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Low FODMAP diet: benefits for autism

Posted by: lorene.amet@gmail.com | Posted on: November 27th, 2013 | 0 Comments

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The Low FODMAP diet

What? Another diet you would hear me say! Haven’t we all tried so many diets already? Didn’t we get the answers we were hoping for with the Gluten-Freen Casein-Free (GF/CF) diet, the Specific Carbohydrates Diet (SCD) or Gut and Psychology Syndromes (GAPS) diet already?

Well, not quite… As it happens there are other potential intolerances that can affect a person’s digestive system, development and behaviour. Yes, it’s complicated, and sometimes we are really at loss on how to identify what is right for our ASD child, what to chose, what to follow and to believe?

Let me tell you a little more about how foods can affect a person’s digestive system and behaviour, then I will tell you why the Low FODMAP diet might help. But before I go into these details, can I say right away, that the Low FODMAP diet is pretty well established.  It has received a lot of attention over the last 10 years, with numerous publications in support of its benefits in IBS (Irritable Bowel Syndrome) and other inflammatory bowel diseases, I have included a few links below to illustrate this. It is endorsed by the NHS too. The NHS can test if the diet might be of some benefit to you or your child and guide you with its implementation. That’s pretty good!

What are food hypersensitivities and intolerances ?

There are basically three types of potential problems with foods: (1) food allergies, (2) non-allergic food hypersensitivities, and (3) food intolerances.

(1): Food allergies are true allergies where the body makes antibodies known as IgE against a particular food stuff (any molecule causing an IgE reaction is called an allergen). In the presence of the allergen, there is release of histamine and other defensive chemicals in the body. This causes a range of symptoms, from irritation, swelling, breathing difficulties, cramps, vomiting, nausea. This can affect the entirety of the digestive system, mouth, skin, lungs, heart, and blood vessels. It is potentially life threatening.

(2) Non-allergic hypersensistivities do not involve IgE antibodies and the symptoms more commonly affect the digestive system, and also in some individuals their behaviour. It can be difficult to diagnose such hypersensitivies as tests are not very reliable, with both false positive and false negative results on for example Immunoglobulin G (IgG) food test panels. It is often easier to identify an hypersensitivity on an bland elimination diet followed by a challenge to test specific foods potentially causing a problem. Dietary guidance with this is beneficial.

(3). Food intolerances are the most common triggers of gut symptoms, but can also cause other issues such as fatigue, depression, low energy, headaches, confusion, memory issues and of course behavioural problems. Some intolerances are directly related to foods containing high levels of bioactive substances and chemicals, that occur naturally in food (e.g. salicylates,caffeine) or that are added during food processing (e.g. monosodium glutamate, aspartame, E numbers). Other intolerances are related to their action on our gut flora. This is by far the most common way in which digestive symptoms can occur. This is when a Low FODMAP diet might help.

What is the FODMAP diet?

I waited till the end of the post to tell you what FODMAP stands for. It’s because it is quite a mouth full, so to speak! It stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. OK, let’s leave it at FODMAP. These are sugars and polyols that are poorly absorbed in the small intestine and consequently remain in the digestive track for too long. They end up being used as source of energy for the our gut flora instead of feeding us. In other words, it can contribute to a bacterial and yeast overgrowth. Now, not everyone has problem with digestive microbial overgrowth, if the digestive flora is well balanced, with a healthy intestinal pH and the right types of bugs, there is no problem. But if there is an imbalance, providing these types of sugars and polyols will likely contribute to further imbalances, overgrowth, inflammation and intestinal permeability, what we call the leaky gut. This is often central to the health problems seen in autism, and there is no way around it: a Gastro-Intestinal (GI) problem needs to be addressed, as first line of intervention in autism.

Breath Hydrogen and Methane testing

This is a test your GP can do. Basically the person to be tested will eat a certain type of sugar, one of the FODMAP, and be tested for the level of hydrogen and methane being produced in their breath afterwards. This can be tricky for some of our children of course, in which case, it is probably easier to trial a Low FODMAP diet for 2 months, that is if GI symptoms are not resolved on a GF/CF, SCD or GAPS diet. You can read more about the breath test here.

If you need help with this diet and would like more information about it, please contact us. You can also talk to your GP or GI consultant about the potential benefits the Low FODMAP diet can bring.

Some links and references

Recent Nature Group publication
NHS in partnership with King’s College London
Useful resources:
What to eat and not to eat (note that I would not recommend to introduce any milk products in the initial phases of the diet)

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