Autism Dietician Brittyn Coleman discusses what it is and how to reduce toxic burden

Toxic Load and Autism

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Increasing levels of toxics are an issue for all of us, but can be especially troublesome for those who may be predisposed to have higher toxic loads and decreased detoxification, such as children with autism. Toxic load refers to the accumulation of different harmful chemicals in our bodies. These toxic chemicals can come from many different sources including our food, water, air pollution, personal care products, household products, and our environment. Susceptibility to toxic overload varies person-to-person and can be impacted by various factors including genetics, environment & lifestyle, diet, gut microbiome composition and diversity, and immune system capacity.

Research suggests that children with autism have increased levels of oxidative stress and lower antioxidant capacity [1]. This can reduce the ability to detox and excrete different chemicals and pollutants from the environment. Glutathione, a master antioxidant, is often decreased in autism which may contribute to overall oxidative stress, immune dysfunction, and may lead to neurodevelopmental abnormalities [2, 3]. Lastly, those with autism also have a higher risk of genetic mutations, such as the MTHFR genetic mutation [4, 5], which plays an important role in detoxification. For these reasons, children and adults with autism should reduce their exposure to different toxics in the environment to ultimately decrease their overall toxic load. While there are many harmful chemicals that should be avoided or reduced, the following three examples are a great place to start:

Glyphosate

Glyphosate is a broad-spectrum herbicide that is used to kill weeds and grasses. It has been linked to cancer development and other chronic conditions and health conditions, but some associations can also be seen with autism. Findings suggest that an offspring's risk of ASD increases following prenatal exposure to ambient pesticides within 2000 meters (~1.2 miles) of their mother's residence during pregnancy [6]. Infant exposure to pesticides could further increase risks for autism spectrum disorder with comorbid intellectual disability. [6]

The ingestion of glyphosate can also reduce the number of beneficial bacteria in the gastrointestinal tract [7], which can impact the immune system and contribute to other gastrointestinal issues that may affect behavior and increase core autism symptoms. Glyphosate can be avoided by buying organic produce, especially the 12 "dirtiest" produce found on the EWG's Dirty Dozen list.

Air Pollution

Research suggests that children with autism present higher levels of neuroinflammation and systemic inflammation, which are hallmarks of exposure to traffic-related air pollution. [8]. Air pollution can be associated with an increased risk of autism. [9. 10]

Air purifiers with HEPA filters can be a great way to reduce the amount of particulate matter in your home, especially since the air quality inside your home can be worse than the air quality outside. Traditional cleaning products and artificial fragrances can also contribute to poor air quality, so choosing non-toxic cleaning products and fragrance-free personal care products can be another great way to reduce air pollution in your home.

Artificial Ingredients

While more research needs to be done on the effects of artificial ingredients and autism, at the end of the day, food additives are synthetic (not naturally-occuring) chemicals. There are various research studies that show certain artificial ingredients, such as artificial food dyes, are contraindicated in children with autism and may contribute to sleep disturbances, attention deficit, and behavioral issues [11].

Artificial ingredients can be avoided by consuming whole foods (such as fruits, vegetables, whole grains, meats, poultry, and fish) or by reading the back of an ingredient label to verify no artificial ingredients have been added.

The Bottom Line

There are many other pollutants and toxic chemicals not listed above that are helpful to avoid to reduce toxic load. Increasing intake of antioxidants in the diet, such as wild blueberries, strawberries, pecans, kale, and dark chocolate can help naturally excrete toxics. Certain supplements may increase detoxification and reduce oxidative stress including NAC and glutathione. Consult your healthcare provider to be sure these are a good fit for your child before implementing diet or supplements changes.

If you're feeling confused about how to introduce diet, supplement, and lifestyle changes for autism, sign up for the Autism Nutrition Library, a one-stop hub for all topics autism and nutrition.


References

[1] Manivasagam T, Arunadevi S, Essa MM, et al. Role of Oxidative Stress and Antioxidants in Autism. Adv Neurobiol. 2020;24:193-206.

[2] Chauhan A, Audhya T, Chauhan V. Brain region-specific glutathione redox imbalance in autism. Neurochem Res. 2012;37(8):1681-9.

[3] Rose S, Melnyk S, Pavliv O, et al. Evidence of oxidative damage and inflammation associated with low glutathione redox status in the autism brain. Transl Psychiatry. 2012;2:e134.

[4] El-Baz F, El-Aal MA, Kamal TM, Sadek AA, Othman AA. Study of the C677T and 1298AC polymorphic genotypes of MTHFR Gene in autism spectrum disorder. Electron Physician. 2017 Sep 25;9(9):5287-5293. doi: 10.19082/5287. PMID: 29038711; PMCID: PMC5633227.

[5] Shaik Mohammad N, Sai Shruti P, Bharathi V, Krishna Prasad C, Hussain T, Alrokayan SA, Naik U, Radha Rama Devi A. Clinical utility of folate pathway genetic polymorphisms in the diagnosis of autism spectrum disorders. Psychiatr Genet. 2016 Dec;26(6):281-286. doi: 10.1097/YPG.0000000000000152. PMID: 27755291.

[6] Von ehrenstein OS, Ling C, Cui X, et al. Prenatal and infant exposure to ambient pesticides and autism spectrum disorder in children: population based case-control study. BMJ. 2019;364:l962.

[7] Argou-cardozo I, Zeidán-chuliá F. Clostridium Bacteria and Autism Spectrum Conditions: A Systematic Review and Hypothetical Contribution of Environmental Glyphosate Levels. Med Sci (Basel). 2018;6(2)

[8] Volk HE, Lurmann F, Penfold B, Hertz-picciotto I, Mcconnell R. Traffic-related air pollution, particulate matter, and autism. JAMA Psychiatry. 2013;70(1):71-7.

[9] Costa LG, Chang YC, Cole TB. Developmental Neurotoxicity of Traffic-Related Air Pollution: Focus of Autism. Curr Environ Health Rep. 2017;4(2):156-165.

[10] Flores-pajot MC, Ofner M, Do MT, Lavigne E, Villeneuve PJ. Childhood autism spectrum disorders and exposure to nitrogen dioxide, and particulate matter air pollution: A review and meta-analysis. Environ Res. 2016;151:763-776.

[11] Bakthavachalu P, Kannan SM, Qoronfleh MW. Food Color and Autism: A Meta-Analysis. Adv Neurobiol. 2020;24:481-504.

Food

What's the Healthiest Sparkling Water?

We're hooked on flavored sparkling water.... But what are we really drinking?

Let's be real: sometimes we reach for sparkling water to make everyday life feel just a little bit swankier. We also do it for our health. For those of us who struggle with drinking enough water, it's refreshing bubbles and flavors are an enjoyable incentive to hydrate. And since sweetened beverages, like traditional sodas, contribute to chronic conditions like diabetes (1), sparkling water offers a satisfying CDC-recommended substitute for sugary drinks (2). Sparkling water is basically H2O with jazz hands, so there's no way it can be bad, right? As it turns out, there are a few things to watch out for. We're diving deep with sparkling water to help support your health and environment (and your bubble habit).

Let's Talk About Natural and Artificial Flavors...

You've probably seen common ingredients like fruit juice, natural flavors, or artificial flavors in your favorite fizzy water brands. Fruit juice is pretty self-explanatory, but what do we know about the rest?

Natural flavors. According to the FDA, a natural flavor must come from non-synthetic source, such as spices, fruits or vegetables (3). However, the rest of the solution carrying the flavor may still contain synthetic additives as preservatives or solvents (which just means substances used to dissolve other things). These additives like propylene glycol are considered "Generally Recognized as Safe" by the FDA, and some like ethyl formate form naturally in plants (5). But safety studies are ongoing for some of these approved chemicals. For example, recent research has shown methyl paraben acts as an endocrine disruptor in mice and contributes to obesity (6). Organic products have higher standards for natural flavors – the National Organic Program only allows natural flavors if "not produced using synthetic solvents and carrier systems or any artificial preservatives" (7). Organic flavors must be used in organic products if commercially available (7) and comply with USDA organic regulations – including that 95% of the flavor must be certified organic (8).

