Autism is a highly sensitive subject.
Members of the autism community, which includes families and supporters of people with autism and related disorders, may disagree with the idea that autism is a form of sickness or should be “cured.”
However, autistic people often face challenges like communication difficulties, gastrointestinal distress, disrupted sleep, poor coordination, anxiety, depression, self-injury, and institutionalization.
For families of people on the autism spectrum, the estimated cost of lifetime healthcare and lost wages is $4.3 million in inflation-adjusted dollars[*].
While remaining sensitive to the full range of individual experiences, it’s clear that there is a need to explore safe, effective ways to improve the health, wellness, and quality of life of people on the autism spectrum.
This article explores the possible causes of autism, the effects and potential benefits of a low-carbohydrate, high-fat diet for autism, and how people with autism can begin the keto diet and see if it improves their experience of life.
What is Autism Spectrum Disorder?
Autism is one of several developmental disorders that makes up autism spectrum disorder.
Symptoms of autism include difficulties with social interaction, trouble communicating, and restricted or repetitive behavior patterns.
Individuals with autism spectrum disorder often experience hypersensitivity to sensory input and difficulties with daily tasks, jobs, and relationships.
In the United States, about one in 59 children has autism spectrum disorder. The prevalence of autism has gone up 254% from the year 2000 to 2014[*].
Signs and symptoms of autism typically appear during the first three years of a child’s life, and can develop gradually or worsen after the child reaches developmental milestones.
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Diagnosis and Cause
Like other developmental disorders, autism is diagnosed and categorized according to impairment, symptoms, and behavior patterns. The diagnosis is not based on mechanisms or causes.
The causes of autism are complex. Scientists think that autism is caused by a combination of multiple genes, environmental factors, and epigenetic factors that can be passed from mother to child[*].
Genetics seem to play a role in autism, although researchers have had a hard time figuring out which genes contribute to autistic development[*].
During pregnancy, a mother’s nutrition and inflammation levels can influence the neurodevelopment of a fetus[*]. An inflammatory diet, air pollution, and other environmental factors during pregnancy or early childhood appear to increase the risk of autism[*].
Mitochondrial dysfunction in mothers and children may play a role in the formation of autism as well[*].
Your mitochondria are the powerhouses of your cells — they provide energy your body needs to function correctly. Stress and environmental factors damage mitochondria, which can affect the way a child’s brain develops and may contribute to autism.
What is the Keto Diet?
The ketogenic diet is a high-fat, low-carb diet with moderate to high protein intake.
Many people find that eating keto helps them burn fat, lose weight, enhance mood and mental clarity, raise their energy levels, and lower their risk of chronic disease.
The primary feature of the keto diet is its focus on consuming healthy fats.
Unlike the low-fat diets recommended by doctors during the second half of the 20th century, people on the ketogenic diet obtain the majority of their calories from healthy dietary fats like coconut oil, extra virgin olive oil, butter, red meat, wild-caught fish, and other animal fats.
When you eat a ketogenic diet, your body enters ketosis, a state in which your body and brain rely on fat for fuel instead of carbohydrates[*].
Running on fat for fuel changes your brain chemistry, protects your cells from inflammation and oxidative stress, improves your metabolism, lowers blood sugar, and increases insulin sensitivity[*][*].
6 Ways the Keto Diet May Benefit Autism Spectrum Disorder
#1: Promotes Healthy Brain Function
Recent studies show that a keto diet enhances brain health and cognitive performance[*][*][*][*][*][*][*][*][*][*][*].
Keto also improves symptoms of autism, epilepsy, amyotrophic lateral sclerosis, Alzheimer’s disease, Parkinson’s disease, and migraine headaches[*][*][*][*].
Compared to diets high in sugar and other carbohydrates, the keto diet is very low-carb, which causes your brain and body to rely on fat-burning and ketone production for fuel.
On a keto diet, high ketone levels reduce brain inflammation and change gene expression for the better, which promotes healthy brain function and improves cognition[*].
Eating a keto diet may improve a variety of autistic symptoms:
Healthy Brain Development
Eating a high-fat diet like the keto diet with abundant nutrients and plentiful healthy fats may improve autistic behavior patterns and encourage healthy brain development in autistic children[*].
Normalized Brain Metabolism
Autistic people have differences in brain glucose metabolism in areas of the brain that are associated with the behavioral symptoms of autism[*][*][*][*][*].
A keto diet shifts your metabolism to burning fat for fuel, feeding your brain ketones instead of glucose. People who switch to keto may see significant improvement in brain areas that are underactive in autism[*].
Decreased Sensory Overwhelm
Insulin resistance — trouble properly controlling blood sugar — can also contribute to autistic symptoms, especially when it comes to sensory overwhelm [*]. A keto diet has beneficial effects on insulin resistance, and could help with sensory hypersensitivity in autism.
Better Motor Function
Research in animals shows that keto can restore impaired motor function, another common symptom of autism[*].
