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The Paleo Diet and Autism

Autism | The Paleo Diet

The word “autism” conjures up a number of different images, which vary widely depending on the person. Traditionally thought of as a very debilitating disorder of neural development, the public awareness of autism has grown and expanded with time.1 With the elimination of Asperger’s from the DSM-5, and its replacement with just ‘autism’ (with accompanying degrees of severity);2 patients now vary widely, from barely functioning to highly functioning. This fascinating condition has no cure, and its causation, and/or mechanism of action, remains a mystery.3 Humans with autism typically exhibit impaired social skills, apparent lack of empathy for others, and repetitive movement patterns. Depending on the severity, altered cognitive function is also observed.4 It is important to note that autism is diagnosed on a spectrum, meaning that someone with high functioning autism may have a near-genius level IQ, but someone lower on the spectrum may not.

As we look into the science behind autism, we see that nerve cells and synapses are altered, both in organization and connectivity.5 How exactly these are altered, is not well understood. One interesting fact regarding prevalence of autism, is that males are four times as likely to be diagnosed as females.6 The underlying cause of this discrepancy is not understood or agreed upon. Within the first 3 years of a child’s life, autism symptoms are usually observed, and hopefully diagnosed. With proper forms of therapy, quality of life can improve. However, heartbreakingly, oftentimes people with autism cannot live alone in adulthood.7 The social aspects of autism are heartbreaking and frustrating, both for those suffering from it, and those related to them. As reported in a study8 by Audrey F. Burgess and Steven E. Gutstein “children with high-functioning autism suffer from more intense and frequent loneliness compared to non-autistic peers, despite the common belief that children with autism prefer to be alone. Making and maintaining friendships often proves to be difficult for those with autism. For them, the quality of friendships, not the number of friends, predicts how lonely they feel.” Keep in mind that this quote refers to HIGH functioning forms of autism. Imagine how a child lower on the spectrum may feel.

But what does diet have to do with a neurological development disorder? Well, as is becoming increasingly well known in the scientific community,9 important neurotransmitters like serotonin are all altered by dietary choices.10 So what does the scientific literature say about autism and diet? In short, quite a bit.11 The anti-inflammatory effects of a diet based on real, whole foods, such as the Paleo Diet, will certainly help many biomarkers related to autism12, 13 To what degree, is still being debated.

Via what mechanism can food alter brain activity? Well, exorphins from grains and dairy can cross the blood-brain barrier and act as opioids in the brain.14 Yes, you read that correctly. Since sufferers of autism typically exhibit ‘leaky gut,’15 the proposed mechanism of action is that these exorphins make their way to the brain, and cause developmental delays.16 This is backed up by different studies,17 and is linked with celiac disease and other conditions like schizophrenia.18 The same mechanism, albeit with addiction-like properties, can be implicated in those suffering from binge eating and obesity, as well.19

There are even more interesting theories, such as the one proposed by John Cannell, M.D., relating low vitamin D levels and damage to the brain.20 As Cannell writes “if your genetics deal you low numbers of VDRs and you have to deal with vitamin D deficiency as well, your developing brain loses. The autism geneticists have been looking for mutations. It is not a mutation; the small de novo mutations they do find (in all 23 pairs of chromosomes) are effects, not causes, of autism because vitamin D deficiency impairs DNA repair mechanisms.”21 This is particularly ground breaking research that deserves more recognition. As Emily Deans, M.D., has also excellently pointed out,22 autism and schizophrenia both exhibit similar gene deletion syndromes, like 1q21.1 deletion syndrome.23 Coincidence? Maybe. But this is certainly an interesting hypothesis.

While no doubt autism and diet are still somewhat controversially linked, it is definitely worth a families’ time and effort to try out a Paleo Diet, because the results can be life-changing. Someone suffering with this disorder deserves the best quality of life possible.

Thank you for reading,

Casey Thaler, B.A., NASM-CPT, FNS
@EatCleanTClean
Eat Clean Train Clean
www.EatCleanTrainClean.com

Casey Thaler | The Paleo Diet TeamCasey Thaler, B.A., NASM-CPT, FNS is an NASM® certified personal trainer and NASM® certified fitness nutrition specialist. He writes for Paleo Magazine® and for PaleoHacks. He also runs his own nutrition and fitness consulting company, Eat Clean, Train Clean®. He is pursuing his Ph.D in Nutritional Biochemistry, hopefully from Harvard University.

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References

1. Wing L, Potter D. The epidemiology of autistic spectrum disorders: is the prevalence rising?. Ment Retard Dev Disabil Res Rev. 2002;8(3):151-61.

2. Huerta M, Bishop SL, Duncan A, Hus V, Lord C. Application of DSM-5 criteria for autism spectrum disorder to three samples of children with DSM-IV diagnoses of pervasive developmental disorders. Am J Psychiatry. 2012;169(10):1056-64.

3. Shelton JF, Hertz-picciotto I, Pessah IN. Tipping the balance of autism risk: potential mechanisms linking pesticides and autism. Environ Health Perspect. 2012;120(7):944-51.

4. Dawson G, Webb SJ, Wijsman E, et al. Neurocognitive and electrophysiological evidence of altered face processing in parents of children with autism: implications for a model of abnormal development of social brain circuitry in autism. Dev Psychopathol. 2005;17(3):679-97.

5. Gutierrez RC, Hung J, Zhang Y, Kertesz AC, Espina FJ, Colicos MA. Altered synchrony and connectivity in neuronal networks expressing an autism-related mutation of neuroligin 3. Neuroscience. 2009;162(1):208-21.

6. Newschaffer CJ, Croen LA, Daniels J, et al. The epidemiology of autism spectrum disorders. Annu Rev Public Health. 2007;28:235-58.

7. Marriage S, Wolverton A, Marriage K. Autism spectrum disorder grown up: a chart review of adult functioning. J Can Acad Child Adolesc Psychiatry. 2009;18(4):322-8.

8. Quality of Life for People with Autism: Raising the Standard for Evaluating Successful Outcomes. Child and Adolescent Mental Health. 12(2):80.

9. Available at: http://www.washingtonpost.com/national/health-science/can-what-you-eat-affect-your-mental-health-new-research-links-diet-and-the-mind/2014/03/24/c6b40876-abc0-11e3-af5f-4c56b834c4bf_story.html. Accessed May 16, 2014.

10. Young SN. How to increase serotonin in the human brain without drugs. J Psychiatry Neurosci. 2007;32(6):394-9.

11. Available at: http://www.ncbi.nlm.nih.gov/pmc/?term=autism diet. Accessed May 16, 2014.

12. Herbert MR, Buckley JA. Autism and dietary therapy: case report and review of the literature. J Child Neurol. 2013;28(8):975-82.

13. Nadon G, Feldman DE, Dunn W, Gisel E. Association of sensory processing and eating problems in children with autism spectrum disorders. Autism Res Treat. 2011;2011:541926.

14. Available at: http://www.childrensdisabilities.info/allergies/developmentaldisordersprotein7.html. Accessed May 16, 2014.

15. De magistris L, Familiari V, Pascotto A, et al. Alterations of the intestinal barrier in patients with autism spectrum disorders and in their first-degree relatives. J Pediatr Gastroenterol Nutr. 2010;51(4):418-24.

16. Elder JH. The gluten-free, casein-free diet in autism: an overview with clinical implications. Nutr Clin Pract. 2008;23(6):583-8.

17. Dubynin VA, Malinovskaia IV, Beliaeva IuA, et al. [Delayed effect of exorphins on learning of albino rat pups]. Izv Akad Nauk Ser Biol. 2008;(1):53-60.

18. Severance EG, Alaedini A, Yang S, et al. Gastrointestinal inflammation and associated immune activation in schizophrenia. Schizophr Res. 2012;138(1):48-53.

19. Drewnowski A, Krahn DD, Demitrack MA, Nairn K, Gosnell BA. Naloxone, an opiate blocker, reduces the consumption of sweet high-fat foods in obese and lean female binge eaters. Am J Clin Nutr. 1995;61(6):1206-12.

20. Cannell JJ, Grant WB. What is the role of vitamin D in autism?. Dermatoendocrinol. 2013;5(1):199-204.

21. John Cannell, M. (2014). Mechanism of action in autism? | Vitamin D Council. [online] Vitamindcouncil.org. Available at: https://www.vitamindcouncil.org/the-paleo-diet-blog/mechanism-of-action-in-autism/ [Accessed 16 May. 2014].

