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:

Lead Contamination in Hot Sauces

Given the lead contamination found in candies containing chili imported from Mexico, 25 hot sauces were tested for heavy metals.

“Lead toxicity is prevalent and a major concern of public health,” especially for babies. “One of the important sources of lead exposure for the fetus and infant is maternal blood. Lead in the maternal blood”—that is, in pregnant and nursing women’s bloodstreams—“readily crosses the placenta and mammary glands,” leaching into breast milk. Where does the lead come from? Most may originate from the mother’s skeleton, where lead from past exposures builds up. Past exposures to what? “The FDA reports that reproductive age women in the U.S. are exposed to lead through food (43%), dust (31%), water (22%), and air (4%).”

Among the more atypical sources of childhood lead poisoning in the United States are “lead-tainted candies,” including, ironically, brands with names like “Toxic Waste.” (The FDA recalled the “Nuclear Sludge” variety of Toxic Waste’s candies, but not its others.) Many of the tainted candies were imported from Mexico, “especially those containing chili and salt as major ingredients.” It’s not clear whether “the chili additives were being contaminated during the open-air drying process. Other potential sources of this contamination might be the grinding stones involved in preparation of chili powder, or the possible use of lead arsenate as a pesticide agent.” They just don’t know.

Wait a second. There’s something else in grocery stores containing imported chilis and salt as major ingredients: hot sauce. I discuss this in my video Lead Contamination in Hot Sauces.

“In the last decade, the U.S. Food and Drug Administration (FDA) has issued several warnings and recalls for food products that exceed FDA standards for lead. Products containing chili peppers and salt”—such as the candies—“were often suspected as sources of lead contamination….However, products such as hot sauces that contain similar ingredients have not been the focus of evaluations” until this “first known investigation of lead concentrations in hot sauces,” that is.

As you can see at 1:52 in my video, researchers tested 25 different hot sauces, and about 9 out of 10 “contained a detectable level of lead,” though only four brands exceeded the FDA’s action level of 0.1 parts per million. But, that 0.1 ppm is the candy standard, so, technically, none of the hot sauces can be recalled from U.S. shelves. Although candy and hot sauce contain common ingredients, there simply is no hot sauce standard.

The most contaminated hot sauces had about a microgram of lead per teaspoon, which may be more than young kids should be getting in their daily diet, but how many six-year-olds are consuming hot sauce by the spoonful? “Although hot sauce would not be intuitively counted amongst food products highly consumed by children, ethnic and cultural practices must be considered. Chili peppers and salt are commonly used in Mexican-style candies, condiments, hot sauces and everyday cuisine.” So, the researchers want to see the same stringent candy standard of 0.1 ppm lead applied to hot sauce—or at least have some limit put in place. 

Without enforceable standards for hot sauces, what motivation do manufacturers have to even look into the problem? It could be the soil, for example. The soil where the peppers grow may be so contaminated with lead that just washing off any residue on peppers after picking may cut lead levels fourfold in the final product—but why bother taking the extra step to rinse off dirt if no one’s checking?

Are there any other imports we should be concerned about? I talked about the heavy metal contamination of herbal supplements in my video Get the Lead Out, but not this kind of herbal supplement: marijuana. “Several hundred people suffered lead poisoning presumably resulting from the desire of drug dealers to maximize profits.” Lead is heavy—about 50 times heavier than oregano—so it is “particularly useful for driving up profits” when the product is sold by weight. And it wasn’t subtle. You can see the little lead particles in the product at 3:48 in my video. Why was there an epidemic of lead poisoning among young students with “body piercings”? Because dealers could make an extra $1,500 per kilogram of marijuana.

Want to make your own hot sauce? I have a delicious recipe for Healthy Hot Sauce with all green-light ingredients in my How Not to Die Cookbook!


Interested in learning more about lead? Take a deep dive:

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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 Much Arsenic in Rice Is Too Much?

What are some strategies to reduce arsenic exposure from rice?