#2: Boosts Mood
Autism changes excitability and inhibition in the brain, which can lead to anxiety and depression. Keto may help in a few ways:
Aggression and Stable Mood
A keto diet stabilizes over-excited brain regions in a way that’s similar to mood-stabilizing drugs like lithium that are sometimes prescribed for aggression and mood swings in people with autism[*][*].
Keto also shifts your body’s energy source from glucose to ketones (also called ketone bodies), which improves brain energy metabolism[*][*]. In these ways, the ketogenic diet may help stabilize and boost the mood of people with autism.
Children with epilepsy see a significant decrease in anxiety, decreased mood disturbance, and raised productivity when they switch to a keto diet[*].
Keto is significantly better than a low-fat, high-carb diet at boosting positive mood (and reducing hunger) in people without autism[*].
#3: Improves Gut Health
Your gastrointestinal tract (GI tract) is filled with trillions of bacteria, and they like to dabble in mind control.
Your gut bacteria have a direct line of contact to your brain, and they produce neurotransmitters and other brain chemicals that can change your mood and brain function, as well as your body’s immune and inflammation responses[*][*].
Your gut bacteria influence serotonin and dopamine, two neurotransmitters that influence mood and motivation[*]. Autistic people tend to have disrupted serotonin and dopamine production, and 74% of autistic children experience gastrointestinal distress[*][*][*].
Diet is a critical factor in the health and diversity of your microbiome[*].
Autistic people often have gut dysbiosis, an imbalance between good and bad gut bacteria[*]. And the more damaging gut bacteria an autistic person has, the more severe their autism symptoms are[*].
Gut flora alterations can contribute to depression, stress response, and autism severity[*].
Eating a ketogenic diet starves bad gut bacteria and supports healthy gut bacteria, which can restore balance to your gut microbiome, and also increases the production of beneficial short-chain fatty acids and the neurotransmitters serotonin and GABA[*][*][*][*].
#4: Reduces Inflammation and Autoimmunity
Researchers think that inflammation, oxidative stress, and immune activation play critical roles in the formation and ongoing symptoms of autism[*][*].
Autistic children are more likely to be overweight or obese compared to children without autism, and autism symptoms are more severe the more overweight a person is[*].
Obesity also contributes to inflammation and autoimmune dysfunction, which can worsen symptoms of autism[*][*][*].
Children who ate keto for six months lost significantly more weight than children on a low-calorie, low-fat diet[*]. The authors concluded that keto is both safe and beneficial for overweight children, and that being in a state of ketosis caused no significant side effects[*].
Eating keto also promotes healthy brain function, increases neuroplasticity, decreases oxidative stress, and reduces inflammation in your central nervous system[*]. All of which could help relieve autistic symptoms that come from inflammation and oxidative stress.
#5: Restores Mitochondrial Function
According to a 2012 meta-analysis of autistic children, 79% of autism spectrum disorder cases are likely the result of mitochondrial issues[*].
Your mitochondria are the power plants of your cells. They create the energy you need to live your life, powering everything you do. Your brain has a particularly high density of mitochondria.
If your mitochondria don’t work properly, your cells can’t get the energy they need to function. Mitochondrial dysfunction seems to be one of the root causes of autism[*].
A keto diet makes your mitochondria more efficient and protects them from damage, and can even help you grow brand new mitochondria, particularly in your brain[*][*].
Keto also increases brain antioxidants and improves overall brain cell function by strengthening mitochondria[*][*][*].
Finally, keto increases autophagy, which is like spring cleaning for your cells; your cells seek out damaged mitochondria and replace them with shiny new versions, which improves mitochondrial function across the board[*].
A ketogenic diet makes your mitochondria stronger, which may improve autistic symptoms.
#6: Makes Mothers Healthier Before and During Pregnancy
Autistic children are much more likely to have severe autism if their mothers weren’t in good health during pregnancy[*][*][*][*].
Mothers who are obese during pregnancy are 47% more likely to have autistic children[*], and their children have a 17-51% increased risk of neurodevelopmental disability[*].
Obese mothers also pass on an increased risk of neuroinflammation, insulin resistance, reduced brain plasticity, and neurotransmitter dysregulation in their children[*][*][*].
Mothers with diabetes or high blood pressure are 61% more likely to give birth to children with autism spectrum disorder or other developmental delays[*].
If you’re going to have a child, you want to make sure you’re as healthy as possible, especially when it comes to body weight.
Following a low-carb, high-fat diet can reduce body weight and improve blood sugar and insulin levels, which may reduce the odds of having autistic children[*].
An unhealthy gut biome increases risk of autism as well[*], probably because mothers pass their gut bacteria down to their children at birth. A keto diet is one of the best diets for weight loss and metabolic health[*] and balances gut bacteria[*][*].
Keto vs. Other Diets for ASD
The gluten-free casein-free diet (GFCF diet) and the elimination diet are two of the most popular diets adopted by families of autistic children hoping to address the core symptoms of autism[*].
Both diets are based on the elimination of potential allergens. The elimination diet includes an initial period of excluding or “eliminating” many different foods, gauging symptoms, then slowly adding them back to determine which foods make autism symptoms worse.
