whipped cream

Yogurt

 

How I Jump Started the Casein-free Process:

When we removed animal milk from our diet, I bought 1 carton each of Rice milk (Costco has the best one, it tastes very much like skim milk and not very much like rice), Almond milk (get the Original, Unsweetened version) and Coconut milk (Unsweetened, Unflavored). I made a taste testing game of it. I blind folded my boys and had them taste each kind and tell me which one they liked the best. Then I used that one for cereal and for drinking. Not one to waste, I used the milks they didn’t like in protein shakes or to make hot cereal (cream of buckwheat or oatmeal). Please remember to purchase unsweetened and unflavored products. There is no point in loading your child up with sugar and artificial flavors as those are implicated in behavioral disorders as well.

 

When it’s time to transition out of dairy yogurt, I would recommend doing the same thing. Keep in mind that if you choose a soy product, make sure it is made with NON-GMO soy beans. It will say on the label. A lot of children are sensitive to soy, so we try to avoid it in our house.

For ice cream – there are non-dairy ice creams available in pints. You could taste test those as well and use the ones you don’t like in smoothies, etc. However, the non-dairy ice creams are pricey. I make my own popsicles (see Popeye Pushups) or I buy sorbet which is usually non-dairy. We live near a Trader Joes and their sorbets are delicious!

 

It’s important to note that while I stick with their preferences for drinking and for use with cereal, I do purchase a variety of different milks and keep them on hand for different culinary purposes. This gives their bodies the best of all worlds in that we aren’t too heavy on one kind of product over another (almond milk vs. rice milk, etc).

 

If you have gone casein-free, please share any tips or ideas on how you implemented the dietary changes in your home. We have many parents who could use your input and support as they attempt to remove casein from their children’s diet. Feel free to post your thoughts in the comments section in order to benefit our readers.

 

Thanks!

 

This post is an excerpt from the ebook: E.A.T. An Italian Mother’s Guide to Going Casein-free in Autism Spectrum Disorders now available on Amazon.  

Sources:

http://psychcentral.com/news/2012/03/03/gluten-free-casein-free-diet-shows-promise-for-autism-symptoms/35555.html

 

β-Casomorphin Induces Fos-Like Immunoreactivity in Discrete Brain Regions Relevant to Schizophrenia and Autism http://aut.sagepub.com/content/3/1/67.short

 

Stanislaw Kaminski, Anna Cielinska, Elzbieta Kostyra (2007). “Polymorphism of bovine beta-casein and its potential effect on health”. Journal of Applied Genetics 48 (3): 189–198. doi:10.1007/BF03195213. PMID 17666771.

 

Kurek M, Przybilla B, Hermann K, Ring J (1992). “A naturally occurring opioid peptide from cow’s milk, beta-casomorphine-7, is a direct histamine releaser in man”. Int Arch Allergy Immunol 97 (2): 115–120. doi:10.1159/000063326 . PMID 1374738.

 

Review of the potential health impact of β-casomorphins and related peptides  European Food Safety Agency , Scientific Report (2009) 231, 1-107

 

beta-Casomorphin-immunoreactivity in the brain stem of the human infant. http://www.ncbi.nlm.nih.gov/pubmed/8351411

 

Effect of casein and beta-casomorphins on gastrointestinal motility in rats. http://www.ncbi.nlm.nih.gov/pubmed/2319342

 

http://nutritionfacts.org/video/cows-milk-casomorphin-and-autism/