Autism and Sourdough

When I moved to Belgium 5 years ago, a period of accelerated learning began for me. I started studying Dutch, I began my sourdough journey and I entered the mysterious world of autism through my partner’s son Jonas. Jonas has Down’s syndrome and severe autism which leaves him non-verbal. Back then he was 15 and just entering a period in his life that is difficult for all adolescents and particularly difficult if they have autism. It was a challenging time to learn about his condition, but with his help and patience and the experience of his mother Sandra, my knowledge and understanding grew.

Autism or ASD (Autism Spectrum Disorder) is a condition that is still largely unexplored and, in general, is poorly understood. As we discover that the autistic spectrum stretches over a wider section of society than we previously thought, we are still surprisingly far behind in our comprehension of the cause and symptoms and, even more, the daily experience of those with ASD.

Sandra works with handicapped children many of whom have ASD, and she has over 20 years’ experience in the field. However, neither she nor her colleagues receive any training to help them to better comprehend the behaviours of those they care for. She has profound insight and empathy, both of which help her greatly, but this alone was not enough for her. So, she reads, as much as she can. One author in particular, Temple Grandin, has helped her understand one of the central aspects of the autistic experience, Sensory Processing Disorder, SPD. I would highly recommend her books to anyone who wants to know more on the subject, she really is way ahead of her time.

The principle understanding behind SPD is this: people with autism process the information they receive through their senses in a very different way than most people and the difficulties they have with this are manifest in their complex behaviours as they struggle to cope. Their nervous system is incredibly sensitive and the messages it receives are experienced in radical ways. This disorder means people with ADS often have to cope with a chaotic overload of sensory data. Because of this, they experience high levels of anxiety and stress on a daily basis. If you have ever seen someone with autism rock backwards and forwards, make strange noises or shake their head from side to side, then these are behaviours that help them feel balance. So, what has this got to do with Sourdough I hear you ask? Well the next level of understanding we had was when Jonas came down with a serious case of Campylobacter and needed a course of antibiotics to help him get better. Sandra had always known his weak spot was his digestive system, he always has regular problems there, as do many people with ASD, but this hit him hard. For the following 4 – 5 months, all of Jonas’s autistic symptoms peaked. He was constantly anxious and restless. He was oversensitive to everything in his environment and in turn became frustrated and irritable. It was exhausting for him. He is non-verbal but he does, in his own way, try to communicate. During this period he shut down completely. He withdrew to a place deep within himself and shut all the doors. It was a nightmare for him and us. Sandra was at a loss. Luckily, we knew a good doctor who immediately put Jonas on a course of treatment to restore his gut flora. Eventually his symptoms balanced out.

I started to do my own research then. I learned that sourdough can contribute significantly towards better digestive health. Some of you may be familiar with articles about digestive health and sourdough by Vanessa Kimbell from The Sourdough School. I also the liked the work of Marco Gorbetti, Professor of Microbiology at the University of Bari, Italy. These pointed me in the right direction and I started reading more medical papers on the subject. The information I discovered was staggering in its implications. I am no specialist on the subject but here is what I have understood. We have trillions of microbiomes that live within our body. They outnumber our own cells roughly 1.3:1 meaning that we are more microbiomes than human. We exist together with them and the relationship we have with them is extremely important. What science is discovering is that we are dependent on their health for our health. Research shows in particular that children and adults with ASD have a very limited spectrum of healthy microbes in their stomach and mouth and are more inclined to have an issue with pathogens, bad bacteria and micro-organisms, that can lead to digestive problems and illness. They suffer more from stomach problems, constipation or diarrhoea, reflux and other digestive issues.

