Comprehensive Nutritional and Dietary Intervention for Autism Spectrum Disorder. A Randomized, Controlled 12-Month Trial

Nutrients 2018, 10(3), 369; doi:10.3390/nu10030369


This study involved a randomized, controlled, single-blind 12-month treatment study of a comprehensive nutritional and dietary intervention. Participants were 67 children and adults with autism spectrum disorder (ASD) ages 3–58 years from Arizona and 50 non-sibling neurotypical controls of similar age and gender. Treatment began with a special vitamin/mineral supplement, and additional treatments were added sequentially, including essential fatty acids, Epsom salt baths, carnitine, digestive enzymes, and a healthy gluten-free, casein-free, soy-free (HGCSF) diet. There was a significant improvement in nonverbal intellectual ability in the treatment group compared to the non-treatment group (+6.7 ± 11 IQ points vs. −0.6 ± 11 IQ points, p = 0.009) based on a blinded clinical assessment. Read more…


The study results suggest that the comprehensive nutrition/diet protocol was safe and effective. The nutritional supplements and healthy diet improved nutritional status, and hence presumably increased the brain’s ability to function and learn. This is supported by the increase in non-verbal IQ, and the substantial 18-month increase in developmental ability in communication, daily living skills, and social skills. Modest improvements in CARS-2 and SAS-Pro suggest some reduction in autism symptoms, consistent with parent reports of improvements on the PDD-BI, ATEC, and SRS. Parent reports also suggest improvements in aberrant behaviours (ABC—Irritability, Lethargy/Social Withdrawal, Stereotypy, and Hyperactivity), sensory processing (SSP), and GI symptoms (6-GSI, PGI-2, ATEC), and Overall (PGI-2). There was not a significant effect on handgrip strength. The treatment efficacy seemed to be similar for both genders and all ages, probably because nutritional requirements are similar for both genders and all ages (after normalizing for caloric intake).
The three unusual case reports, in which three very different long-term problems were greatly improved, shows the power of comprehensive nutritional interventions in addressing complex, puzzling medical conditions which may involve one or more nutritional deficiencies.
There were many significant increases in vitamins, essential fatty acids, and carnitine, and an improvement in homocysteine. The vitamin/mineral supplement and essential fatty acids appeared to have the most clinical benefit, although other treatments appeared to have some benefit for some individuals. So, this comprehensive treatment approach is recommended as a promising therapy for children and adults with ASD, with an emphasis on the vitamin/mineral supplement and essential fatty acids as probably being the most helpful.
The data also suggest some possible improvements could be made to the treatment combination. Specifically, it appears that l-carnitine may be better absorbed than acetyl-l-carnitine. Also, although many vitamins were well-absorbed, larger doses and/or more bioavailable forms of the other vitamins are needed to have a significant effect on blood levels, and larger doses/absorption may in some cases result in greater therapeutic benefit. So, it seems likely that the current treatment protocol could be further improved by making these changes.