Autism: A Brain or Whole-Body Disorder?

You could say this post is a long time coming. In the last few years, I’ve lost count of the huge number of emails I get from parents with kids who have special needs either asking for advice or explaining how The Primal Blueprint has made a significant difference for their children. These are parents who love their kids for all their abilities and differences and who want to explore every reasonable lifestyle intervention they can to make their kids’ lives everything they can and should be.

I’ll state the obvious here. I’m not a disability expert, but I’ve been moved and motivated by these parents’ emails. From a general health perspective, I’ve wondered how our modern lives could be contributing to the epidemic. Likewise, I’m curious how research can illuminate potential benefits of lifestyle interventions. What is the biological picture behind the dysfunction in these conditions, and how can biology be harnessed to restore functioning? A recent approach focused on the whole brain and whole body is asking those exact questions – and finding answers.

Like most people, I have friends and acquaintances who are raising children with developmental or behavioral disabilities. Some of us here are raising children with these conditions. Some of us have nieces or nephews, family friends, or neighbors with these disabilities. Others in the PB community have these disabilities themselves. Regardless of our personal connection, we’ve all heard about the skyrocketing rates of developmental and behavioral disabilities like autism and ADHD. Recent studies show one in six kids in the U.S. has been diagnosed with a developmental disability – mostly resulting from the spike in autism and ADHD. There’s general agreement now it’s not solely a matter of improved diagnosis, and few anymore argue that it’s purely a genetic phenomenon. Simple math negates the possibility that a “genetic” condition would spike in the span of less than half a generation. Since 1995, autism alone has gone from a rate of 1/3300 children to 1/88 children. Prevailing opinion now connects the rising prevalence of these conditions with a confluence of some kind of genetic vulnerability with pivotal environmental factors that somehow set off this genetic potential.

Enter the growing focus on not just “whole brain” but even “whole body” research and intervention for these kinds of disabilities. Our bodies are incredibly complex systems operating with an intricacy conventional medicine is just beginning to grasp. Experts are increasingly applying these principle to the study of autism, ADHD, and other developmental and behavioral disabilities. They’re looking at elements as diverse as gut profiles, neurological connectivity, and gene expression. A picture is emerging as researchers study the surge of these conditions. The “genetic” root is relatively seldom the traditional, identifiable pattern in family lines. Rather, it appears many of these children have inherited a genetic risk factor characterized by a heightened sensitivity to “assaults” on the system from toxins, infections, and other environmental influences. As Nancy Minshew, a University of Pittsburgh professor of psychiatry and neurology explains, “Genes do not code for diagnoses. They code for proteins, which then go about creating an effect.” In other words, a cycle is set in motion. Is it possible to stop the cascade that unfolds and even reverse it – at least in part?

A New Focus for Autism Research

Dr. Martha Herbert, a Harvard pediatric neurologist who has studied autism for seventeen years, believes it can be done. She began research into autism with the same genetics-focused approach common to the field. In her words, she quickly found the picture to be much more complex. In her recently published book The Autism Revolution: Whole-Body Strategies for Making Life All It Can Be, Dr. Herbert explains how addressing basic coexisting medical issues and optimizing overall health can positively and sometimes dramatically impact the symptoms associated with autism. I’d definitely recommend Dr. Herbert’s book to anyone interested in learning more about a biological treatment approach to autism.

Initially interested in comparing MRIs of her patients, Dr. Herbert began to see an interaction of neurological functioning with other physical issues like poor digestion, low muscle tone, fatigue, frequent infections, nutritional deficiencies, and food allergies. She found that “treating health” ended up treating autism. Herbert describes the series of “vicious cycles” that often plague those with autism as one of “genetic glitches, oxidative stress, mitochondrial dysfunction, and weakened repair systems.” Biologically based treatment, she asserts, can support basic cellular health, aid neurological balance and connectivity, and promote healthier gene expression. It’s a systems biology approach that appreciates the interactions – both big and subtle.

