Exploring the Connection Between Inflammatory Foods and Neurodivergence

In recent years, the term “neurodivergent” has become more common. But what does it mean? Neurodivergence refers to differences in the way a person’s brain functions compared to the “neurotypical” majority. This can affect how individuals think, learn, and process information. As someone with attention deficit hyperactivity disorder (ADHD), I identify as neurodivergent, and I’ve noticed this condition in several of my family members as well. Neurodivergence encompasses a range of conditions, including autism spectrum disorder (ASD), ADHD, and anxiety disorders. While the field is still developing, research suggests that certain foods may influence the symptoms of neurodivergent conditions, either worsening or improving them.

The Gut-Brain Connection:

The gut and the brain are connected through what we call the “gut-brain axis.” This axis is like a communication highway between your gut (stomach and intestines) and your brain, allowing them to send messages back and forth using nerves, chemicals, and the immune system. What happens in your gut can affect your mood and brain function, and vice versa. The foods we consume can either increase or reduce inflammation, which in turn influences our overall well-being. Eating well and taking care of your gut health positively impacts this communication, ensuring your gut and brain stay in good harmony (1).

The mix of trillions of bacteria in your gut affects how your body processes nutrients, influencing the release of substances like hormones and neurotransmitters from gut cells that impact the gut-brain connection. For example, the neuropeptide galanin plays important roles in sleep, mood, and the stress response. Galanin can activate part of the brain’s stress response system, leading to the release of hormones like cortisol. This shows how the types of bacteria in your gut might impact how your body responds to stress through these complex pathways.

The gut microbiota is essential for digestion, nutrient absorption, immune function, and overall well-being, including mental health. Emerging research indicates that gut dysbiosis, a condition where harmful microorganisms outnumber beneficial ones, can negatively impact health. One of the leading causes of gut dysbiosis, especially in children, is the Standard American Diet (SAD), also known as the Western Diet (WD) (2).

Ultra Processed Foods, Gluten & Dairy

A diet high in ultra processed foods, sugars, and low in fiber not only lacks essential vitamins/minerals needed for growth and development but it also negatively impacts the composition of the gut microbiota. Here is how:

1. Ultra processed foods (UPFs) high in refined sugar and artificial additives cause inflammation.
   • UPFs promote “leaky gut” which allows harmful substances to pass through the gut lining causing inflammation.
   • They favor the growth of pro-inflammatory bacteria which produce/contain endotoxins which enter the bloodstream and trigger an immune response
   • UPFs cause rapid blood sugar spikes which causes both inflammation and insulin resistance
   • UPFs contain unhealthy fats (such as trans fats and refined seed/vegetable oils)
     • Unhealthy fats promote increased visceral adiposity (fat accumulation around the organs) which results in the release inflammatory molecules by the inflamed fat (3), contributing to chronic systemic inflammation.
   • UPFs lack anti-oxidants; without these the cells in our body see more oxidative stress inflammation and tissue damage.
2. Individuals with neurodivergent conditions have been found to be more prone to food sensitivities or allergies. Identifying and managing these sensitivities can be crucial in reducing inflammation and improving symptoms.
   • Gluten: found in wheat and other grains giving dough its elasticity and helping it rise and maintain its shape. Bread in the US has been selectively bred over the last hundred years to contain high amounts of gluten. People with celiac disease develop an autoimmune response that damaged the small intestine when they ingest gluten. There are also people with gluten intolerance or insensitivity that experience gastrointestinal symptoms similar to celiac disease and/or multi systemic disease after consuming gluten-containing foods, but without the autoimmune response seen in celiac disease. Neurodivergent children with autism are at high risk of celiac disease and gluten insensitivity. In fact, there have been multiple observations that children with neuropsychiatric symptoms such as autism and ADHD have benefited from having gluten free diets.
   • Casein: When casein is broken down in the digestive tract it is converted to smaller peptides and a result is beta-casomorphin-7 (casomorphin) which has a structure similar to that of morphine. This allows them to bind to opioid receptors in the brain and gut (4).
     • Opioid receptors are found in various parts of the brain and are involved in regulating pain, reward, and addictive behaviors.
     • When casomorphins bind to these receptors, they can mimic the effects of opioids to some extent, though typically less potent.
     • Casein is one of the proteins most frequently causing an immune reaction in children.
   • Studies have shown that a significant number of children with autism who go on an elimination diet of both gluten and casein have improved behavioral and cognitive function (5).
3. Incorporating Anti-Inflammatory Foods Improves Mental Health.
   • Foods such as fruits, vegetables, nuts, and fatty fish into the diet may have a positive impact on neurodivergent individuals. These foods provide essential nutrients and antioxidants that support overall health.

Recent research extensively links high sugar intake to increased hyperactivity in neurodivergent children (6). Meta-analysis involves pooling data from multiple studies to provide a broader understanding of the topic at hand. A comprehensive meta-analysis confirmed that diets rich in refined sugar and saturated fats elevate the risk of ADHD and hyperactivity. Conversely, diets emphasizing fruits and vegetables appear to offer protective benefits against these neurodivergent behaviors.

Currently, children with ASD who exhibit disruptive and violent behavior are often prescribed potent psychiatric medications. These medications can lead to adverse effects such as weight gain, sedation, tremors, abnormal movements, and drooling. Similarly, medications for children with ADHD, including stimulants and non-stimulants, may also cause side effects and potential dependency. While further research is necessary to fully understand how dietary changes can positively impact behavior in neurodivergent children, it is undeniable that the gut-brain connection is significant. Addressing gut health is crucial and should be considered as important as discussing medications in managing these conditions.

While the implementation of these dietary changes can be a challenge, eliminating inflammatory foods can have major beneficial effects on neurodivergent children with sensitive nervous systems, and can be healthier for the ENTIRE FAMILY. I invite you to read the following article from a peer reviewed scientific journal (6): “Here we [review], in non-technical, plain English, how cereal grains-the world’s most abundant food source-can affect human behavior and mental health. We present the implications for the psychological sciences of the findings that, in all of us, bread makes the gut more permeable and can thus encourage the migration of food particles to sites where they are not expected, prompting the immune system to attack both these particles and brain-relevant substances that resemble them, and releases opioid-like compounds, capable of causing mental derangement if they make it to the brain. A grain-free diet, although difficult to maintain (especially for those that need it the most), could improve the mental health of many and be a complete cure for others.” -Ma, X. et al. Front Hum Neurosci. 2016 Mar 29:10:130.

Our Personal Journey With Our Son

As I eluded to on the home landing page, our son with neurodivergence is one the main reasons why I created this site. As an endocrinologist, I am aware that diet is crucial in causing metabolic changes that can prevent or worsen disease such as high blood pressure, abnormal cholesterol levels, and diabetes. However, I was not aware that dietary changes can make a significant impact in day to day behavior, cognition and emotional regulation in children, until I saw it first hand with my son. During his toddler years we were told he required more direct supervision compared to his peers and when he reached preschool age we realized that his problems with inattention were impacting his ability to reach important developmental milestones such as holding a pencil or crayon. He could not draw or recognize shapes, stay in his seat for long periods of time, and let alone recognize any letters in the alphabet. Most alarmingly for us were his labile emotional outbursts. They were explosive. While his pediatrician said he was ok, we could not even take him out on daily errands or allow him to play with other children at the playground without heavy supervision. While we awaited for neuropsychiatric evaluation our day to day became almost unbearable.

We encountered research in the space of dietary changes reported to help children with neurodivergence. To be honest, I was very skeptical that any dietary change would make a difference, because our son already had what I considered to be a pretty healthy and balanced diet. He enjoyed a diversity of foods including fish and plenty of non starchy vegetables. However, we were willing to try anything at that point and decided to pursue a diet low in sugar and to eliminate factors associated with gut sensitivity such as dairy, gluten, food dyes and heavily processed foods. See the table below learn what specific changes we made (Table 1).

Since we incorporated the dietary changes I mentioned, our son he showed MARKED improvement in emotional lability, among other neuro-functioniong areas. Cleaning up his diet has made a major difference in his day to day behavior. Prior to the dietary change, going to school was a daily struggle. However, in less than a year he started bringing amazing art work from his kindergarten class every day (Fig 1), and his emotional outbursts are fewer and not nearly as explosive. It’s like he became a different kid.

The emerging data regarding the neurologic effects of these unhealthy food products is real. While more research is needed to fully understand the mechanisms and implications of the gut-brain connection, from my personal experience and research into the available literature I speculate the following: Factors such as genetic predisposition, immune system function, and environmental influences (such as diet and its effect on the gut microbiome) all contribute to the complex interplay between the gut and the brain to directly affect behavior and cognition in particular in individuals that are neurodivergent.

As a physician and a mother my goal is to share this vital information with you and other families that might benefit from reading this. While this diet is hard to maintain, and there were many dietary variables eliminated that probably helped more than others, or not at all, as an Endocrinologist I can attest to the fact that this diet is beneficial for everyone in the household who wants to have a healthy weight and lower their insulin resistance. I myself still eat dairy such as kefir, yogurt and cheese because this is my favorite form of obtaining probiotics. In addition, I am not gluten free, though I do not eat much bread anyway. Since the entire household has incorporated a cleaner way of eating everyone is healthier. My lipid parameters are at an all-time best mirroring values I hadn’t seen since I was in my 20s. Elimination of all of these food items can appear daunting and a stepwise approach might be better suited for some or prioritizing one or two items to eliminate. The first step I would recommend to any family struggling with symptoms of neurodivergent children is to reduce children’s sugar intake and avoid artificial dyes and chemicals like the ones banned in Europe. The data are insurmountable showing that excess sugars and artificial dyes are harmful to neurosensitive children and exacerbate symptoms of emotional dysregulation and inattention. For tips on how to reduce sugar intake at home see my post on sugar.

While research in this field is still ongoing, there is a definite known link between inflammatory foods and neurodivergence. I join countless of families who have seen remarkable improvement in ADHD, executive functioning and emotional regulation symptoms in their neurodivergent children after switching them to a low inflammatory, low sugar, and gluten/dairy/dye free diet (7). As we continue to unravel the complexities of the gut-brain connection, a holistic approach that includes both dietary and therapeutic interventions will likely pave the way for the improved well-being of neurodivergent individuals.