Helpful Foods to Support People with Autism

The sulforaphane found in five cents’ worth of broccoli sprouts has been shown to benefit autism in a way no drug ever has in a randomized, double-blind, placebo-controlled study.

You may remember my series of videos, which includes Prevent Cancer from Going on TOR, about target of rapamycin (TOR), the engine-of-aging enzyme. Kids with autism tend to have higher TOR activity in their bodies, and this hyperactive TOR signaling may play a role in causing autism, which makes TOR a potential target to treat autism or even theoretically reverse it if we could target downstream TOR signaling, like between TOR and S6K1, as you can see at 0:29 in my video Best Foods for Autism. In fact, that’s one of the ways sulforaphane, a compound in broccoli and other cruciferous vegetables, kills off prostate cancer cells—by inhibiting the signal transduction between TOR and S6K1. Sulforaphane is also “a potent inhibitor” of breast cancer cells because “it targets downstream elements of the [TOR] pathway.”

So, if broccoli blocks TOR and if we give it to those with autism, maybe it would block some of the synaptic dysfunction that contributes to the features of autism—and that’s in addition to blocking autism pathways four other ways: oxidative stress, lower antioxidant capacity, mitochondrial dysfunction, and brain inflammation. What’s more, this doesn’t only occur in a petri dish. “Importantly, sulforaphane can cross the blood-brain-barrier,” so when you eat broccoli, sulforaphane quickly reaches your brain “to exert its protective effects”—at least it does in theory. You don’t know, of course, until you put it to the test.

You can understand why such a study could attract researchers from such leading institutions as Harvard and Johns Hopkins, and get published in one of our most prestigious journals, the Proceedings of the National Academy of Sciences. What did they find? First, what did they do? “In a placebo-controlled, double-blind, randomized trial, young men (aged 13–27) with moderate to severe ASD [autism] received sulforaphane from broccoli sprouts or an indistinguishable sugar pill. They were dosed according to body weight: Those under 100 pounds got about a tablespoon of broccoli sprouts’ worth of sulforaphane a day, which is about a cup’s worth of broccoli, those weighing between 100 and 200 pounds got about the equivalent of two cups of broccoli or two tablespoons of fresh broccoli sprouts, and those over 200 pounds got three cups’ worth a day or a little under a quarter cup of broccoli sprouts. Why didn’t the researchers use actual broccoli or actual sprouts? If they had, it wouldn’t have been a blinded study. The patients, doctors, and parents would know who was and who wasn’t getting the special treatment, which could introduce bias through the placebo effect. Instead, with this study set-up, no one knew until the end who got the sulforaphane and who got the placebo.

The researchers chose dietary sulforaphane because of its capacity to reverse oxidation, dysfunction, and inflammation, but when put to the test, did it actually work? The placebo didn’t. Give people with autism nothing, and nothing much happens. But effectively secretly sneak them some broccoli, and substantial improvements in behavior, social interaction, and verbal communication occurred. However, it all disappeared once the broccoli was stopped. As you can see at 3:25 in my video, on the Aberrant Behavior Checklist, which includes things such as repetitive behaviors, there was no big change in the placebo group, which is what you’d expect, but the abnormal behaviors plunged in the sulforaphane group—the group who got the sulforaphane found in only about five cents’ worth of broccoli sprouts a day. The study ended in week 18, however, and a month later, things were heading back to where they started.

There were similar findings on a Social Responsiveness Scale: significant improvements were seen until the treatment was stopped, and then the participants went right back to functioning as poorly as those in the placebo group had continued to function. And these weren’t just scores on a page. “The substantial improvements…were conspicuous”—the doctors, parents, and caregivers could see the improvements. No drug has ever been shown to have these kinds of effects. What’s more, these were young men, starting at age 13. One could imagine it working as well or even better with younger children because their brains are still developing. And, is there a downside? “Broccoli sprouts are widely consumed as a food item all over the world by a very large number of individuals, without any reports of adverse effects”—but remember we’re talking about whole foods, not sulforaphane supplements.

Indeed, broccoli sprouts work, but commercial broccoli sprout supplements hardly work at all. As you can see at 4:55 in my video, broccoli has sulforaphane, with the florets more so than the stems, and broccoli sprouts have about ten times more sulforaphane. In comparison, broccoli pills, powders, and supplements have little or none. So, broccoli and other cruciferous vegetables are for all kids, whether they have autism or not, and they may be for pregnant women as well for the potential prenatal prevention of autism in the first place.

This article covers the big finale to my initial three-part video series on autism. For the background that led researchers down this path of clues, check out Fever Benefits for Autism in a Food and Fighting Autism Brain Inflammation with Food. You can also check: Flashback Friday: The Best Foods for Fighting Autism and Brain Inflammation. 