22. Available at: http://www.psychologytoday.com/the-paleo-diet-blog/evolutionary-psychiatry/201104/diet-and-autism-newer-studies-and-intriguing-links. Accessed May 16, 2014.

23. Bottillo I, Castori M, De bernardo C, et al. Prenatal diagnosis and post-mortem examination in a fetus with thrombocytopenia-absent radius (TAR) syndrome due to compound heterozygosity for a 1q21.1 microdeletion and a RBM8A hypomorphic allele: a case report. BMC Res Notes. 2013;6:376.

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13 Comments on "The Paleo Diet and Autism"

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  1. Dear Mara,

    As a card-carrying behavioral psychologist, who teaches Skinnerian principles of reinforcement and its application to behavioral disorders to a large body of undergraduates at UCLA, and as someone who was invited to give the Skinner lecture at ABAI a couple of years ago, let me refute what you are saying. While it is true that schedules of reinforcement can have a profound impact on modifying behavior, diet and lifestyle factors (e.g., sunlight exposure, sleep, stress management) do also have profound effects on behavior. There is enough convincing evidence from many case reports, and even from clinical trials and scientific research (some of it from my own lab) to show without a shadow of a doubt that diet and other lifestyle factors can have a huge impact on changing behavior.

    Also, a paleo and/or gluten free diet is not a scam out to “break the bank” of anyone who wishes to try. It might cost a little more to eat only whole foods and avoiding industrially-processed and refined foods, but it is not a bank-breaker. And no one should have to wait for gold-standard double-blind trials before adopting such simple, harm-free, benefit-laden dietary approaches.

    Don’t worry, you’ll still have plenty of ASD patients to treat through behavior analytic techniques. Those methods have been adopted for the betterment of those suffering from ASD and other mental disabilities. Nevertheless, we all have a moral obligation to provide any aide we can give folks by advising them to remove toxins and dangerous components of their diets.

    • Casey Thaler Casey Thaler says:

      Aaron,

      Thank you for stating this better than I ever could have. Autism is not a one-size-fits-all disorder, and I hope I was clear in stating that a paleo diet is just one method by which we can try and improve quality of life, in those suffering.

      I also believe in Skinner’s principles and would love to see your above-referenced lecture, if it is available anywhere online.

      Thanks for reading my work, very humbled.

      Casey Thaler
      B.A., NASM-CPT, FNS
      Eat Clean, Train Clean®:
      Eat Real Food, Change Your Life™
      http://www.EatCleanTrainClean.com

  2. Tricia says:

    Hi, I am a gluten free baker and I have a customer that has come to me for a year for GF DF cookies for her sons treat. Well they came to the market to day. I have not seen them since February. So we talked and kept commenting on how much her son had changed. She put him on the Paleo diet. He has changed so much. He tals to you, instead of wondering a circle looking down and his facial expressions have changed. She said ever since she did the paleo for him. He is another boy!!

    • Casey Thaler Casey Thaler says:

      Tricia,

      That’s a great story. I wrote this piece with the hopes that I could introduce a paleo approach to those who are suffering, as a POTENTIAL method for improving their quality of life. I was going to pen a long rebuttal to some of the comments posted here, but I believe Aaron has done a beautiful job of that. I do not think much more needs to be stated. The science is not yet completely definitive, but adopting a different diet is one method that MAY improve quality of life, for the thousands of children and adults suffering from autism.

      Casey Thaler
      B.A., NASM-CPT, FNS
      Eat Clean, Train Clean®:
      Eat Real Food, Change Your Life™
      http://www.EatCleanTrainClean.com

  3. Marti says:

    ‘Mara’, of course diet can change behaviour. Until there are studies to prove or disprove it, how can you suggest that behaviour cannot be changed by diet? Declaring autism is not a neurological condition, doesn’t negate the fact that food and medicine can alter neurological function. The only reason there is no ‘scientifically validated’ evidence is because EVERYONES neurological functioning is unique, so there’s no distinguishable group of traits named ‘autism’ that can be empirically supported.

    I have ‘aspergers syndrome’, as does my father. My two younger twin brothers and a younger sister are moderate to low functioning autistic. My mother and father never tried to alter our diet because they believed the expenditure and efforts could be wasted as there is no ‘proof’ that it helps. As a child I was a very fussy eater, and therefore had a poor diet. Despite the fact that I was underweight throughout childhood, I had become overweight by the time I reached 20 as I found certain foods very addictive. Once I left home I decided to cut those foods out, which led to me following a diet not too dissimilar from the paleo diet, eliminating grains, dairy and processed food. It CERTAINLY without question changed and improved my ‘neurological disorder’.

    I had always been extremely sensitive, nervous and overwhelmed around other people and typical environments. I became far more at ease and my anxiety has completely subsided. My mother never had a particularly good diet and grew up in relative poverty, so she often suffered deficiencies and poor dental health, which have since been remedied and severely benefited her mental health (depression). I would assume her deficiencies were likely to have had an impact on her children developing in utero. I believe this caused us to be born with extreme deficiencies and heightened sensitivity. We all suffered from allergies, eczema, asthma and general ill health, or at least did until I began eating nutritiously.

    The fact that so many people assume a ‘neurological disorder’ can’t be improved by adapting your diet frankly astounds me. Neurotransmission is synthesised by INGESTION, therefore it is scientifically proven that the consumption of all substances will affect neurological function. It may not be wise to prescribe a specific diet to an unknown individual, due their unique nutritional needs, but of course diet changes behaviour. I assume most people would agree starvation would result in behavioural changes.

    There is far more danger that there are children going through life suffering, as I was, both emotionally and physically because they are unaware that their diet has major implications in their social, cognitive, neurological and physiological well being. You can still be starved of nutrition and have severe deficiencies even if you believe you are following a relatively ‘normal’ diet. As a child I suffered constant joint ache, chronic constipation and general poor health. I never thought anything of it as I thought I was just unlucky. The only reason I actually changed my diet was because I was desperately fixated on my appearance in the hope that it would bring me success socially. I never adjusted my diet in the belief it could improve my aspergers because I had been led to believe my behavioural traits were invariable. It was only after a few months I began to wonder why I no longer felt as though I was in a constant state of anxious, nervous, painful distress.

    I can attest that after two years there is certainly a correlation between the two, and the longer people insist that these ideas are dangerous ‘pseudo science’, the longer we are ‘bankrupting’ people of a decent quality of life. The correlation is not unproven, there is just not enough proof documented. Also there is clearly a link between dental and physiological and neurological health, but again no one is interested in documenting the results. Dental health is a precursor to mental health as both are evidently connected to the nervous system. Therefore if we make the assumption that diet affects your dental health we should also assume it affects neurological function. If more people would recognise health holistically, rather than perpetuating the idea that psychological and physiological health are distinct, then we can eliminate the cause of autism, rather than relying on pharmacological studies and remedies.

    If behaviour is only sensitive to a history of reinforcement then how did they develop that behaviour in the first place? Until you have proof, perhaps I would ask that you tread very carefully not to reinforce the belief that dietary recommendations are unproven and can lead to bankruptcy. We should accept and embrace all differences, but no-one should just accept and tolerate suffering. The sooner people stop perpetuating this ridiculous outdated belief that some people, or now most people, are just born with incurable genetic disorders and inherent conditions the sooner we can improve all health and wellbeing.

    No one can deny that our behaviour is influenced by our emotions, which are affected by our nervous system and hormones. Food is as potent as medicine at synthesising neurotransmission, so to void diet would also void medicine as ineffective. Never mind the fact that food is likely more potent as medicine is unlikely to follow typical digestion as it’s not chewed. Neurological function can adapt, otherwise it would be impossible for most people to recover from injury and illness.

    I believe as a child my allergies were caused by malnutrition as I was lacking in essential minerals and vitamins. This meant I was very sensitive to food, expressly to the taste of foods such as pesticides. This caused me to develop a very narrow list of ‘food that is preferred’ because I was terrified of trying other foods. So this ‘positive reinforcement’ was actually the result of a ‘negative reinforcement’, I chose the lesser of two evils.

    I am now healthy and happy. Consuming food that drastically improves your well being is positive reinforcement and therefore your ‘scientifically validated’ proof, proves that it is in fact possible to change behaviour. You just have to widen your pseudo scientific analysis of behaviour to more than just ‘behaviouralism’ which completely neglects to acknowledge other stimulus and factors involved in determining psychological, let alone neurological function.

    • Casey Thaler Casey Thaler says:

      Marti,

      Thanks for sharing your wonderful story, and backing up my writing. It is very much appreciated, and I’m glad you have vastly improved your quality of life. We need more people like you to carry the simple message of ‘eating real food’ in regards to hopefully improving behaviors and mental health issues. The mainstream is still behind, and my goal is to help those suffering, who may not know that food can play a part in their improvement.

      Thanks again,

      Casey Thaler
      B.A., NASM-CPT, FNS
      Eat Clean, Train Clean®:
      Eat Real Food, Change Your Life™
      http://www.EatCleanTrainClean.com

  4. Mara says:

    A healthy diet is beneficial for everyone, howevever, I ask you tread very, very carefully when you make dietary recommendations to families with children diagnosised on the autism spectrum. There is ONLY one scientifically validated and proven way of helping children with autism – using the science of behavior analysis and the principles of learning (based on behavioralism (BF Skinner). Many families, desparate to find some “cure” for autism – will bankrupt their life’s savings on psudeo science such as gluten free diets, mega vitamins, bleach, chemical “castration”, chelation, hyperbolic oxygen chambers and stem cells.

    Untill the meta-analysis can show that multiple random controlled trials prove that the behavior deficits of autism can be manipulated by a dietary intervention – please make sure to establish that correlation between autism and diet is unproven – and that diet does not cause autism. We have no evidence that negates the null hypothesis that autism is a neurological disorder that is has an undiscovered cause.

    You cannot change behavior by changed one’s diet. Behavior of an organism is only sensitive to contingencies and the history of reinforcment. In addition, food that is preferred to an individual with autism may act a form of positive reinforecment contingent on engaging in learned appropriate behaivor.

    • Marti says:

      Of course diet can change behaviour. Until there are studies to prove or disprove it, how can you suggest that behaviour cannot be changed by diet? Declaring autism is not a neurological condition, doesn’t negate the fact that food and medicine can alter neurological function. The only reason there is no ‘scientifically validated’ evidence is because EVERYONES neurological functioning is unique, so there’s no distinguishable group of traits named ‘autism’ that can be empirically supported.

      I have ‘aspergers syndrome’, as does my father. My two younger twin brothers and a younger sister are moderate to low functioning autistic. My mother and father never tried to alter our diet because they believed the expenditure and efforts could be wasted as there is no ‘proof’ that it helps. As a child I was a very fussy eater, and therefore had a poor diet. Despite the fact that I was underweight throughout childhood, I had become overweight by the time I reached 20 as I found certain foods very addictive. Once I left home I decided to cut those foods out, which led to me following a diet not too dissimilar from the paleo diet, eliminating grains, dairy and processed food. It CERTAINLY without question changed and improved my ‘neurological disorder’.

      I had always been extremely sensitive, nervous and overwhelmed around other people and typical environments. I became far more at ease and my anxiety has completely subsided. My mother never had a particularly good diet and grew up in relative poverty, so she often suffered deficiencies and poor dental health, which have since been remedied and severely benefited her mental health (depression). I would assume her deficiencies were likely to have had an impact on her children developing in utero. I believe this caused us to be born with extreme deficiencies and heightened sensitivity. We all suffered from allergies, eczema, asthma and general ill health, or at least did until I began eating nutritiously.

      The fact that so many people assume a ‘neurological disorder’ can’t be improved by adapting your diet frankly astounds me. Neurotransmission is synthesised by INGESTION, therefore it is scientifically proven that the consumption of all substances will affect neurological function. It may not be wise to prescribe a specific diet to an unknown individual, due their unique nutritional needs, but of course diet changes behaviour. I assume most people would agree starvation would result in behavioural changes.

      There is far more danger that there are children going through life suffering, as I was, both emotionally and physically because they are unaware that their diet has major implications in their social, cognitive, neurological and physiological well being. You can still be starved of nutrition and have severe deficiencies even if you believe you are following a relatively ‘normal’ diet. As a child I suffered constant joint ache, chronic constipation and general poor health. I never thought anything of it as I thought I was just unlucky. The only reason I actually changed my diet was because I was desperately fixated on my appearance in the hope that it would bring me success socially. I never adjusted my diet in the belief it could improve my aspergers because I had been led to believe my behavioural traits were invariable. It was only after a few months I began to wonder why I no longer felt as though I was in a constant state of anxious, nervous, painful distress.

      I can attest that after two years there is certainly a correlation between the two, and the longer people insist that these ideas are dangerous ‘pseudo science’, the longer we are ‘bankrupting’ people of a decent quality of life. The correlation is not unproven, there is just not enough proof documented. Also there is clearly a link between dental and physiological and neurological health, but again no one is interested in documenting the results. Dental health is a precursor to mental health as both are evidently connected to the nervous system. Therefore if we make the assumption that diet affects your dental health we should also assume it affects neurological function. If more people would recognise health holistically, rather than perpetuating the idea that psychological and physiological health are distinct, then we can eliminate the cause of autism, rather than relying on pharmacological studies and remedies.

      If behaviour is only sensitive to a history of reinforcement then how did they develop that behaviour in the first place? Until you have proof, perhaps I would ask that you tread very carefully not to reinforce the belief that dietary recommendations are unproven and can lead to bankruptcy. We should accept and embrace all differences, but no-one should just accept and tolerate suffering. The sooner people stop perpetuating this ridiculous outdated belief that some people, or now most people, are just born with incurable genetic disorders and inherent conditions the sooner we can improve all health and wellbeing.

      No one can deny that our behaviour is influenced by our emotions, which are affected by our nervous system and hormones. Food is as potent as medicine at synthesising neurotransmission, so to void diet would also void medicine as ineffective. Never mind the fact that food is likely more potent as medicine is unlikely to follow typical digestion as it’s not chewed. Neurological function can adapt, otherwise it would be impossible for most people to recover from injury and illness.

      I believe as a child my allergies were caused by malnutrition as I was lacking in essential minerals and vitamins. This meant I was very sensitive to food, expressly to the taste of foods such as pesticides. This caused me to develop a very narrow list of ‘food that is preferred’ because I was terrified of trying other foods. So this ‘positive reinforcement’ was actually the result of a ‘negative reinforcement’, I chose the lesser of two evils.

      I am now healthy and happy. Consuming food that drastically improves your well being is positive reinforcement and therefore your ‘scientifically validated’ proof, proves that it is in fact possible to change behaviour. You just have to widen your pseudo scientific analysis of behaviour to more than just ‘behaviouralism’ which completely neglects to acknowledge other stimulus and factors involved in determining psychological, let alone neurological function.

    • Katie says:

      Standing ovation, Mara. You have restored my faith in humanity.

    • Khatie says:

      My son was diagnosed with autism at two years old. We were told he may not speak at all if ever. He was diagnosed with failure to thrive prior to that and was very fussy with all eating. Thank God for the Internet in 1998 as fledging as it was – i found groups of parents who had children with ASD and were trying different diets. We took Ben off gluten and dairy and his behavior changed remarkably. Almost overnight. He could look us in the eye. He would stop spinning now and then for a glimpse of who he potentially could actually be.

      I then added essential fatty acids and a multimineral drop into his formula and cereals. He refused to eat anything solid until he was older than three years old. But we added a lot of things to his cereal like fruits and vegetables and we would grind up his meats. Just two weeks after we added the essential fatty acids he said his first word. And within about four days of adding the minerals he was noticeably calmer and coped much better in social situations. He continued to learn to talk and he continued to put on healthy weight.

      At that time, there was a company that made a children’s vitamin supplement high in copper and vitamin A and we were giving him that, too. It was powdered and orange-flavored and was tremendous. Unfortunately that supplement is not made anymore, but I am convinced that was also one of the key factors in his recovery. Yes recovery! When Ben was six years old, the doctors told us he was no longer in the PSD umbrella. They removed the diagnosis of autism and said that he no longer needed to be followed by the autism psychiatrist, or a behavioral specialist. We kept his occupational therapist for some of his sensory issues, and we kept taking him to his speech therapy. We stopped using both of these when he was eight and no longer needed them.

      Ben is now 15, in grade 10, getting 80s and is sociable and engaged. When I tell people he had autism when he was little they can’t believe it. Every once in a while someone will say he seems quirky, but other than that there is no trace of ASD. And who isn’t quirky? We all have our quirks. Food can change your life. You just need to know what to eat and why, and let it happen. Please don’t ever scare anyone out of trying diet to change their health. It works.

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