By just placing the patient on a diet free from dairy products, chocolate, and whole wheat, one can see an immediate improvement in function caused presumably by a lessening of immune system stress, reducing inflammation of the brain. Again, the presumed reason for this is to help by removing a trigger, reducing stress on the immune system. This has nothing to do with the false idea of GF/CF (removes dairy and gluten but then adds “other” whole-grain products with their own negatives), but with the now recognized fact that while “bovine protein” is the number one allergen in the world, wheat and other grains is number two. If dairy, milk chocolate, and whole wheat are taken away, as much as 98 percent of probable allergies are alleviated. However, while often a very helpful start, and critically important over time, I do not believe that you can correct this condition by diet alone. If this were possible, parents (and physicians) by now would have heard of multiple, “unbelievable” successes over the years. Reputable institutions would be conducting clinical trials to investigate the successes. Since nutritional therapies have not resulted in cures, or even published reports of significantly improved cognitive function, it is illogical, in fact potentially detrimental, to put these children on extreme diets. However, sometimes these children put themselves on extreme diets by only eating a limited number of foods. I don’t think there are a lot of normal children who would be healthy on some of the diets these children put themselves on. Since these children are often drawn to and even crave negatives like a drug addict, this is often a helpful clue to tell parents what to avoid (even if a child seems to go through a withdrawal, that will be far better long-term for that child).
For most of the children, all that is necessary is to eliminate the “main offenders” in their diets that will cause the immune system to react. It is not necessary to eliminate all wheat (but over time, restriction of grain-based carbs has become more and more important/critical). Some doctors and homeopaths recommend the elimination of all gluten and wheat. I feel strongly at this point that the reason so many of these children show initial (but not long-term) improvement when they are put on a gluten/wheat free diet is they no longer are eating whole wheat or have dairy! Usually, all that is really needed is to eliminate whole wheat and other whole grains (due to allergenic potential) from the diet, not the full extreme of GF/ CF (but I do have a few children that seem to benefit from the extremely limited diet, even though they do not have celiac disease).
Many parents comment how after just the initial food/dietary phase that their children become more manageable and more amenable to reason. Some to the extreme of beginning to talk that did not talk before. One should not underestimate or ignore the potential reactivity of the immune system, and various foods, proteins, peptides, or other sensitivities (while these areas need better clinical markers and standards, till “proven” it is an area one cannot just ignore, but must approach with logic and reason). If a parent notices a good effect from a diet elimination, effort should be made to support the family in their search for other “logical” exclusions. Unless there is a very significant jump, “extremes” are usually not necessary or justified (particularly in children). What I have experienced clinically is that as a child begins to do better, it is easier to judge what throws him or her off. You need to be expecting a general continuous upswing (or consistency from medical agents); if there is variability, try to think what did he/she have to eat before a decline. What was done differently? One must stay very “tuned in” with the parents to pick out variables and problems. It is useful to keep a diary, particularly tracking “off” times, when there is no immediate, obvious answer.
I never cease to be amazed at how many parents will say “my child is allergic to milk,” but then the kids are still getting cheese or other dairy products. The truth is, you don’t see as bad a reaction to a processed product as you do to a healthier, natural product. This is part of the whole argument, when you get into nutrition, about processing something, how you change the protein structure. So a child that might go berserk on milk may not appear weird on processed cheese. But if a product is a negative, in this type of reactive system, any exposure is not good. The concept that when you change the protein structure, you frequently alter its allergenic characteristics was illustrated early in my pediatric practice. A child could do well on formula for twelve months, but when switched to milk, the introduction of dairy products, one will observe diarrhea or congestion, the start of chronic stuffiness, other signs of allergies (recurrent ear infections, sinusitis, etc.). A child may react to milk, but seem to tolerate the cheese. The trouble with the philosophy of “tolerance” or rotation is if you understand the reactive immune system, anything firing it off further is not helping. The child may not be over the edge when you see red ears or some other “tolerable” reaction, but you’re still firing off that body and the immune system behind it. So it’s really worth being very strict. Many parents, particularly early along, did not recognize how important a factor this is. Occasionally, rarely down the line, especially a child that was not real high on food screens with dairy or some food they particularly want, I’ll say to go cheat (very hesitantly, very cautiously, almost never at this time). It gets very easy if a child’s doing well, and they receive something “illegal” or forbidden. It will become obvious very quickly if you’re throwing them off or not. If you’re not, (and there is no evidence of increased eosinophilia on blood work) an occasional cheat may be okay. A sugar treat is better than a dairy or other such reactive treat as it leaves the body more rapidy then the effects of dairy, and does not activate the immune system. A dairy treat can throw the immune system off for seven to ten days or longer, so if your child cheats once a week, this can be a serious impediment to progress. A key common issue in therapy is separating when one is dealing with the normal issues of postnasal drip or other environmental allergies versus when a cold or allergy has turned into a sinus infection. Typically, the ideal of a “postnasal drip” is a child who has a little sniffle or is congested in the morning (upon waking), perhaps a minor cough or two, but is then generally clear the rest of the day, maybe becoming a little congested again by the evening. If that congestion is continuing most of the day, for more than a few days, odds are high the child is moving from just allergy, to at least a low-grade sinus infection, or early fluid in the ears. Likewise, if a child has external allergy exposure or food allergy (not good), they may become congested at times, but again, should be an off-and-on situation, unless constant exposure, constant error in diet choices leads to the emergence of a chronic sinus or ear condition. The crossing over from “just” allergies, to a cold, to sinus infection, is important to recognize and understand clinically, for any time these children are ill, any time they legitimately do not feel well, they are not going to do as well. A key role in removing stresses, helping a child (or adult) become healthier is prevention of illness whenever possible, and then treat, and assist the child judiciously in handling an infection, rather than allowing a major stress to set them back or weaken them further. In a heavy orientation to prevention, particularly in regard to allergies, I was fortunately taught to think of how to keep a child (or adult) clear, avoid repeated complications, rather than just treat recurrent complications and infections.
Long before antihistamines or decongestants were in common use, doctors were left to diagnose and treat each ear infection as it developed. By being preventative in my practice and treating congestion and mild fluid aggressively, I rarely had a child with a major infection requiring heavier antibiotics and have never had a child admitted to the hospital for more serious complications. In my many years of practice, I’ve had very few children require ear tubes.
Prevention is a key to keeping a child healthy by removing stress on his or her immune system. As discussed, diet is a key starting point always. But if a patient lives in an area surrounded by pollen (perhaps everywhere but the part of L.A. I live in) or spends the day in a classroom environment open to molds and other contaminan
ts, then the use of “preventative” inhalers becomes a very safe and wise move. Nasalcrom or Astellin are for the nose and nasal passages, Intal or Tilade for the chest. These are key choices to help prevent inflammation, reactions, infections, but if a child is ill, congested, or fighting a sinus or chest infection, they in theory do not hurt, but really do nothing at that point to treat the infection (but may help in preventing ongoing stress, exposure during recovery).
Prevention carries over to the routine use of what are termed “nighttime” twelve- or twenty-four-hour antihistamines. The goal is to use a slowrelease antihistamine that does not cause any clinical side effects (child does not awake tired or hyper), but helps that child start off the day clear. This idea of prevention is illustrated by how the simple step of avoiding chronic (overnight) inflammation to the throat prevents the lowering of resistance common when the mucosa of the throat is inflamed. What we call an intact mucosa is a key to helping a child (or adult) resist the many infectious agents they may come in contact with at school or elsewhere. By preserving an intact mucosa, the first barrier to protecting against entry by many respiratory, throat, and ear pathogens, one is going to have a child with a much better chance of staying healthy, in spite of their “allergy” tendencies. The use of an effective nighttime antihistamine and judicious choice of inhalers often ends the need for other antihistamines or systemic medications during the day.
With many of the children, it can become very deceptive when on surface they appear to be doing very well, but they do not yet a fully “normalized” immune system. By “well,” I mean tuned in, cognitively connected, alert, processing on their own, learning quicker, doing the steps you expect the brain to be doing. I’ve received frequent “panic calls,” the child’s off the wall; they’re doing this and doing that. Usually (particularly when no recent medication change) the child will be coming down sick or they’ve gotten strawberries, cherries, dairy, or something else to eat that day (throwing them off significantly).
The Dos and Do Nots of the Diet
As noted, many of these children have major allergies or intolerances to many chemicals and foods (understood in terms of activated immune system, immune sensitivities, and not always true allergies). The main offenders appear to be cow’s milk, wheat (and potentially other whole grains), and salicylates (among multiple chemical sensitivities noted). Occasionally these reactions may turn into urticaria or asthma, but in the majority of these children the effect is the concept of activating, triggering a system one is trying to calm down. This often results in a worsening of autistic-like or negative behaviors, physically a zonier or often more irritable child. Interestingly, the family history of these children often reveals eczema, migraines (especially in mothers), hay fever, and asthma.
These children may often crave the very thing that does them harm (reflects the negative idea of a brain addicted to a drug, rather than the brain or body craving what it really needs). They do this not only with foods, but also nonfood items they ingest, mouth suck, or chew (e.g., metal, plastic, perfume, soap, plastic, dirt, etc.). Frequently, these children become picky eaters at the time they “change,” eating only a few different foods and both craving some and avoiding some. Some autistic children begin to eat nonfood items with notable immoderation. It is important to encourage the child to eat more protein. This will help balance out naturally their own amino acids, which in turn is part of helping their bodies become healthier. All these children need protein. It is also necessary to restrict starches. Healthy breakfasts, lunches, and dinners should be served.
One should:
Avoid all dairy, chocolate, whole wheat, and whole grains—while limiting sugars. This does not mean to replace them with equally allergic grains easily available at heath food stores.