We understand there may be a variety of challenges pertaining to catering to picky palates, sensory and food texture sensitivities, or kids who are reluctant to try new foods, and we hope this evidence-based article can provide some helpful health information to parents and health practitioners. For more tips and tricks, check out How to Get Kids to Eat Their Vegetables.


For more on autism, see:

My video Broccoli: Sprouts vs. Supplements underscores the importance of plants over pills, and Biggest Nutrition Bang for Your Buck tells you how to grow your own.

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

How to Treat Polycystic Ovary Syndrome (PCOS) with Diet

Given the role that oxidant free radicals are thought to play in aging and disease, one reason fruits and vegetables may be so good for us is that they contain antioxidant compounds. As you can see at 0:20 in my video Benefits of Marjoram for Polycystic Ovary Syndrome (PCOS), different vegetables and herbs have different antioxidant content. When making a salad, for example, spinach, arugula, or red leaf lettuce may provide twice the antioxidants as butterhead lettuce, and choosing purple cabbage over green, or red onions over white can also boost the salad’s antioxidant power.

Fresh herbs are so powerful that even a small amount may double or even quadruple the antioxidant power of the entire meal. For instance, as you can see at 0:50 in my video, the total antioxidants in a simple salad of lettuce and tomato jump up by adding just a tablespoon of lemon balm leaves or half a tablespoon of oregano or mint. Adding marjoram, thyme, or sage not only adds great flavor to the salad, but effectively quadruples the antioxidant content at the same time, and adding a little fresh garlic or ginger to the dressing ups the antioxidant power even more.

Herbs are so antioxidant-rich that researchers decided to see if they might be able to reduce the DNA-damaging effects of radiation. Radioactive iodine is sometimes given to people with overactive thyroid glands or thyroid cancer to destroy part of the gland or take care of any remaining tumor cells after surgery. For days after the isotope injection, patients become so radioactive they are advised not to kiss or sleep close to anyone, including their pets, and if they breathe on a phone, they’re advised to wipe it “carefully” or cover it “with an easily removed plastic bag.” Other recommendations include “avoid[ing] splatter of radioactive urine,” not going near your kids, and basically just staying away from others as much as possible.

The treatment can be very effective, but all that radiation exposure appears to increase the risk of developing new cancers later on. In order to prevent the DNA damage associated with this treatment, researchers tested the ability of oregano to protect chromosomes of human blood cells in vitro from exposure to radioactive iodine. As you can see at 2:25 in my video, at baseline, about 1 in 100 of our blood cells show evidence of chromosomal damage. If radioactive iodine is added, though, it’s more like 1 in 8. What happens if, in addition to the radiation, increasing amounts of oregano extract are added? Chromosome damage is reduced by as much 70 percent. Researchers concluded that oregano extract “significantly protects” against DNA damage induced by the radioactive iodine in white blood cells. This was all done outside the body, though, which the researchers justified by saying it wouldn’t be particularly ethical to irradiate people for experimental research. True, but millions of people have been irradiated for treatment, and researchers could have studied them or, at the very least, they could have just had people eat the oregano and then irradiate their blood in vitro to model the amount of oregano compounds that actually make it into the bloodstream.

Other in vitro studies on oregano are similarly unsatisfying. In a comparison of the effects of various spice extracts, including bay leaves, fennel, lavender, oregano, paprika, parsley, rosemary, and thyme, oregano beat out all but bay leaves in its ability to suppress cervical cancer cell growth in vitro while leaving normal cells alone. But people tend to use oregano orally—that is, they typically eat it—so the relevance of these results are not clear.

Similarly, marjoram, an herb closely related to oregano, can suppress the growth of individual breast cancer cells in a petri dish, as you can see at 3:53 in my video, and even effectively whole human breast tumors grown in chicken eggs, which is something I’ve never seen before. Are there any clinical trials on oregano-family herbs on actual people? The only such clinical, randomized, control study I could find was a study on how marjoram tea affects the hormonal profile of women with polycystic ovary syndrome (PCOS). The most common cause of female fertility problems, PCOS affects up to one in eight young women and is characterized by excessive male hormones, resulting in excess body or facial hair, menstrual irregularities, and cysts in one’s ovaries that show up on ultrasounds.

Evidently, traditional medicine practitioners reported marjoram tea was beneficial for PCOS, but it had never been put to the test…until now. Drinking two daily cups of marjoram tea versus a placebo tea for one month did seem to beneficially affect the subjects’ hormonal profiles, which seems to offer credence to the claims of the traditional medicine practitioners. However, the study didn’t last long enough to confirm that actual symptoms improved as well, which is really what we care about.