Artificial flavors. Yep, you guessed it – unlike natural flavors, artificial flavors need not derive directly from natural sources like those listed above (3). Instead they are chemically synthesized. This doesn't actually mean that the main flavor's chemical structure differs from that of the natural flavor. As University of Minnesota food science professor Gary Reineccius explains, "there is little substantive difference in the chemical compositions of natural and artificial flavorings…the distinction in flavorings comes from the source of these identical chemicals" (9). But the kicker again comes from the additional synthetic chemicals allowed to accompany the flavor. Some of these originally occur in nature (such as butyl phenylacetate, found in fruits), while others are totally synthetic and potentially problematic (like phenylethyl benzoate, which is "toxic to aquatic life with long lasting effects.")

Bonus round: what is "naturally essenced"? This is its own category used in particular by LaCroix products. Its true meaning is still unknown, as LaCroix has not disclosed this information publicly. What we do know, according to their website, is that "all LaCroix flavors are derived from the natural essence oils extracted from the named fruit...there are no sugars or artificial ingredients." Furthermore, Business Insider clarifies that "essence is created by heating items such as fruit and vegetable skins, rinds, and remnants at high temperatures, producing vapors. These vapors are condensed and then sold by the barrel."

Bottom line: though natural and artificial flavors are chemically similar, they both come with long lists of potential additives that may be detrimental to our health and environment . When in doubt, stick with what you know is good – like real fruit juice – or opt for brands with organic ingredients and flavors.

How to Sparkle from the Inside Out

Sparkling water containers matter just as much for our health and environment as the inside ingredients. The lining of aluminium cans contain BPA and similar chemicals that are known endocrine disruptors with the potential to cause hormonal and reproductive harm. While these chemicals are less likely to leach into beverages like sparkling water than more acidic beverages, we don't like to make a habit of drinking from cans. Sparkling water beverages also often come in plastic. Microplastics can also end up with your bubbles – a study in 2018 showed that microplastics contaminated 93% of plastic water bottles (10). The research world is still seeking to understand the health implications of microplastics, but given what we already know, we say it's better to play it safe and avoid plastic bottles as much as possible in the meantime. Reducing plastic use is even more important for environmental health now that international governments have stopped buying recycling products from the US (cities in the US are throwing away formerly recyclable types of plastic because they can't afford to recycle, as reported by The Atlantic). Your choice of carbonated beverage is that much better for our health and environment when it doesn't come with plastic!

Simple Solutions for Keeping Your Sparkle Alive

1) Choose glass over plastic containers if buying carbonated beverages from the store

2) Check out the ingredients of your current brands and *gasp* consider trying a new one (we know you're dying for a new pandemic adventure). Try brands with fruit juice flavoring (Iike Spindrift) or organic natural flavors to be extra safe in avoiding sneaky synthetic additives.

3) Consider DIY! You can easily make your own sparkling water at home and have total control over what goes in it, including water quality and flavor choice. SodaStream's Aqua Fizz water carbonating machine uses glass bottles. Or if you're on a budget, consider a more basic model and transfer your newly carbonated water over to glass carafes for storage, or just quickly consume it (not a problem for us!). They also have organic flavoring options and a carbon dioxide cylinder exchange program to reduce waste. You could also experiment with adding your own fruit juice flavor concoctions – the possibilities are endless.

Stay fizzy, my friends.


Resources:

(1)https://www.cdc.gov/nutrition/data-statistics/sugar-sweetened-beverages-intake.html

(2)https://www.cdc.gov/healthyweight/healthy_eating/drinks.html

(3)https://www.ecfr.gov/cgi-bin/text-idx?SID=20a79c9179f3c43d5b514f5f13c06d7b&mc=true&node=se21.2.101_122&rgn=div8

(4)https://www.ecfr.gov/cgi-bin/text-idx?SID=c3057692e430edc601fcb3e3352fed1c&mc=true&tpl=/ecfrbrowse/Title21/21cfr184_main_02.tpl

(5)https://www.ecfr.gov/cgi-bin/text-idx?SID=e5c407d421f852bcf58b25fd5c700a4d&mc=true&node=se21.3.184_11295&rgn=div8

(6) https://link.springer.com/content/pdf/10.1007/s13679-017-0240-4.pdf

(7)https://ota.com/sites/default/files/indexed_files/OrganicFlavorsPracticalGuidance_OrganicTradeAssociation.pdf

(8)https://www.qai-inc.com/media/docs/qai_guide_for_natural_flavors_in_organic_products.pdf

(9) https://www.scientificamerican.com/article/what-is-the-difference-be-2002-07-29/

(10)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6141690/

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