Those who are exposed to the most arsenic in rice are those who are exposed to the most rice, like people who are eating plant-based, gluten-free, or dairy-free. So, at-risk populations are not just infants and pregnant women, but also those who may tend to eat more rice. What “a terrible irony for the health conscious” who are trying to avoid dairy and eat lots of whole foods and brown rice—so much so they may not only suffer some theoretical increased lifetime cancer risk, but they may actually suffer arsenic poisoning. For example, a 39-year-old woman had celiac disease, so she had to avoid wheat, barley, and rye, but she turned to so much rice that she ended up with sky-high arsenic levels and some typical symptoms, including “diarrhea, headache, insomnia, loss of appetite, abnormal taste, and impaired short-term memory and concentration.” As I discuss in my video How Much Arsenic in Rice Is Too Much, we, as doctors, should keep an eye out for signs of arsenic exposure in those who eat lots of rice day in and day out.

As you can see at 1:08 in my video, in its 2012 arsenic-in-rice exposé, Consumer Reports recommended adults eat no more than an average of two servings of rice a week or three servings a week of rice cereal or rice pasta. In its later analysis, however, it looked like “rice cereal and rice pasta can have much more inorganic arsenic—a carcinogen—than [its] 2012 data showed,” so Consumer Reports dropped its recommendation down to from three weekly servings to a maximum of only two, and that’s only if you’re not getting arsenic from other rice sources. As you can see from 1:29 in my video, Consumer Reports came up with a point system so people could add up all their rice products for the week to make sure they’re staying under seven points a week on average. So, if your only source of rice is just rice, for example, then it recommends no more than one or two servings for the whole week. I recommend 21 servings of whole grains a week in my Daily Dozen, though, so what to do? Get to know sorghum, quinoa, buckwheat, millet, oatmeal, barley, or any of the other dozen or so common non-rice whole grains out there. They tend to have negligible levels of toxic arsenic.

Rice accumulates ten times more arsenic than other grains, which helps explain why the arsenic levels in urine samples of those who eat rice tend to consistently be higher than those who do not eat rice, as you can see at 2:18 in my video. The FDA recently tested a few dozen quinoa samples, and most had arsenic levels below the level of detection, or just trace amounts, including the red quinoas that are my family’s favorite, which I was happy about. There were, however, still a few that were up around half that of rice. But, overall, quinoa averaged ten times less toxic arsenic than rice. So, instead of two servings a week, following the Consumer Reports recommendation, you could have 20. You can see the chart detailing the quinoa samples and their arsenic levels at 2:20 in my video.

So, diversifying the diet is the number-one strategy to reduce exposure of arsenic in rice. We can also consider alternatives to rice, especially for infants, and minimize our exposure by cooking rice like pasta with plenty of extra water. We found that a 10:1 water-to-rice ratio seemed best, though the data suggest the rinsing doesn’t seem to do much. We can also avoid processed foods sweetened with brown rice syrup. Is there anything else we can do at the dining room table while waiting for federal agencies to establish some regulatory limits?

What if you eat a lot of fiber-containing foods with your rice? Might that help bind some of the arsenic? Apparently not. In one study, the presence of fat did seem to have an effect, but in the wrong direction: Fat increased estimates of arsenic absorption, likely due to the extra bile we release when we eat fatty foods.

We know that the tannic acid in coffee and especially in tea can reduce iron absorption, which is why I recommend not drinking tea with meals, but might it also decrease arsenic absorption? Yes, by perhaps 40 percent or more, so the researchers suggested tannic acid might help, but they used mega doses—17 cups of tea worth or that found in 34 cups of coffee—so it isn’t really practical.

What do the experts suggest? Well, arsenic levels are lower in rice from certain regions, like California and parts of India, so why not blend that with some of the higher arsenic rice to even things out for everybody?

What?!

Another wonky, thinking-outside-the-rice-box idea involves an algae discovered in the hot springs of Yellowstone National Park with an enzyme that can volatize arsenic into a gas. Aha! Researchers genetically engineered that gene into a rice plant and were able to get a little arsenic gas off of it, but the rice industry is hesitant. “Posed with a choice between [genetically engineered] rice and rice with arsenic in it, consumers may decide they just aren’t going to eat any rice” at all.


This is the corresponding article to the 11th in a 13-video series on arsenic in the food supply. If you missed any of the first ten videos, watch them here:

You may also be interested in Benefits of Turmeric for Arsenic Exposure.

Only two major questions remain: Should we moderate our intake of white rice or should we minimize it? And, are there unique benefits to brown rice that would justify keeping it in our diet despite the arsenic content? I cover these issues in the final two videos: Is White Rice a Yellow-Light or Red-Light Food? and Do the Pros of Brown Rice Outweigh the Cons of Arsenic?.

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: