Rates of autism spectrum disorder (ASD) are skyrocketing. According to the most recent National Health Interview Survey from 2014, 2 percent of children aged three to seventeen in the United States (or one in forty-five) are on the autism spectrum,1 versus one in ten thousand U.S. children in the 1980s. The U.S. has one of the highest autism rates in the world.
Mainstream medicine defines ASD as an incurable brain disorder characterized by repetitive behaviors and social and communication deficits.2 Harvard neurologist Dr. Martha Herbert, one of the country’s foremost autism experts, broadens this definition’s narrow focus on the brain, instead describing ASD as a whole-body problem affecting cells, organs and multiple body systems.3 According to Dr. Herbert, anywhere from 9 to 90 percent of people with ASD experience digestive problems.3 Medical experts acknowledge that these gastrointestinal disturbances are a likely trigger for many of the behavioral symptoms displayed by individuals with autism.4,5 Borrowing from the lyrics to a famous spiritual, Dr. Herbert comments that “the autism bone is connected to the digestive bone and the immune bone.”3
Biomedical treatment approaches seek to address the root causes of autism rather than just the symptoms. In light of the widespread prevalence of digestive disorders in ASD individuals, dietary modification is typically a top recommendation for families interested in autism recovery. For many years, advocates of biomedical intervention have touted the benefits of a gluten-free and casein-free diet. Even mainstream authorities such as the American Academy of Pediatrics (AAP) grudgingly have admitted that elimination of the two problematic peptides might be worth a try.6 Cautioning against the risk of nutritional deficiencies, however, the AAP promotes soy milk as an alternative source of vitamin D and calcium.6
More recently, many in the autism community have come to consider soy as an equally problematic entity. A number of autism websites now describe a gluten-free, casein-free and soyfree (GFCFSF) diet as the autism diet of choice,7 justifying the exclusion of gluten, casein and soy on the basis of evidence that individuals with ASD have abnormal T-cell (immune system) reactivity to the three proteins.8 The organization Talk About Curing Autism (TACA) notes that the elimination of soy dramatically enhances autism recovery.7 TACA claims that nearly all ASD children (91 percent) experience some level of improvement when they follow a GFCFSF diet, versus two-thirds (65 percent) of ASD children when just gluten and casein are avoided.7
Other diets that more explicitly acknowledge the gut-brain connection—such as the specific carbohydrate diet, the gut and psychology syndrome diet, and the body ecology diet—also deservedly have earned many enthusiastic proponents within and outside of autism circles. In common with the GFCFSF diet, these three diets exclude gluten, casein and soy—at least initially—but sometimes allow their reintroduction in their fermented forms, depending on the stage of gut healing and individual sensitivities.
The autism community’s soy-free camp does not tend to elaborate very much on soy’s health-damaging properties, although these are legion. Some of soy’s intrinsic harms are related to its high levels of phytic acid (which reduce mineral assimilation) and endocrine-disrupting phytoestrogens (estrogen-like compounds). In addition, industrial processing of soy introduces neurotoxic, excitotoxic and carcinogenic byproducts (including aluminum and MSG) and denatures soy’s fragile proteins.9,10 Soy is listed in the poisonous plant database of the U.S. Food and Drug Administration (FDA), “with warnings regarding goiter, growth problems [and] amino acid deficiencies,” to name just a few of the listed problems.11 Even worse, well over 90 percent of the soy grown in the U.S. is genetically modified (GM) and as a result contains substantial residues of toxic glyphosate (the active ingredient in the herbicide Roundup).12 Children with autism, already exceptionally vulnerable to toxins and nutritional deficiencies, do not need what soy has to offer.
SOY INFANT FORMULA AND SEIZURES
Seizures are disproportionately common in individuals on the autism spectrum, affecting from one-fifth to almost two-fifths of those with ASD, versus under one percent of the general population.13,14 In many ASD children, these seizures are extremely disabling and difficult to control.13 In the Spring 2013 issue of Wise Traditions, Kaayla Daniel reviewed emerging research by University of Wisconsin neurology expert Cara Westmark, PhD, on the link between soy and seizures in mice.15 Westmark’s startling research found that a soy-free diet attenuated seizure susceptibility while a soy-based diet increased seizure propensity in several strains of laboratory mice.16
Westmark and colleagues especially zeroed in on the seizure-promoting effects of the soy phytoestrogen daidzein.16 As Sylvia Onusic points out in a recent Wise Traditions article about infant formula, human infants who are soy-formula-fed consume the equivalent of five to six birth control pills’ worth of these estrogen-like compounds daily, generating phytoestrogen blood levels that are thirteen to twenty-two thousand times higher than levels found in non-soy-formula-fed infants.17 In an earlier 2011 editorial in the journal Translational Medicine, Westmark had already articulated her concerns about the questionable effects of soy phytoestrogens on fetal and early childhood development in humans.18
Subsequent work by Westmark (unpublished at the time of Daniel’s article) went on to scrutinize the effects of dietary soy in a subpopulation of children with autism. Specifically, a 2014 publication in PLoS ONE extended Westmark’s earlier research to consider the relationship between consumption of soy infant formula and subsequent seizures in children with autism.19 Westmark retrospectively examined medical record data from almost two thousand children who had a diagnosis of autistic disorder, Asperger’s disorder or pervasive developmental disorder not otherwise specified (PDD-NOS) and who exhibited “moderate to severe autistic symptoms with relatively little intellectual disability.”19 The medical records were part of the Simons Foundation Autism Research Initiative (SFARI) Simplex Collection, which obtained phenotype data and biospecimens from autism simplex families. A simplex family is one in which just one child is on the autism spectrum—but not the parents or siblings.
Westmark found that almost one-fifth (18 percent) of the autistic children from the SFARI database had been fed soy-based infant formula.19 The database was unable to provide information about the duration of soy formula use, age of initiation or reasons for using soy formula. Even so, Westmark detected significant and clinically meaningful differences between the soy-fed and non-soy-fed autistic children, including a 2.6-fold higher rate of febrile seizures (seizures or convulsions accompanied by fever) in both males and females, a 2.1-fold higher rate of epilepsy comorbidity in autistic males and a fourfold higher rate of simple partial seizures (seizures not associated with altered consciousness).19 Westmark concluded that consumption of soy-based infant formula may be associated with reduced seizure threshold “in a vulnerable population of children diagnosed with autism.”
SOY INFANT FORMULA AND AUTISTIC BEHAVIORS
On its own, the compelling association between soy infant formula and seizures should be enough of a red flag to urge caution where use of soy infant formula is concerned. But it gets even worse. Using the same population of autistic children from the SFARI database, Westmark also described (in the journal Autism Open Access) an exploratory analysis of the link between consumption of soy infant formula and autistic behaviors.20 Westmark examined soy-based infant formula consumption and autism scores from three distinct diagnostic tests: the fifty-eight-item Aberrant Behavior Checklist (ABC); the ninety-three-item Autism Diagnosis Interview-Revised (ADI-R), which is a structured interview with parents; and the Autism Diagnostic Observation Schedule (ADOS) assessment.
Westmark’s analyses identified a number of specific behavioral ASD symptoms that may be associated with the use of soy-based infant formula, including measures of irritability and communication (Table 1).20 There were also notable differences in the effects observed in the male and female cohorts, particularly in the area of communication, suggesting “a possible gender-specific response…in association with the use of soy-based infant formula.”20 Considering the broader implications of her work on both seizures and autistic behaviors, Westmark states that it is not yet possible to ascertain whether “seizures cause language regression and cognitive decline” or whether both “share an underlying neuropathology with autism.”20
One of the most intriguing (and disturbing) observations in Westmark’s examination of the ADI-R data (which represent parental views regarding their child’s ASD behaviors over time) is that some behaviors “appeared more significantly worse in the present but not the past.” The investigator infers from these data that consumption of soy-based infant formula may be the evil gift that keeps on giving—affecting autistic behaviors “long after formula use is discontinued.”20
A final paper by the prolific Dr. Westmark (in Frontiers in Neurology) furnishes an extremely detailed examination of potential molecular mechanisms that might explain the soy-induced seizure effects she and her colleagues have observed (and possibly the autistic behavioral effects as well).11 Returning to the fact that soy is rich in phytoestrogens, Westmark hypothesizes that soy phytoestrogens interfere with metabotropic glutamate receptor (mGluR) signaling.11 mGluRs participate in many important central nervous system functions, modulating cell excitability and synaptic transmission.21 According to Westmark’s hypothesis, the activated mGluR signaling that results from excessive exposure to soy-derived estrogenic compounds leads to decreased seizure threshold and “increased epileptiform activity.”21 And if it is true that soy phytoestrogens affect neuronal excitability, it follows that soy-based infant formula also could be contributing to the increased incidence (and severity) of neurological disorders such as autism.
RECLAIMING OUR FOOD SUPPLY
Dr. Westmark’s impressive body of work11,16,18-20 raises many important questions, but—by her own admission—ventures into virtually uncharted territory, as few other investigators have displayed an interest in the relationship between soy and seizures or neurological disorders in humans. Could this be because soybeans (primarily GM) are the second largest cash crop in the U.S., and soy-derived additives feature in almost every industrially processed food on the market?11 Pointing to the growing evidence that glyphosate is associated with autism, Alzheimer’s disease, cancer and other diseases, Westmark conservatively suggests that parents and clinicians consider non-soy-based infant formulas as a preferable option for vulnerable infants.11
Dr. Martha Herbert (and many others) are more direct in describing ASD as a condition embedded in a wide-ranging set of challenges to human and planetary health. One of these challenges is a seriously compromised food supply “that is nutrient-poor, chemical-laden, processed and manipulated.”22 Most modern soybean products fit this definition to a “T.” It is well and good to recommend a soy-free diet as one step toward autism recovery, but Cara Westmark’s compelling studies suggest that parents would be wise to strongly question the role of soy in their infants’ and children’s diets well before the moment of receiving an autism diagnosis.
SOY INFANT FORMULA’S MANY TOXIC INGREDIENTS
As outlined in Sylvia Onusic’s excellent and thorough article, The Scandal of Infant Formula: A Poor Replacement for Mother’s Milk (Wise Traditions, Fall 2015), most infant formulas fail dismally in their duty to nourish infants’ brains and bodies adequately. In addition to the soy phytoestrogens that are the particular focus of Dr. Cara Westmark’s work, soy infant formula contains a number of alarming toxic ingredients. Some of these include:
• Synthetic L-methionine, which is produced with materials that include a hazardous air pollutant and a chemical warfare
• Soybean oil extracted with high heat and hexane.
• High levels of fluoride, aluminum and cadmium.
• Carcinogenic glyphosate residues in genetically modified soy.
ALTERNATIVE EXPLANATIONS FOR SOY’S SEIZURE EFFECTS
Cara Westmark hypothesizes that soy phytoestrogens lead to increased seizure activity through interference with central nervous system functions performed by metabotropic glutamate receptors.11 However, the open-minded Dr. Westmark also is willing to consider alternative scenarios that might explain soy’s seizure effects. These include:
• Effects of soy isoflavones on the make-up of the gut microflora
• Bacterial transformation of genetically modified soy DNA into gut bacteria capable of expressing toxic proteins that damage the intestinal lining
• Effects of chemical contamination from glyphosate residues on neurological and gut function
• Soy-induced activation of the immune system and altered production of inflammatory cytokines associated with febrile seizures
One of these explanations does not necessarily rule out the others. Regardless of precise mechanisms, what is certain is that the predominantly GM soy that is being forced into the American diet under a variety of guises is not doing our gut or brain health any favors—no matter what claims are made about purported beneficial effects.
1. Autism Speaks. New government survey pegs autism prevalence at 1 in 45. November 13, 2015.
2. Mayo Clinic. Autism spectrum disorder. June 3, 2014. http://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/basics/definition/con-20021148.
3. Herbert, M., K. Weintraub. The Autism Revolution: Whole-Body Strategies for Making Life All It Can Be. New York, NY: Ballantine Books, 2012.
4. Buie, T., D.B. Campbell, G.J. Fuchs Jr., et al. Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report. Pediatrics 2010;125 Suppl 1:S1-S18.
5. Williams, B.L., M. Hornig, T. Buie, et al. Impaired carbohydrate digestion and transport and mucosal dysbiosis in the intestines of children with autism and gastrointestinal disturbances. PLoS One 2011;6(9):e24585.
6. American Academy of Pediatrics. Gluten-free/casein-free diets. Updated November 21, 2015. https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Gluten-Free-Casein-Free-Diets.aspx.
7. Bortfeld, H. Understanding the GFCFSF diet for children with autism. TACA, September 29, 2015. http://www.tacanow.org/family-resources/in-defense-of-the-gfcfsf-diet-for-children-with-autism/.
8. McCandless, J. Children with Starving Brains: A Medical Treatment Guide for Autism Spectrum Disorder, Fourth Edition. Wilton Manors, FL: Bramble Books, 2009.
9. Campbell-McBride, N. Gut and Psychology Syndrome. Cambridge, United Kingdom: Medinform Publishing, 2010.
10. Weston A. Price Foundation. Confused about soy?—Soy dangers summarized. http://www.westonaprice.org/soy-alert/.
11. Westmark, C.J. A hypothesis regarding the molecular mechanism underlying dietary soy-induced effects on seizure propensity. Front Neurol 2014;5:169.
12. Philpott, T. Monsanto GM soy is scarier than you think. Mother Jones, April 23, 2014.
13. Frye, R.E., M.F. Casanova, S.H. Fatemi, T.D. Folsom, T.J. Reutiman, G.L. Brown, S.M. Edelson, J.C. Slattery, J.B. Adams. Neuropathological mechanisms of seizures in autism spectrum disorder. Front Neurosci 2016;10:192.
14. Tuchman, R., M. Rosanoff. How common are seizures among people with autism, and what can help? Autism Speaks Official Blog, August 5, 2011. https://blog.autismspeaks.org/2011/08/05/how-common-are-seizures-among-people-with-autism-and-what-can-help/.
15. Daniel, K. Soy and seizures: bad news for the soy industry. Wise Traditions 2013;14(1):71-75.
16. Westmark, C.J., P.R. Westmark, and J.S. Malter. Soy-based diet exacerbates seizures in mouse models of neurological disease. J Alzheimers Dis 2013;33(3):797-805.
17. Onusic, S. The scandal of infant formula: a poor replacement for mother’s milk. Wise Traditions 2015;16(3):22-53.
18. Westmark, C.J. Concocting the right diet for brain health. Translational Medic 2011;1:106e.
19. Westmark, C.J. Soy infant formula and seizures in children with autism: a retrospective study. PLoS One 2014a;9(3):e80488.
20. Westmark, C.J. Soy infant formula may be associated with autistic behaviors. Autism Open Access 2013;3:20727.
21. Niswender, C.M. and P.J. Conn. Metabotropic glutamate receptors: physiology, pharmacology, and disease. Annu Rev Pharmacol Toxicol 2010;50:295-322.
22. Herbert, M. Welcome to my website. http://www.marthaherbert.org/.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Fall 2016