A healthy and diverse range of good microbiota, good bacteria and other micro-organisms, in the digestive system forms a protective lining that defends against bad bacteria and other pathogens, allows the body to absorb nutrients and contributes to a healthy immune system. Studies into the health of gut bacteria are opening up a greater understanding of illnesses such as diabetes, obesity, leaky gut syndrome, immune deficiency, nutritional deficiency and most importantly for my story about autism, our emotional and neurological health. That’s a pretty significant role for gut bacteria, isn’t it? Then there is also research into what is called the gut – brain axis. Many articles have looked at the influence of the gut microbiota on the central nervous system and have suggested the existence of a microbiota gut-brain axis. The gut-brain axis is the connection between how the health of our digestive system and the nerve bundles that are a part of it, can directly impact our mind and emotions. Some have likened our digestive system to a second brain, so important is its function for our day to day experience. The microbiota-gut-brain axis is showing the way the brain and the gut microbiota communicate with each other. Yes, you heard me, they communicate with each other! This has huge implications for our health and wellbeing. Studies are now linking lack of healthy gut microbiota with mental health issues such as depression and anxiety.
We know how important the nervous system and its connection with the mind is in regard to autism. We know people with ASD have impaired diversity of gut bacteria and we also know that this impairment can lead to a greater number of bad bacteria which in turn negatively impact the gut and nervous system. We can form a link between the importance of healthy, diverse gut bacteria and digestive health and how this can be linked to mental and emotional wellbeing for people with ASD. Studies show that probiotics (live microbial cultures) /prebiotics (food that feeds beneficial gut micro-organisms) can normalize the gut microbiota, enhance gut barrier and relieve the ASD-like behaviours in animals or ASD patients. The better their digestive health becomes the more likely they will experience relief from the symptoms of their Sensory Processing Disorder.

Autistic children, often due to SPD, can have very limited diets. Certain foods may be difficult for them because of the taste or texture or even the sound the food makes as they chew it. Jonas eats a tremendous amount of white bread for his breakfast and often his dinner. It is soft in his mouth and, as he has difficulty chewing, he can swallow it easily with water. We were uncertain if he would tolerate a change in his usual habits, but we were surprised when he took a real liking to sourdough. Now he always asks for more. He loves the texture (I bake a softer crust for him) and its flavour makes his mouth water which in turn makes it easier for him to chew and swallow. I know that fermented bread supports his digestive system and, as well as the probiotic pills he takes, he now also receives prebiotics through sourdough. We are contributing, through his diet not just to his physical health but also supporting his mental and emotional wellbeing.
I know that this journey into a deeper understanding is just beginning but this is a great place to start. I am sure that, in the future, we will discover more about diet and autism, about how small changes that can be tolerated by those with ASD, can significantly improve their lives and the lives of the families that look after them. Most autistic people go through a tremendous amount in an ordinary day. They cope with more than we can imagine, enduring experiences that we dismiss as normal. For them each day requires an almost heroic level of courage and determination. Children with ASD are also usually heavily medicated to manage their symptoms and behaviours. This treatment often disregards the deeper impact such medication has on their sensitive systems. A more natural approach would benefit them greatly.
Jonas is in full time care and we are only able to offer a special diet while he is at home. He does receive probiotic pills at school and this is a great help, but I know they could take further steps. I can see how much better Jonas could cope with his SPD if he had a diet that supported healthy digestive flora. His tolerance and wellbeing could improve which in turn would allow him to enjoy the moments he experiences rather than just endure them. This would not only improve his life but also the lives of those who form the care network around him.
We know that sourdough breads and fermented foods in general have a higher content of both probiotic and prebiotic ingredients. There is still a lot more research to be done into how sourdough can contribute to digestive health but there is enough information to show that this research will be positive. Sourdough may not provide the total solution but, as part of a dietary plan, full of probiotics and prebiotics to nourish their friendly companion bacteria, we can help autistic people develop a lifestyle that supports good microbial health and live healthier and more fulfilling lives. So, if you know someone who has ASD or who has a member in their family with ASD, bake them a loaf or, even better, gift them some starter and teach them how to bake one for themselves. You may just change their life.

Alex Rawlings, July 2018

The Sourdough School
https://sourdough.co.uk/microbiome/

The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems
Carabotti et al, Annals of Gastroenterology, 2015
https://ncbi.nlm.nih.gov/pmc/articles/PMC4367209/

The Gut Microbiome: A New Frontier in Autism Research
Mulle et al, Curr Psychiatry Rep. 2013
https://ncbi.nlm.nih.gov/pmc/articles/PMC3564498/

The Gut Microbiota and Autism Spectrum Disorders
Li et al, Frontiers in Cellular Neuroscience, 2017
https://ncbi.nlm.nih.gov/pmc/articles/PMC5408485/

New evidences on the altered gut microbiota in autism spectrum disorders
Strati et al, Microbiome 2017
https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-017-0242-1

Targeting gut microbiome: A novel and potential therapy for autism
Yang et al, Science Direct 2018
https://www.sciencedirect.com/science/article/pii/S0024320517306653

Alterations of oral microbiota distinguish children with autism spectrum disorders from healthy controls
Qiao et al, Scientific Reports volume 8, 2018
https://www.nature.com/articles/s41598-018-19982-y