It may not sound much to most parents, but Kevin has autism and Isabel had been trying for ten years to get him to eat anything other than plain brioche, with zero success.
‘When he reached out and put my hand on the tub of cream cheese as if to say: “I want that too”, it was an incredible moment — I had tears in my eyes because it was the first time Kevin had ever accepted a major change in his food routine,’ says Isabel, 56, a college lecturer from Hertfordshire.
Isabel puts the transformation down to a prebiotic supplement Kevin had started taking the previous week. Within days, she says, he was sleeping better, eating more and was calmer and making more eye contact.
Around 700,000 people in Britain have autism, a developmental disorder which affects communication and social skills; some, like Kevin, 16, are non-verbal and have behavioural difficulties.
There is no treatment as such — but could prebiotics help, as Isabel claims they have helped her son? A prebiotic is a form of indigestible fibre that feeds the billions of probiotic ‘good’ bacteria in our gut.
An intriguing study by the University of Reading published in the journal Microbiome last year, showed that taking a daily prebiotic for six weeks not only boosted the number of good bacteria in the guts of children with autism, it also improved their mood, behaviour and sleep.
After taking the supplement, children’s ‘anti-social’ behaviour scores (avoiding eye contact, ignoring other people and being unco-operative) fell from 18 points to 14, whereas those taking a placebo stayed the same or rose.
Measures of how hard the children found social situations and meeting new people also fell. And almost a quarter of those taking prebiotics had improved sleep.
‘We didn’t expect to see such an impact on mood and behaviour — we were trying to find out what effect the prebiotic would have on gut bacteria and gastro-intestinal problems,’ says Dr Roberta Grimaldi, a reader in food and nutritional sciences, who led the study. ‘But parents told us their children were less stressed around other people and were more able to interact, and they were calmer generally. That was a surprise.’
It was a small study, involving just 26 children aged four to 11, and the prebiotics didn’t help everyone, she says.
However, these results appear to echo a U.S. study published last month, which found that symptoms of autism improved in children given a ‘faecal’ transplant of digestive bacteria. Eight of the 18 youngsters treated at Arizona State University improved so much that they were no longer considered to have autism.
Kevin began taking prebiotics after Isabel watched a documentary in which TV doctor Michael Mosley discovered that prebiotics could help his chronic insomnia.
‘At the time, we had reached rock bottom with Kevin,’ says Isabel. ‘He would often get only two or three hours’ sleep a night and would keep getting up, so my husband, James, and I were also severely sleep-deprived, which was torture. Kevin also wasn’t eating much. No one could help us.
‘After watching the documentary, I researched prebiotics and found they wouldn’t do harm, so decided to try them.’
Isabel began mixing half a dose of the prebiotic powder Dr Mosley used into Kevin’s water after he came home from school, which he’d have with his brioche.
‘Within a week he began to sleep half-an-hour longer and be less agitated and restless,’ she says.
Kevin goes to a special school, and within weeks teachers noticed he was calmer, more able to focus and less frustrated. And, for the first time since being diagnosed with autism aged three, Kevin was willing to try new foods.
Until then there were only a few foods he would eat: a cereal imported from France, plain fish or chicken, basic vegetables such as peas, carrots and broccoli, and only pasta shaped like penne — plus his beloved brioche.
The cream cheese with brioche was the first step, then he progressed to pointing at the lasagne on his parents’ plates.
‘These were foods he would refuse before,’ says Isabel. ‘But suddenly he’d grab his fork as if to say: “What’s that — I want some”.
‘It was like he was coming out of his world and into ours. He reached out and ate a plateful.’
Before starting prebiotics in February last year, Kevin, who is just under 5ft, weighed a worrying 4½st; he is now nearly 6st.
Dr Grimaldi was keen to test prebiotics on children with autism after reading a previous study that suggested probiotic drinks might help gut problems, which are eight times more likely in children on the autistic spectrum.
The trouble with probiotics — which contain ‘good’ bacteria and are available as supplements and in yoghurts — is that they can get destroyed on the way to the gut.
As prebiotics are simply food for the bacteria, they don’t suffer the same problems. You can get prebiotics from your diet, as the fibre — called inulin — is present in vegetables such as Jerusalem artichokes, onions, garlic and leeks.
Dr Grimaldi’s study found it was children with autism on a restricted diet — such as gluten-free or dairy-free — who saw the biggest improvements in gut symptoms; other children showed a much lesser effect. Why is unclear.
The intriguing aspect of prebiotics is the effect they seem to have on sleep, mood and behaviour, although most of the research so far has been on animals, not humans. Studies, mainly on mice, have suggested they can reduce levels of the stress hormone cortisol, lower anxiety and sharpen brain function.
But how could your gut bacteria affect what’s going on in your head? Scientists aren’t sure yet. But when the bacteria are breaking down their prebiotic ‘food’ they produce substances called metabolites, which produce chemicals such as serotonin, the ‘happy hormone’ which directly affect mood. In fact, 90 per cent of the body’s serotonin is made in the gut.
We think that subtle alterations in your gut microbes can have a big effect on mental health and mood,’ says Professor Glenn Gibson, a microbiologist at the University of Reading.
‘There’s a connection between the gut and the brain — if you get nervous, you get butterflies in your stomach; and people who get constipated often get migraines. We just haven’t yet unravelled the whole connection.’
He believes prebiotics may also help children less severely affected by autism, such as those with Asperger’s syndrome, who don’t have learning difficulties or problems with speech but can have problems in social situations and with processing language. But he admits there’s no evidence yet. ‘Even if you take the least optimistic view, people who choose to take this won’t do any harm.’
Dr James Cusack, director of science at the UK’s autism research charity Autistica, is not yet convinced by the evidence for prebiotics and points out that Dr Grimaldi’s study was ‘very small’.
‘It doesn’t mean prebiotics aren’t useful, it just means the results are not conclusive,’ he says.
One challenge with research on children, he says, is that there’s a huge placebo effect. ‘There have been studies which involve doing nothing and you speak to the parents ten weeks later and they will describe huge improvements. And children change over time.
‘Parents are desperate to find ways to help their children so I understand the temptation to try things that are unproven. It’s important that we act on the basis of evidence. We need bigger and better trials to find out if prebiotics are truly useful.’
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