The GFCF diet excludes gluten (found in wheat and other grains) and casein (a type of dairy protein).
Immune and inflammatory components may contribute to the severity of autism symptoms. And since gluten and casein cause immune activation and inflammation in some people, the logic is that eliminating them could be helpful for autistic people[*].
Not all autistic people are sensitive to gluten and casein, which is why some studies don’t show any benefits to these diets for autism[*][*][*][*]. However, a GFCF or elimination diet is safe and worth a try for improving autism symptoms.
On the other hand, the keto diet offers the same benefits of a GFCF or elimination diet, as well as the many other benefits you just read about.
Keto automatically excludes gluten because it’s grain-free. And if you want to experiment with eliminating dairy and casein, that’s an easy step if you’re already keto.
With any diet, please speak with your child’s primary care physician before getting started. And remember that it might take weeks to months on a diet like keto before you start to see any results.
How to Get Started on a Keto Diet
The ketogenic diet was designed for children with epilepsy. So, if you’re worried about your children cutting carbs, rest assured that many children have done the diet successfully.
There is an initial adjustment period when people begin the keto diet that lasts between two and four weeks. Along with the psychological aspect of changing habits and getting used to a new menu, it also takes a few weeks for your body to adapt to keto and fat-burning.
Commitment to keto means trying it for at least a month without straying. If you don’t commit for at least a month, you won’t experience the full spectrum of health benefits you can achieve by eating a low-carb, high-fat diet.
To ease your transition, check out the Ultimate Keto Shopping List and learn about minor issues some people experience when starting keto. Note that not everyone has problems starting keto — some people feel better immediately.
Keto For Children
The good news is that kids can follow the same ketogenic diet as adults. Studies of the keto diet in children have found it’s well-tolerated, safe, and effective for reducing neurological symptoms[*][*][*][*][*].
However, autistic children (and others) may be picky eaters. If you’re a parent of an autistic child and you want him or her to try eating keto, here are some tips to ease the transition:
- Try transitioning gradually — for example, begin by cooking keto dinners at first.
- Explain the health benefits of the keto diet, and how it can help your child feel better.
- Consider adopting the keto diet yourself to show solidarity.
You can also follow these helpful keto-friendly recipe suggestions to get your child on board with eating keto:
- Breakfast: Keto pancakes or waffles, smoothies, eggs and bacon, breakfast tacos
- Lunch or dinner: Sandwiches with low-carb bread, meatballs, keto pizza, chili, buffalo bites, keto enchiladas
- Desserts or snacks: Fat bombs, nuts, seeds, nut or seed butters, jerky, or keto cookies (find more keto snacks here)
Keto suppresses hunger, which can lead people to naturally eat under calories and lose weight[*]. Unless your child is overweight or obese, it’s an excellent idea to monitor their weight a few times each month to determine if you should increase the calorie content of ketogenic meals.
If you need to add calories, you can increase serving sizes or add more healthy fats and whole-food protein sources.
Resources for Families of Autistic Children
Dietary changes are an exciting and promising area to improve the health and quality of life of autistic people.
But if your child has recently received a diagnosis of autism spectrum disorder, consider consulting other resources to ensure your family adjusts to the situation in a healthy and supportive manner.
Along with seeking local support groups and other resources in your community, here are some resources you can use:
- Charity Navigator ranks the Organization for Autism Research number one among autism charities. They support applied research, offer scholarships, promote inclusive hiring practices, and encourage autistic self-advocacy.
- The Autism Society of America is an organization with grass-roots chapters across America. They offer community-based support and advocacy, online databases with local info, and recommendations for parents and providers.
- The Autism Speaks directory lists services, support, advice, and providers for families.
- National Autism Resources is a web-store for autistic people and their families that provides products designed for calming, sensory needs, classroom focus, and more.
- The Autism Support Network has a recommended reading list for a variety of situations and needs experienced by families of autistic people.
- Autism Beacon offers a glossary of autism-related terms and runs a blog about parenting children on the spectrum.
- Autism Now provides info to help autistic people function in classrooms, jobs, and their communities.
- Autism After 16 teaches families about transitioning to secondary education, jobs, housing, and community living arrangements for autistic people.
- Train 4 Autism is for athletes and physical activity enthusiasts who want to participate in charity runs and other activities to support autism research and related causes.
The Takeaway: Keto May Help With Autism Symptoms
Autism spectrum disorder usually brings challenges in the form of mood issues, social impairment, and physical symptoms.
Low-carb, high-fat diets like the ketogenic diet are a promising option for improving the health, wellness, and quality of life for people with autism.
In addition to promoting healthy brain function, enhancing gut health, and reducing inflammation, the keto diet also makes it easier to maintain a healthy weight and reduces the risk of cancer, heart disease, high blood pressure, and diabetes.
Dietary changes can be one part of a practical approach to managing autism for families, but it’s also helpful to remember you aren’t alone.
If you connect with experts and other parents of autistic children, you may find it easier to address challenges that arise as a result of an autism diagnosis.