eLetters to:

SUPPLEMENT ARTICLES: Timothy Buie, Daniel B. Campbell, George J. Fuchs, III, Glenn T. Furuta, Joseph Levy, Judy VandeWater, Agnes H. Whitaker, Dan Atkins, Margaret L. Bauman, Arthur L. Beaudet, Edward G. Carr, Michael D. Gershon, Susan L. Hyman, Pipop Jirapinyo, Harumi Jyonouchi, Koorosh Kooros, Rafail Kushak, Pat Levitt, Susan E. Levy, Jeffery D. Lewis, Katherine F. Murray, Marvin R. Natowicz, Aderbal Sabra, Barry K. Wershil, Sharon C. Weston, Lonnie Zeltzer, and Harland Winter Evaluation, Diagnosis, and Treatment of Gastrointestinal Disorders in Individuals With ASDs: A Consensus Report Pediatrics 2010; 125: S1-S18 [Abstract] [Full text] [PDF]

eLetters published:

GI status and nutrients

Tim P. Earnest   (5 January 2010)

Autism and Diet

Scott S. Field   (27 February 2010)

GI status and nutrients 5 January 2010
Tim P. Earnest, Pediatric psychiatrist Woodcreek Healthcare Send letter to journal: Re: GI status and nutrients dawnmome{at}comcast.net Tim P. Earnest	Thank you for your combined work in evaluating the issue of gastrointestinal disorders in those with autistic disorder. My concern with GI disorders involves the number of nutrients already associated with autistic disorder. If there is poor absorption of these nutrients, then symptoms of autistic disorder may arise or worsen, depending on one's genetic predisposition. This includes low vitamin D, given possible association with autistic disorder as seen with higher rates of residence for children with autistic disorder in counties with higher rainfall in California, Oregon, and Washington. It also includes low iron, given the association between low iron measured as ferritin and sleep disorders in children with autistic disorder. Deficiencies in each could be due to lactose intolerance, celiac disease, food allergies, or small intestine bacterial overgrowth. Being alert for GI problems in those who frequently have communication difficulties is practicing wise and cost-effective healthcare. Waldman, Michael, et al., "Autism Prevalence and Precipitaion Rates in California, Oregon, and Washington Counties", Archives of Pediatrics and Adolescent Medicine, 2008; 162 (11): 1026-34. Dosman, Cara, et al., "Children with autism: effectg of iron supplementation on sleep and ferritin", Pediatric Neurology, 2007 Mar; 36 (3): 152-58. Conflict of Interest: None declared
Autism and Diet 27 February 2010
Scott S. Field, pediatrician Field Pediatrics, P.C. Send letter to journal: Re: Autism and Diet fielddocs{at}knology.net Scott S. Field	Dear Authors: Your consensus statements regarding gastrointestinal disorders in people with autism spectrum disorders (ASD) [1] were extensive but lacked information linking autism with omega-3 fatty acid (n3FA) deficiency [2- 5]. Consensus statement 9 acknowledged "potential nutritional problems" in ASD patients, but failed to mention the role of essential fatty acids in normal brain function and the potential link between their dietary deficiency and autism. Statement 11 refers to dietary interventions for ASD claiming "few studies in the literature are difficult to interpret without adequate control groups" without referencing any studies. Unfortunately, few studies have been conducted in this area, but most studies done so far support the utility of n3FAs in treating children with ASDs [6-8]. There is also good evidence for the benefit of n3FAs in treating children with attention deficit hyperactivity disorder [9] and schizophrenia [10] which are often associated with ASD. The greatest benefit of n3FAs is likely to be in the prevention of brain disorders by ensuring adequate supplies from conception through the first few years after birth during critical brain development. References: 1. Buie T, et al. Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report. Pediatrics. 2010;125(suppl 1):S1-18 2. Saugstad LF. Infantile autism: a chronic psychosis since infancy due to synaptic pruning of the supplementary motor area. Nutr Health. 2008;19(4):307-317 3. Kidd PM. Omega-3 DHA and EPA for cognition, behavior and mood: clinical findings and structural-functional synergies with cell membrane phospholipids. Altern Med Rev. 2007;12(3):207-227 4. Clark-Taylor T, Clark-Taylor BE. Is autism a disorder of fatty acid metabolism? Possible dysfunction of mitochondrial beta-oxidation by long chain acyl-CoA dehydrogenase. Med Hypotheses. 2004;62(6):970-975 5. Field SS. Omega-3 fatty acids, prematurity, and autism. [letter] Pediatrics. 2008;122(6):1416-1417 6. Amminger GP, Berger GE, Schafer MR, et al. Omega-3 fatty acids supplementation in children with autism: a double-blind randomized, placebo-controlled study. Biol Psychiatry. 2007;61(4):551-553 7. Meiri G, Bichovsky Y, Belmaker RH. Omega 3 fatty acid treatment in autism. J Child Adolesc Psychopharmacol. 2009;19(4):449-451 8. Meguid NA, Atta HM, Gouda AS, et al. Rople of poysunsaturated fatty acids in the management of Egyptian children with autism. Clin Biochemistry. 2008;41:1044-1048 9. Johnson M, Ostlund S, Fransson G, et. al. Omega-3/omega-6 fatty acids for attention deficit hyperactivity disorder. J Attn Dis. 2009;12(5):394- 401 10. Arvindakshan M, Shate M, Ranjekar PK, et al. Supplementation with a combination of omega-3 fatty acids and antioxidants (vitamins E and C) improves the outcome of schizophrenia. Schizophr Res. 2003;62(3):195-204 Conflict of Interest: None declared