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Sanctuary MR, Kain JN, Angkustsiri K, et al. Dietary Considerations in Autism Spectrum Disorders: The Potential Role of Protein Digestion and Microbial Putrefaction in the Gut-Brain Axis. Front Nutr. 2018;5:40doi: 10.3389/fnut.2018.00040.
Sanctuary, M. R., Kain, J. N., Angkustsiri, K., & German, J. B. (2018). Dietary Considerations in Autism Spectrum Disorders: The Potential Role of Protein Digestion and Microbial Putrefaction in the Gut-Brain Axis. Frontiers in nutrition, 540. https://doi.org/10.3389/fnut.2018.00040
Sanctuary, Megan R, et al. "Dietary Considerations in Autism Spectrum Disorders: The Potential Role of Protein Digestion and Microbial Putrefaction in the Gut-Brain Axis." Frontiers in nutrition vol. 5 (2018): 40. doi: https://doi.org/10.3389/fnut.2018.00040
Sanctuary MR, Kain JN, Angkustsiri K, German JB. Dietary Considerations in Autism Spectrum Disorders: The Potential Role of Protein Digestion and Microbial Putrefaction in the Gut-Brain Axis. Front Nutr. 2018 May 18;5:40. doi: 10.3389/fnut.2018.00040. eCollection 2018. PMID: 29868601; PMCID: PMC5968124.
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Front Nutr. 2018 May 18;5:40. doi: 10.3389/fnut.2018.00040. eCollection 2018.

Dietary Considerations in Autism Spectrum Disorders: The Potential Role of Protein Digestion and Microbial Putrefaction in the Gut-Brain Axis.

Frontiers in nutrition

Megan R Sanctuary, Jennifer N Kain, Kathleen Angkustsiri, J Bruce German

Affiliations

  1. Department of Nutrition, University of California, Davis, Davis, CA, United States.
  2. Department of Neurobiology, Physiology and Behavior Department, University of California, Davis, Davis, CA, United States.
  3. School of Medicine, Department of Pediatrics, University of California, Davis, Sacramento, CA, United States.
  4. Department of Pediatrics, UC Davis MIND Institute, Sacramento, CA, United States.
  5. Department of Food Science and Technology, University of California, Davis, Davis, CA, United States.
  6. Foods for Health Institute, University of California, Davis, Davis, CA, United States.

PMID: 29868601 PMCID: PMC5968124 DOI: 10.3389/fnut.2018.00040

Abstract

Children with autism spectrum disorders (ASD), characterized by a range of behavioral abnormalities and social deficits, display high incidence of gastrointestinal (GI) co-morbidities including chronic constipation and diarrhea. Research is now increasingly able to characterize the "fragile gut" in these children and understand the role that impairment of specific GI functions plays in the GI symptoms associated with ASD. This mechanistic understanding is extending to the interactions between diet and ASD, including food structure and protein digestive capacity in exacerbating autistic symptoms. Children with ASD and gut co-morbidities exhibit low digestive enzyme activity, impaired gut barrier integrity and the presence of antibodies specific for dietary proteins in the peripheral circulation. These findings support the hypothesis that entry of dietary peptides from the gut lumen into the vasculature are associated with an aberrant immune response. Furthermore, a subset of children with ASD exhibit high concentrations of metabolites originating from microbial activity on proteinaceous substrates. Taken together, the combination of specific protein intakes poor digestion, gut barrier integrity, microbiota composition and function all on a background of ASD represents a phenotypic pattern. A potential consequence of this pattern of conditions is that the fragile gut of some children with ASD is at risk for GI symptoms that may be amenable to improvement with specific dietary changes. There is growing evidence that shows an association between gut dysfunction and dysbiosis and ASD symptoms. It is therefore urgent to perform more experimental and clinical research on the "fragile gut" in children with ASD in order to move toward advancements in clinical practice. Identifying those factors that are of clinical value will provide an evidence-based path to individual management and targeted solutions; from real time sensing to the design of diets with personalized protein source/processing, all to improve GI function in children with ASD.

Keywords: constipation; diarrhea; dietary protein; fragile gut; gastrointestinal; gut-brain; microbiota; probiotics

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