In the meantime, experts were finding – and confirming – that seemingly unrelated factors like fevers or the use of certain steroids or blood pressure medications could almost instantaneously dial back autistic symptoms. These instances – as well as the basic progress of many individuals on the spectrum – suggested autism was perhaps more of a flexible “state” than a fixed “trait.” If this was possible, what could be done safely and systemically to take advantage of this potential fluidity?

Dr. Herbert outlines a whole host of lifestyle based suggestions surrounding diet, toxin free living, supplementation, sleep, sensory exposure, stress, and other daily factors. There’s too much to explain here, but let me summarize a few of her central points and put it in context for those who live Primally.

Nutrition Is Key

However it shakes out in the chicken versus the egg picture, individuals on the autism spectrum are prime targets for nutritional deficiencies, yet they’re more in need of nutrients than their typically functioning counterparts. As Dr. Herbert and others have found, individuals on the spectrum show signs of oxidative stress and impaired cellular dysfunction. Dr. Herbert explains, for example, that mitochondria dysfunction is much more common in those with autism than it is in the population as a whole. Research suggests a third of those with autism have mitochondrial dysfunction. As I’ve noted before and as Herbert explains, mitochondria are the energy centers or “furnaces” for cells. If your mitochondria are choking through their day, so are you. Fueling these furnaces means feeding them well. B-vitamins are critical as are minerals like magnesium and zinc. Not surprisingly, these are common deficiencies in many people on the autism spectrum.

Likewise, research shows basic toxin and cellular waste removal may not be as efficient in individuals with autism. Antioxidants are essential here, particularly the heavy hitters like vitamins C and E as well that powerhouse glutathione. Nutritional deficiencies mean the building blocks for glutathione (which the body produces itself) are in short supply. When glutathione levels are inadequate, a whole host of vital processes feel the impact. For one, the body can’t effectively dispose of cellular waste, a condition that then further feeds oxidative stress. Among other impaired activities is methylation, which is involved in producing neurotransmitters, managing gene expression, and creating functional cell membranes.

Dr. Herbert advises getting a full nutritional panel, eating a nutrient rich and clean (e.g. organic, grass-fed, “caveman” – yes, she really says this) diet, supplementing with oversight from a qualified physician with experience in autism disorders, and using Epsom salt baths to help the body detoxify in a safe and convenient way. Her dietary and supplementation recommendations are too complex to fully describe here, but some key nutrients she notes include B-vitamins, zinc, vitamin D, selenium, EPA, and DHA. The irony is, of course, that these children’s diets are often more likely to be deficient because of sometimes extreme sensory aversions to the taste, smell, texture, or even appearance of certain foods. In yet another example of vicious cycle, nutritional deficiencies (e.g. zinc) can contribute to these sensory aversions. She suggests correcting deficiencies and taking advantage of feeding clinics and sensory therapies to expand food tolerance.

Neurologically speaking, the connections between parts of the brain in people with autism, she found, are weaker than they are in typically functioning individuals. Other research suggests people with autism show hyperlocal connections, a concentration of connections within the brain – generally in the frontal cortex, and weaker “distant” connections throughout the whole brain. It began to make sense, Dr. Herbert suggests, that people with autism often exhibit lower functioning in complex, neurologically integrated tasks like language and socialization as well as a heightened sensitivity to sensory stimuli.

Options like music and certain play therapies cultivate connectivity because they use multiple sites in the brain simultaneously, but Dr. Herbert also stresses the importance of nutrition for neural health. She homes in on the role of astrocytes (glial cells), which act as the “interface between body, brain, and environment.” If they’re unable to perform their duties, here comes the cascade of neurochemical imbalance (including a dearth of relaxation-promoting GABA), oxidative stress, drained mitochondrial health, and cellular dysfunction. Again, it’s another downward spiral. Feeding the glial cells means incorporating copious essential fatty acids, especially EPA and DHA, as well as B vitamins, and magnesium. In the cases of those with autism, upper limits on nutrients like B6 may not apply the same way. Nonetheless, Dr. Herbert suggests working with a doctor who can find a therapeutic dose that doesn’t impose unwanted and risky side effects.

Immune Function (Especially Gut Health) Is Key

Remember those glial cells? Most of your glial cells are found in the digestive system rather than the brain. As Dr. Herbert explains, research is just beginning to understand the implications of this for autism disorders. Overall, she explains that gut bacteria has a huge impact on the brain. Abnormal gut bacteria can deplete nutrients and produce unhealthy chemicals Herbert calls “toxic trash.” Research has found, for example that the more p-cresol (a chemical produced by abnormal gut bugs) that was present in subjects’ urine, the more severe their autistic symptoms were.

Dr. Herbert stresses that we don’t know when the abnormal gut profile takes root, but everyone’s gut immune system is established early on. She suggests incorporating fermented and cultured foods, using a probiotic supplement, avoiding over-sanitation, eliminating artificial additives, and limiting carb intake. While some experts poo-poo diet elimination techniques, Dr. Herbert says she’s seen more than enough evidence in research and in her patients to suggest that these elimination diets (e.g. gluten, casein) can make a critical difference. The key is to give it time – some three to six months – to judge real change and to work with a physician who can differentiate between “die off” (e.g. yeast) transitions and other health responses when looking at any coinciding setbacks.

Some Final Primal Words

Our lives – and our children’s lives – are so vastly different today than they were just a couple of generations ago. These differences are embedding themselves faster than we sometimes appreciate. I wonder if it’s just simple coincidence that many new treatments for autism spectrum, ADHD, and other developmental and behavioral disabilities are homing in on maximizing what I’d call the basics of healthy development itself – enhanced nutrient density, increased time outdoors, more exercise and movement, rich play opportunities. To be sure, many of these are often adapted for particular therapeutic purposes like specialized social play therapies, music therapy, or Anat Baniel’s movement methods. Nonetheless, these approaches prioritize the building blocks of physical, cognitive, and socio-emotional development.

It’s true there are plenty of children with autism or ADHD who grew up eating real, organic, even Primal food, who played outside nonstop, and lived with fewer household toxins. Likewise, there are millions of kids walking around without a disability who have been fed a steady diet of fast food, candy, and junk food. As Herbert and others suggest, it’s a complicated, confounding picture we’re dealing with. It can seem random and unjust.

I can’t say I know this from personal experience with special needs in particular, but I’ve seen friends wade their way through the tangle of emotion and services as well as the confusion of expert opinions. (It’s a pattern that also obviously holds in other “expert” based arenas as well like health care.) Just because the bulk of research goes down a certain path doesn’t mean you have to. Often the best, most sensical and personally effective means for bettering one’s health and life are to be found in the margins, the up and coming or as-yet little understood approaches.

Make no mistake. I’m all for the importance of good research. I look for confirmation. I know, however, that effective options don’t always get studied or published with the same frequency as conventional choices. As the folks at Brain Parenting put it, “the ‘good science’ metric is often wielded like a stick against parents or teachers who try new and novel techniques to help kids with unusual brains. Parenting doesn’t just rely on ‘good science.’ It also relies on observation, and derives great power from the narrative.”

The research on whole brain, whole body intervention doesn’t negate the importance of traditional interventions like speech and occupational therapy, social therapies, etc. It doesn’t nullify the call for medications that can actually make a positive difference in the lives of those with autism, ADHD, or other similar conditions. It doesn’t undercut the significance of parental love and acceptance. And, inevitably, it doesn’t offer a simple or universal resolution to the difficulties imposed by autism or other developmental and behavioral disabilities. As Dr. Herbert explains, it’s not about promising a cure but revolutionizing the way we think about and address these developmental and behavioral conditions. The whole brain, whole body approach seeks to harness the basics of biology – cultivating the power of cells, the fitness of whole systems, and the potential of brain plasticity – to foster the healthiest and richest life possible for every individual whether he/she is disabled or not.

Thanks for reading today, everybody. I hope you’ll offer your own thoughts and perspectives. I’ll look forward to reading your feedback.

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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