Dietary Supplementation in Children with Autism Spectrum Disorders: Common, Insufficient, and Excessive

Goldilocks, oh Goldilocks, how much should you have? Is your porridge too hot? Is that bed too soft? And how many vitamins did you take today? How much is just right?

A recent study published by Journal of the Academy of Nutrition and Dietetics asked just that question. In kids on the autism spectrum, how many vitamins are they taking? The title of the study is interesting: Common, Insufficient, and Excessive. It brings into conversation our common ignorance of RDA (recommended daily allowances) or DV (daily values), which are the % of vitamins we commonly see on our ingredient list.

Most people interpret the 100% RDA as optimal, but in reality, it’s far from it. The NIH (National Institute of Health), a government association that governs these vitamin numbers, refers to this RDA as the bare minimum we should have to stay alive. How much Vitamin C do you need to avoid scurvy?

Most people are unaware of the other limits that the NIH has defined. Let’s go back to Goldilocks:

RDA Bare Minimum Porridge is too cold
TUL Tolerable Upper Limit of Safety Porridge is too hot
AI Adequate Intake – healthiest range Just right

This study, as may other research studies, analyze vitamin intake, either through diet or supplements and reference the RDA, when in actuality, if we want a healthy person, should reference the AI, or measure an individual blood or urine nutrient level. That would be a better analysis of nutrition and health.

This particular study looked at 288 children with ASD (Autism Spectrum Disorders) on a GF/DF diet. It identified a deficiency of certain nutrients, most notably Vitamin D and calcium, along with potassium, pantothenic acid, and choline. It also identified an “excess” of Vitamin A, folate, and zinc.

Vitamin deficiencies are extremely common in the ASD population. This occurs for three reasons. First, many children with ASD are picky eaters. Their sensory symptoms cause a heightened sensation to tastes, smells, and textures. They therefore only eat certain select foods, often with little nutrient value. These sensory issues also make it difficult to give vitamin supplements, which may have tastes that the children don’t like. Secondly, the disease process in ASD may cause the children to utilize nutrients faster than the average child. Therefore the RDA for one person is not equal to the RDA of another. Thirdly, many children with ASD have GI inflammation, which reduces their nutrient absorption, leading to nutrient deficiencies.

With those three things creating a need for more nutrients, the best way to analyze an individual is not by comparing them to an RDA created from a healthy population, but by testing the individual’s nutrient status through lab work. You then obtain individualized medicine that is more effective.

The study’s assessment of low Vitamin D and calcium intake should be highlighted. Vitamin D has gained popularity over the last five to ten years as a nutrient that most of our population has a frank deficiency. Humans spent most of their time outside until one hundred years ago. We hunted, we farmed, and we didn’t spend all day in the office, the school, or playing video games. The old RDA of 400 IU was subpar, and people should be taking enough Vitamin D to keep their blood levels at mid-range of their lab work. Calcium, as well, is deficient in many. Those who don’t eat dark, leafy green vegetables, or sardines, and those on a dairy-free diet, are at risk for low calcium levels. These should be tested and treated for the individual.

The study’s assessment of excess vitamins may be flawed. They claim excess levels of Vitamin A, folate, and zinc in the majority of the children in their study. However, this assessment is only in reference to the bare minimum. The porridge is too cold! We want these nutrient intakes to be just right. Vitamin A levels should be measured. Folate levels should be checked in ratio to 5-MTHF levels and in consideration to MTHFR genetic mutations, and zinc is commonly deficiency in ASD children, as shown through a multitude of studies. So, the question should not be, is our diet in excess of the RDA bare minimum, but rather, what is the nutrient status of each individual, and then tailor supplements and diet to them.

I just glazed over MTHFR genetic mutations, didn’t I? Folate is directly used in blood cells, but needs to be converted (methylated) into its active form to be used by the brain. Methylated folate (known as 5-MTHF) eventually helps produce serotonin and dopamine, which are essential for proper brain function, learning, and healthy sensory and motor function. MTHFR gene mutations are present in approximately 50% of people in the US. Therefore, if someone has a problem converting folate, they will have the following:

Low 5-MTHF (methylated, activated folate) levels

Low or low-normal serotonin and dopamine levels

Worsened mood, behavior, and sensory issues

High folate levels (if you can’t use it, you build up an excess)

So, let’s recap. When is an excess really an excess? When the individual’s lab work shows an elevation. Not when someone eats 2 bowls of Total cereal and gets 200% of the RDA. Not when they have GI yeast and poor absorption. Not when they have genetic mutations. And not when they use more nutrients in their brain than the average person. However, when is a deficiency a deficiency? More often than you think. We don’t eat enough healthy food and our food is not as healthy as it once was. Look at the individual, not a number on an ingredient list that was made decades ago when looking at healthy people, and remember the individual person ALWAYS must be taken into consideration.

About Dr. Jared Skowron

Dr. Jared Skowron is the Amazon best-selling author of 100 Natural Remedies For Your Child, and national expert in natural medicines for children. Co-founder of the Pediatric Association of Naturopathic Physicians, he is dedicated his life to keeping children healthy and happy, naturally.

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