All dairy means any product that has milk or bovine protein listed as a “major” ingredient.
This includes cheese, yogurt, chips with cheese on them (Doritos, Cheetos, etc.).
Common sense and logic fall back onto basic principles taught through my training programs. Bovine protein is the number one allergen in the world. With the recognition that in somebody with a reactive, sensitive immune system, just like a virus particularly a flu bug can trigger off the immune system in any individual, so can bovine protein exposure in a reactive individual. Whether a virus, or bovine protein, the immune system makes a mistake, attacks the pancreas; and in some cases a person can becomes diabetic for the rest of their life. This happened to my wife. In this discussion lays an explanation for what many say is “most confusing” regarding the dietary advice I give. We have grown up with the concept that whole grains are what are good for us, and with a food pyramid that was saying we needed six portions of grain. As a physician it remains my experience that biology is what runs us, and we evolved primarily as carnivores (yes, we can eat other things, but our muscles and our brain builds on the basis of amino acids. Growth is extremely difficult to maintain in a child from just plant sources), so WHO decided we needed six portions of grains a day. If we were living two hundred or two thousand years ago, maybe the argument that whole grains were better than “processed” would hold up, make sense, but in this case, anything reactive (a major characteristic of whole grains) is going to do far more harm to the body than good. Perhaps we need to get back to the advice of the 1950s or 1960s—meat, vegetable, and some fruit, a little bit of carbohydrates. In that advice think of it as if your grandparents didn’t eat it, maybe you shouldn’t, either. How many products do you eat without additives and chemicals? We need to go back to eating food, not chemicals. Unfortunately, whole grains are the number two allergen in the world; this has created a terrible mistake in many children. The initial, mistaken concept these children might have something called celiac disease, produced the ideal of the gluten-free/casein-free diet recommendations. As noted, while some children may initially improve upon removal of dairy and gluten, when one takes away dairy and gluten but substitutes other whole grains, it has been my sad experience to see many children come in with a more reactive immune system, more reactive food screens being created by GF/CF. While counterintuitive, after years of being accused of borderline quackery to think of diet elimination, a university-based MD and PhD gave the mother of one of my patients even more reasons to be concerned about organic meats. While “organic” (no pesticides, etc.) might be a healthy way to grow an acceptable fruit or vegetable, this researcher (and his colleagues) are seeing a tremendous problem with organic meat. Instead of “organic” meaning grass-fed, or naturally fed, many of the cows are being fed whole grains, which are going through the meat to the children ingesting it. This has completely “muddied” the concept of natural, organic (particulary when it comes to meats). There are ranchers who will argue that all of this comes back to physiology—cows were not meant to eat corn (apparently it really changes their meat in other ways). For now, grass fed, naturally fed, whether labeled organic or not, is probably the safest step. Perhaps some of the milk and meat sensitivities would be nonexistent if cows were just fed grass (like years ago). Initially this whole issue would have been illogical to me, as the concept of processing, cooking, and heating changes many of the proteins. Many years ago I treated a child who was so sensitive that his allergy cells, eosinophils, would go up when given milk-fed veal! So contrary to the idea heat treating changed this, it has become obvious that these children (perhaps most of us) are much better off with range-fed, grass-fed, naturally-fed meat, rather than just trusting or buying “organic.”
The reason for this is physiologic—if you start recognizing the correct problem, you can start to think correctly. Under the ideal of gluten-free/ casein-free you are removing gluten but often using other grains, other whole grains as substitutes. Unfortunately these substitute grains to these children are just as reactive, if not more so, than gluten. In fact a few years back, a patient that had been with me for a while was doing well overall but had ongoing allergy issues, came back after the mother had dropped ou
t of the practice for a while. She was an intelligent mom, did not fall into doing anything foolish or considered dangerous to her child, but did try gluten-free /casein-free. This child, who had a very high IgE while in the practice, an IgE of 700 (Note: in the mid-late 1980s, I sent a teenager to UCLA for an IgE of 700, never before having seen a number that high—now this number and higher ones have become routine), this child came back on a gluten-free/casein-free diet, with an IgE of greater than 2200! Since grains are considered allergenic, it is a wise idea to limit carbohydrates in these children. Ironically, many of these children are attracted to carbohydrates, leading to a crossover discussion that these children, perhaps like drug addicts, are wanting to consume something that is harmful to the brain and body. As noted, it is almost always fair for a mother to assume that if a child is craving something, loving something, be suspicious. Although a large amount of carbohydrates is not ideal, it is safer for these children to consume carbs derived from simple potato. For instance a potato chip may be much safer, if a child is old enough, than any gluten-free/casein-free pretzel. Perhaps the only real need for bread in these children should be a sandwich at lunchtime. In that circumstance, many times, well-processed, inexpensive white bread is less allergenic than any GFCF bread with other whole-grain substitutes. In the rare circumstance that the child does react to that white bread, then very carefully look for a choice that is not going to trigger allergies.
The Myth of Autism Page 16