Is there anything that’s been shown to help? Well, reducing one’s intake of dietary glycotoxins may help prevent and treat the disease. Over the past 2 decades there has been increasing evidence supporting an important contribution from food-derived advanced glycation end products (AGEs)…[to] increased oxidative stress and inflammation, processes that play a major role in the causation of chronic diseases,” potentially including polycystic ovary syndrome (PCOS). Women with PCOS tend to have nearly twice the circulating AGE levels in their bloodstream, as you can see at 0:33 in my video Best Foods for Polycystic Ovary Syndrome (PCOS). 

PCOS may be the most common hormonal abnormality among young women in the United States and is a common cause of infertility, menstrual dysfunction, and excess facial and body hair. The prevalence of obesity is also higher in women with PCOS. Since the highest AGE levels are found in broiled, grilled, fried, and roasted foods of “mostly animal origin,” is it possible that this causal chain starts with a bad diet? For instance, maybe eating lots of fried chicken leads to obesity, which in turn leads to PCOS. In that case, perhaps what we eat is only indirectly related to PCOS through weight gain. No, because the same link between high AGE levels and PCOS was found in lean women as well.

“As chronic inflammation and increased oxidative stress have been incriminated in the pathophysiology [or disease process] of PCOS, the role of AGEs as inflammatory and oxidant mediators, may be linked with the metabolic and reproductive abnormalities of the syndrome.” Further, the buildup of AGE inside polycystic ovaries themselves suggests a potential role of AGEs contributing to the actual disease process, beyond just some of its consequences.

RAGE is highly expressed in ovarian tissues. The receptor in the body for these advanced glycation end products, the “R” in RAGE, is concentrated in the ovaries, which may be particularly sensitive to its effect. So, AGEs might indeed be contributing to the cause of PCOS and infertility.

Does this mean we should just cut down on AGE-rich foods, such as meat, cheese, and eggs? Or hey, why not come up with drugs that block AGE absorption? We know AGEs have been implicated in the development of many chronic diseases. Specifically, food-derived AGEs play an important role because diet is a major source of these pro-inflammatory AGEs. Indeed, cutting down on these dietary glycotoxins reduces the inflammatory response, but the “argument is often made that stewed chicken would be less tasty than fried chicken…” Why not have your KFC and eat it, too? Just take an AGE-absorption blocking drug every time you eat it to reduce the absorption of the toxins. What’s more, it actually lowers AGE blood levels. This oral absorbent drug, AST-120, is just a preparation of activated charcoal, like what’s used for drug overdoses and when people are poisoned. I’m sure if you took some ipecac with your KFC, your levels would go down, too.

There’s another way to reduce absorption of AGEs, and that’s by reducing your intake in the first place. It’s simple, safe, and feasible. The first step is to stop smoking. The glycotoxins in cigarette smoke may contribute to increased heart disease and cancer in smokers. Then, decrease your intake of high-AGE foods, increase your intake of foods that may help pull AGEs out of your system, like mushrooms, and eat foods high in antioxidants, like berries, herbs, and spices. “Dietary AGE intake can be easily decreased by simply changing the method of cooking from a high dry heat application to a low heat and high humidity…” In other words, move away from broiling, searing, and frying to more stewing, steaming, and boiling.

What we eat, however, may be more important than how we cook it. At 4:00 in my video, I include a table showing the amounts of AGEs in various foods. For instance, boiled chicken contains less than half the glycotoxins of roasted chicken, but even deep-fried potatoes have less than boiled meat. We can also eat foods raw, which doesn’t work as well as for blood pudding, but raw nuts and nut butters may contain about 30 times less glycotoxins than roasted, and we can avoid high-AGE processed foods, like puffed, shredded, and flaked breakfast cereals.

Why does it matter? Because study after study has shown that switching to a low-AGE diet can lower the inflammation within our bodies. Even just a single meal high in AGEs can profoundly impair our arterial function within just two hours of consumption. At 4:54 in my video, you can see the difference between a meal of fried or broiled chicken breast and veggies compared with steamed or boiled chicken breast and veggies. Same ingredients, just different cooking methods. Even a steamed or boiled chicken meal can still impair arterial function, but significantly less than fried or broiled.

“Interestingly, the amount of AGEs administered [to subjects] during the HAGE [high-AGE] intervention was similar to the average estimated daily intake by the general population,” who typically follow the standard American diet. This is why we can decrease inflammation in people by putting them on a low-AGE diet, yet an increase in inflammation is less apparent when subjects switch from their regular diet to one high in AGEs. Indeed, they were already eating a high-AGE diet with so many of these glycotoxins.

