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 Hiccups

Nearly everyone has experienced hiccups, but what exactly are they? It used to be thought that a hiccup is just a simple muscle spasm of the diaphragm, but that was apparently disproven more than 40 years ago. Instead, hiccups involve a complex, orchestrated pattern of muscle contractions. But, why?

Hiccups might be a leftover from the womb. During fetal life, “hiccups are universally present, their incidence peaking in the third trimester…[This] suggest[s] that hiccups might represent a necessary and vital primitive reflex” that would permit in-the-womb training of the breathing muscles without choking on amniotic fluid.

In adulthood, nearly anything can trigger hiccups. Case in point: A 19-year-old woman presented with persistent hiccups. Her physical exam was normal except for an ant crawling on her eardrum. Once the ant was removed, her hiccups stopped.

There appear to be as many cures for hiccups as there are causes, as I discuss in my video How to Stop Hiccups. As the famous Dr. Mayo put it, the less we know about something, the more treatments we seem to have for it—and perhaps “there is no disease which has had more forms of treatments…than has persistent hiccups.”

There are drugs, of course. There are always lots of drugs, from thorazine to apomorphine, but there are also a whole slew of non-pharmacological approaches—from breathing into a paper bag and drinking from the far side of a glass to smearing mustard on your tummy (as you can see at 1:24 in my video). “Many of these ‘remedies’ have not been tested and some appear to have been invented ‘purely for the amusement of the patient’s friends’.” One method, “forcible traction of the tongue” (which means pulling on someone’s tongue) was attributed to the great Dr. Osler, the first Chief Physician at Johns Hopkins Hospital, but the “therapy, however, is much older and (perhaps not surprisingly) of French origin.”

Another trick that might work to cure hiccups is “a modified Heimlich maneuver,” consisting of just three thrusts and moderate pressure. In one instance, it was so successful the patient’s “hiccups ceased immediately.” In general, however, “[t]reatment is notably disappointing, as is evidenced by the hundreds of remedies have been tried, none of which have been regularly curative.” You know doctors are starting to get desperate when they suggest things like chilling the ear lobe, and you know they are really getting desperate when they have to add prayer to the end of a miscellaneous hiccup cures list.

“Use of vinegar to relieve persistent hiccups in an advanced cancer patient” was the paper that started me down the hiccup rabbit hole. I was reviewing the latest research on vinegar and stumbled across a case where, “[a]fter the failure of common treatments for hiccups, the patient was given a sip of vinegar and his hiccups abated”—stopped after just a single sip. Evidently, sour tastes, such as vinegar and lemon, have been used to treat hiccups since the 1930s, but “nonpharmacological remedies such as vinegar…fell out of favor with the widespread use of pharmacotherapy,” that is, drugs. After all, how much can you charge for a sip of vinegar?

If worse comes to worst, there is the “phrenic nerve crush” surgery, which is as bad as it sounds. Before going that route, though, you may find it “surprising how many patients with hiccups respond to digital compression of the eyeballs.” Yes, we’re talking about digit as in finger, as in pushing your finger into someone’s eyes as a counter-irritation measure. That will get their mind off their hiccups!

If a finger in the eye somehow doesn’t distract them enough, doctors can try “digital rectal massage.” A 27-year-old man presented to the ER with “intractable hiccups.” Emergency staff tried massaging other places and even tried the digital eyeball compression, but nothing seemed to do it. So, bend over. “Digital rectal massage was then attempted using a slow circumferential motion”—and it worked! So, before giving patients drugs, maybe we would give them a massage. It’s “easy to perform” and may be less dangerous than sticking your fingers into people’s eye sockets, which, if you’re in medical school and have to memorize all these ridiculous names, is known as the Dagnini-Aschner Maneuver. (Medicine loves its eponyms.)

Speaking of maneuvers, how’s this for a pick-up line? “Hello. (Hic!) Want to help me (hic!) cure my hiccups?” In one case, on the fourth day of continuous hiccuping, the patient’s hiccups finally “suddenly and completely ceased,” with some spousal help, at the point of climax. “It is unclear,” the doctor wrote, “whether orgasm in women leads to a similar resolution, an issue that could be investigated further.” 

And it was, back in 1845. An infamous, disturbing case report that amounted to effectively bragging about sexual assault was published in what was to be become the New England Journal of Medicine. A young, religious woman with intractable hiccups fell into the hands of a Dr. George Dexter. He first attempted the best modern medicine could offer—bloodletting—but she continued to hiccup, until he pressed his hand on her genitals for a few minutes and that apparently worked. This went on for month after month, with the doctor frequently calling in his colleagues to show them this “singular phenomena.”

Who was this guy? “Although his interaction with the young female patient would not meet today’s ethical standards”—you could say that again!—“his medical observation was valid…” Even though rectal massage and sexual stimulation may help, “this kind of recommendation is reserved for carefully selected patients!”


DO NOT drink vinegar straight. In this blog, I talked about taking a tiny sip, not full-on drinking it. If you do drink instead of sip, you can make the problem worse, as I discuss in my video Vinegar Mechanisms and Side Effects. Vinegar can be great stuff, though. Check out my video series to find out why I include it in my own family’s daily diet:

There’s another way to treat hiccups—one that I’ve used myself since I was a kid. Since then, I’ve never had more than one or two hiccups because I can stop them in their tracks. Learn my trick in my video How to Strengthen the Mind-Body Connection.

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: