The Nutritional Needs of Autism Spectrum Disorders (ASD) May Not Be Met By Diet and Supplements Alone

While autism is a complex neurodevelopmental disorder influenced by genetic and environmental factors, researchers and families are increasingly focusing on the nutritional deficiencies associated with the disorder. Researchers are finding specific nutritional insufficiencies and metabolic abnormalities associated with ASD while parents aggressively try a variety of diets and supplements despite a lack of formal data.

There are currently no safe and effective treatment options for the three core characteristics of ASD, so many parents seek out alternative methods for managing the symptoms of the disease. In many cases, certain foods such as casein (milk protein) and gluten (wheat protein) are excluded from diets in an attempt to modify behavior. This approach, although sometimes effective, does raise concerns about potential nutritional deficiencies that can affect brain and body development. Others provide supplements without any assurance that the nutrients are adequately absorbed. Scientists working with Medical Foods are convinced that by offering a combination of amino acid precursors to specific neurotransmitters, provided under a physician’s supervision, there might be a solution. Based on positive preliminary investigational results, they are designing clinical studies to prove their hypothesis.

The history of nutrition and autism begins with the knowledge that vitamins, minerals and amino acids are critical to human health and that poor diet is a major contributing factor to many child health problems, including rickets (calcium/vitamin D deficiency), anemia (low iron), hypothyroid (low iodine), and scurvy (vitamin C deficiency). Research has demonstrated that there are nutritional deficiencies associated with developmental disabilities such as attention deficit disorder and intellectual development. Those with ASD have the same needs for calcium and protein and in addition were found to have more essential amino acid deficiencies consistent with poor protein nutrition than an age/gender matched control group.[i] Those on restricted diets tended to have lower plasma levels of essential acids including the neurotransmitter precursors tyrosine and tryptophan than both controls and children with autism on unrestricted diets.  A 2013 study of 55 children with ASD found Low levels of biotin, plasma glutathione, and plasma tryptophan and several other measures; and also high levels of oxidative stress markers and plasma glutamate.[ii] Work continues examining the role of glutathione – a small peptide derived from the amino acids glutamic acid, glycine and cysteine and the body’s chief detoxifier.

Understanding the nutritional status of ASD means not just looking at diet and intake, but also examining digestion, absorption, metabolic processing, metabolic demand, metabolic turn over rate and elimination. Each of these plays a role in nutritional insufficiency and altered metabolic turnover rates. For example, the use of nutritional supplements without taking into account the processing capacity of receptors involved in the metabolism of these nutrients or their ability to get beyond the blood brain barrier can result in uneven absorption or simply generate a nutrient-rich urine without clinical benefit or long-term improvement in behavior.Female_Scientific_Research

Scientists at Targeted Medical Pharma, a Los Angeles based biotechnology company are convinced that the patented technology behind their medical foods, Targeted Cellular Technology (TCT) addresses these issues. TCT is an integrated molecular system that facilitates the uptake and utilization of nutrients by target cells within the nervous system. This patented five step system consists of (1) specific neurotransmitter precursors such as amino acids and nutrients; (2) a stimulus for the neuronal uptake of these precursors by specific neurons; (3) an adenosine antagonist that blocks the inhibitory effect of adenosine on neuronal activity (adenosine brake); (4) a stimulus to trigger the release of the required neurotransmitters from targeted neurons; and (5) a mechanism to prevent attenuation of the precursor response, a well known phenomenon associated with amino acid, nutrient and drug administration. Use of Targeted Cellular Technology improves the metabolic efficiency of neurotransmitter synthesis, thereby reducing the amounts of precursors needed to correct neurotransmitter imbalances. TCT synchronizes the availability of the neurotransmitter precursor supply with the fluctuating demand for the corresponding neurotransmitters.

A recent investigator initiated clinical observation looked at 26 children who were diagnosed with ASD or suffering from related symptoms including explosive behavior, social isolation, and mood disorder, treated for a time period ranging between 30 days and one year using an amino acid based formulation of TCT based medical foods. The investigator reported significant improvement with regards to decreased disruptive outbursts, improved socialization, improved mood and reduction in drug dose. Scientists hypothesized that nutritional insufficiency and metabolic imbalances that play a role in ASD may be dramatically improved using the approach of certain medical foods. They are now using an autism-specific formulation with milligram amounts of amino acid precursors and other biogenic ingredients designed to correct nutritional deficiencies associated with ASD. They plan test their hypothesis in a placebo-controlled, randomized, double-blind study.


 

[i] Arnold, et al. Plasma amino acids profiles in children with autism: potential risk of nutritional deficiencies. J Autism Dev Disord. 2003 Aug;33(4):449-54.

[ii] Adams, J. Summary of Dietary, Nutritional, and Medical Treatments for Autism. Arizona State University, Autism Research Institute.