Do we have evidence that reducing AGE intake actually helps with PCOS? Yes. Within just two months, researchers found differences from subjects’ baseline diets switched to a high-AGE diet and then to a low-AGE diet, with parallel changes in insulin sensitivity, oxidative stress, and hormonal status, as seen at 5:54 in my video. The take-home learning? Those with PCOS may want to try a low-AGE diet, which, in the study, meant restricting meat to once a week and eating it only boiled, poached, stewed, or steamed, as well as cutting out fast-food-type fare and soda.

What if instead of eating steamed chicken, we ate no meat at all? Rather than measuring blood levels, which vary with each meal, we can measure the level of glycotoxins stuck in our body tissues over time with a high-tech device that measures the amount of light our skin gives off because AGEs are fluorescent. And, not surprisingly, this turns out to be a strong predictor of overall mortality. So, the lower our levels, the better. The “one factor that was consistently associated with reduced [skin fluorescence]: a vegetarian diet.” This “suggests that a vegetarian diet may reduce exposure to preformed dietary AGE…potentially reduc[ing] tissue AGE,” as well as chronic disease risk


What’s so great about antioxidants? See my videos:

Just how many antioxidants do we need? Check out:

For a few simple tips on how to quickly boost the antioxidant content of your food with herbs and spices, see my video Antioxidants in a Pinch.

I touched on the benefits of spearmint tea for PCOS in Enhancing Athletic Performance with Peppermint. Another sorely under-recognized gynecological issue is endometriosis, which I discuss in How to Treat Endometriosis with Seaweed.

Because of AGEs, I no longer toast nuts or buy roasted nut butters, which is disappointing because I really enjoy those flavors so much more than untoasted and unroasted nuts. But, as Dr. McDougall likes to say, nothing tastes as good as healthy feels. For more on why it’s important to minimize our exposure to these toxic compounds, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

 

 

Topical Lemon Balm Lotion for Alzheimer’s

Improving cognitive performance with aromatherapy in young, healthy volunteers is one thing, but how about where it really matters? As I discuss in my video Best Aromatherapy Herb for Alzheimer’s, a group of Japanese researchers had a pie-in-the-sky notion that certain smells could lead to “nerve rebirth” in Alzheimer’s patients. Twenty years ago, even simply raising such a possibility as a hypothetical was heretical. Everybody knew that the loss of neurons is irreversible. In other words, dead nerve cells are not replaced, an important factor in neurodegenerative diseases. That’s what I was taught and what everyone was taught, until 1998.

Patients with advanced cancer volunteered to be injected with a special dye that’s incorporated into the DNA of new cells. On autopsy, researchers then went hunting for nerve cells that lit up in the brains. And, as you can see at 1:14 in my video, there they were: new nerve cells in the brain that didn’t exist just days or months before, demonstrating “that cell genesis occurs in human brains and that the human brain retains the potential for self-renewal throughout life”—something in which we can take comfort.

It still doesn’t mean smells can help, though. An aromatherapy regimen of rosemary, lemon, lavender, and orange essential oils was attempted for a month. At 1:43 in my video, you can see the trajectory of the subjects’ cognitive function and their ability to form abstract ideas starting six weeks before the treatment. Prior to the aromatherapy regimen, there was a rather steady decline, which was reversed after the aromatherapy. The researchers concluded that aromatherapy may be efficacious and “have some potential for improving cognitive function, especially in AD [Alzheimer’s disease] patients”—all, of course, without any apparent side effects.

What about severe dementia? We always hear about the cognitive deficits, but more than half of patients with dementia experience behavioral or psychiatric symptoms. Thorazine-type antipsychotic drugs are often prescribed, even though they appear to be particularly dangerous in the elderly. “Antipsychotic medication may be viewed as an easier option than non pharmacological alternatives,” such as aromatherapy. Another study examined the effect of rubbing a lemon balm-infused lotion on the arms and face of patients twice daily by caregiving staff, compared with lotion without the scent. “During the 4 weeks, significant improvements were seen” in agitation, shouting, screaming, and physical aggression, as were improved quality of life indicators, with patients less socially withdrawn and more engaged in constructive activities, compared to the unscented control. This is important because antipsychotics cause patients to become more withdrawn and less engaged. They are like a chemical restraint. The drugs can reduce agitation, too. So, aromatherapy with lemon balm “is safe, well tolerated, and highly efficacious, with additional benefits on key quality of life parameters.”

These findings clearly indicate the need for longer-term multicenter trials,” but we never had any, until…never. We still don’t have any. This study was conducted in 2002, and there have been no follow-ups. Is that a surprise? Who’s going to fund such a study: Big Balm?

I’ve produced one other video on lemon balm: Reducing Radiation Damage with Ginger and Lemon Balm. We grow lemon balm in our garden. It makes a delicious tea. Give it a try!


For more on the potential (and limitations) of aromatherapy, check out:

It’s better, of course, to prevent dementia in the first place. Learn more:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations: