10 September, 2018

Gut Health and Autism

In this post, the first in a series on gut health, I’ll cover why gut health is so important to assist healing and improving health, particularly those children with Autism. Hopefully, after reading through this post and others, you'll see how important it is to heal your child's gut microbiome.

In our case, it was clear that our son had gastrointestinal problems. We decided to determine if these gastrointestinal problems could contribute to his symptoms of Autism. Our reading on the subject convinced us that they could be linked. We were convinced enough that gut health could contribute to the symptoms that we decided to provide a diet aimed at healing his gut. Years later, I'm convinced that the improvement in his happiness and development has a lot to do with his improvement in his gut microbiome.

Anyone looking to improve the symptoms of Autism Spectrum Disorder should spend a great deal of effort in improving gut health. Gut health isn't just important for Autism. It's important for many issues relating to the brain including ADHD and anxiety. Gut health is also very important for some chronic diseases and overall health and quality of life.

Health starts in the gut. Our gut is the supplier of nutrients to our body and therefore impacts our health in a big way. Traditionally we’ve thought of the digestive system as a bunch of tubes used to break down foods and absorb nutrients, with the remaining unneeded food to come out the other end. That is part of the function of the gut, but there’s much more to it.

My passion is to help children with Autism and developmental issues, and I’ll focus a bit on that, but before I do, I’d like to cover some general basics….

We all eat, but how much thought do we put into it? Many people eat to feel full or feel satisfied. Most people think we eat to provide calories to meet our energy needs. My view is that there are two other very important reasons that we eat, other than calories.

In my opinion, the focus should be on these other two.
  • We eat to provide nutrients for our cells so that they can carry out their functions and promote health and wellbeing.
  • We eat to feed the gut bacteria so that they can provide additional nutrients and promote health and wellbeing in us.

How much of your eating choices are about nutrients? How much of your eating choices are about calories?

But the key question is……..
How much are your eating decisions about feeding the gut bacteria that you want to thrive?

Why should you care about gut bacteria?

Some studies indicate that diet affects gut microbiota. This may be one of the reasons why health often improves when people modify their diet. It’s interesting, and rarely considered, how much of a role our gut bacteria have on our health. The products produced by our gut bacteria affect our body and our health.
Products produced by our gut bacteria, enter our system via the gut wall. These nutrients may not be consumed directly, but instead, are produced by the bacteria from our food. Fermentation of fibre and protein by the gut bacteria produce some of the most essential products. One group of products are short-chain fatty acids (SCFA). SCFA’s are a key source of energy for the body, including the gut wall tissue.

Some bi-products of SCFA metabolism also influence gene expression. This mechanism may be a key reason why dietary fibre has been shown to reduce the risk of colon cancer.

SCFAs can reach the bloodstream and impact immune function and inflammation.

Butyrate (a type of SCFA) is important and well known for its’ positive effect on the health of our gut lining. It helps modulate gut inflammation and promotes the stability and expression of genes, as mentioned above. Butyrate also regulates apoptosis (normal cell death used to remove unwanted cells), supporting the removal of dysfunctional cells, and is another way that gut microbes have a role in protecting against colon cancer.

Butyrate also reduces the risk of metabolic and immune system disorders, such as osteoarthritis, obesity, type II diabetes and cardiovascular disease [link].

There are many other products which are produced by gut bacteria. Bacteria such as Bifidobacterium can generate vitamins (e.g., K, B12, Biotin, Folate, Thiamine) [link].

Gut bacteria, and gut health, including the integrity of the gut wall, influence how well we absorb nutrients and block toxins from entering our bloodstream. Our gut microbes also produce enzymes. Many enzymes produced by microbes influence digestion and health. Our microbial diversity requirements may have a lot to do with our need for enzymes. Some microbes may be responsible for enzymes to break down foods, which provide access to nutrients for other bacteria. In other words, one type of bacteria relies on another kind of bacteria. They work together.

Gut bacteria and cravings

Gut microbes have also been shown to influence diet choices. For some time, it was unknown exactly how bacteria could influence our decisions on which foods to eat. In 2006, neuroscientists found that specific types of gut flora help detect which nutrients are missing in the diet and then influence how much of those nutrients the person needs to eat.

In other words, the bacteria in our gut influence our drive to eat, and what we crave. This means that it’s possible to reduce our cravings for sugar by reducing the microbes that want sugar, and are influencing us to eat sugar. So although you may think that your child won’t comply with dietary changes, the nutritional changes may eventually reduce their craving for unhealthy food.

Of course, this works for adults too. Many adults have tried dieting for weight loss. They may have tried many different diets, and believe they have tried everything. But have they tried to control their cravings and drive to eat by balancing their gut bacteria? Eating fewer calories, mainly by reducing fat, may mean that they are still eating food that the sugar-loving microbes want. Those sugar-loving microbes may still be a significant driver for the craving and drive to eat. It takes an incredible amount of willpower to overcome these cravings, and the cravings get stronger until you finally give in, and fall off your low-calorie diet. You may see some ice-cream, and eat the whole tub. The most important trick to losing weight is to find the diet for you, that kills the cravings! Balancing gut microbes is a key component of that.

There’s also evidence that altering bacteria in the gut can influence body mass index and obesity]. This effect can be unrelated to diet. Studies in mice have shown weight gain differences despite the mice having identical diets, but very different gut bacteria [link].


Gut bacteria and the Autistic brain

Most parents with a child on the spectrum, are told that their child was born with a permanent brain disorder. We, as many of you, may have questioned this, as there was no sign of any issues in the early years. In our case, our son lost skills that he did have when he was younger. We were still told, however, that we must have imagined it, as Autism is from birth, and your son has Autism (yes, I love deep thinking). Note, that this opinion was formed after no direct brain testing. There were no brain scans to find any permanent damage carried out. There were no diagnostic pathology tests to attempt to understand any neurotransmitter imbalance. Just the standard Psychology, OT and Speech assessments were done.

Our brain function is affected by things other than the physical structure. Brain function is influenced by things such as neurotransmitters, inflammation and oxidative stress. The treatment of many brain disorders is with medicines that affect neurotransmitters, and their effect on neurotransmitters are the reason for their success. In autism, it isn’t standard to test for any indication of neurotransmitter imbalance, let alone inflammation, oxidative stress or structural issues.

If a baby is born with a compromised gut ecosystem, and their colon cannot produce certain chemicals, including neurotransmitters, there is a natural workaround. The workaround is breast milk. Breast milk contains many of the nutrients that the baby requires, even in cases whereby the baby doesn’t have the bacteria to produce the nutrients. The baby may develop normally until the introduction of formula, or they are weaned off breast milk. Once they no longer are fed breast milk, the child relies on their colon to produce various nutrients and neurotransmitters (and their precursors), as we all do. If they were unable to repair their gut ecosystem in time for this change, they could start to develop problems.

Similarly, the gut imbalance can occur a little later in their development. The imbalance may often be due to antibiotics. In today’s world, it common for both parents to work. There is, as a result, a need to reduce our children’s number of sick days. We can’t afford to be regularly home, and away from work, looking after our sick children. This tends to mean more antibiotics. We ask for help from our doctors sooner than our parents did. When the imbalance comes later, in a different developmental stage, various symptoms can arise. Often the resulting diagnosis is ADHD if the imbalance occurs around school age.

The gut environment and microbes affect brain development by producing various nutrients and proteins, including neurotransmitters and brain-derived neurotrophic factor (BDNF, which promotes brain growth and development. Yes the brain can grow and restructure). An association has been shown between the gut and various mental conditions including Autism spectrum disorders, depression and anxiety [link]. In cases of brain-related disorders, it’s crucial to consider interventions relating to gut health.

When considering gut health for the brain, it’s important to look at all the general gut health principles future posts in this series.

The microbiome affects the brain via various mechanisms including:
  • Proteins, lipopolysaccharides and other products produced by the microbes can produce inflammation throughout the body, including the central nervous system.
  • The microbes can produce neurotransmitters and hormones that are identical to those produced by our body.
  • Gut microbes produce SCFA’s that provide clean energy for cells, including brain cells.
  • Gut microbes stimulate the enteric nervous system (the nervous system of the gut, or the second brain) to send signals to the brain via the vagus nerve.

Although there are studies that show certain strains of bacteria produce certain proteins and neurotransmitters, we have to remember that they work in communities. It’s not enough to only promote the chosen few. We need to encourage a diverse community of wanted microbes. One food may require various strains of bacteria to contribute to its’ proper digestion. For example, strain A may break down a fibre partially, allowing strain B to access elements of the food that it would not be able to if strain A wasn’t there to start the process of digestion.

So what does all of this mean? It means that if heal and you look after your gut, you have better health. You will require less nutritional supplements and medicines to improve your health. You will have an enhanced immune system and feel more energetic while feeling calmer and happier.