Docstoc

Slide 1 ______

Document Sample
Slide 1 ______ Powered By Docstoc
					Slide 1                                                   ___________________________________

              The Autism Spectrum Part III
                       Marcia Zimmerman                   ___________________________________

                Detoxification and the Exclusion Diet –
                           The 30-Day Plan
                                                          ___________________________________
                          October 18th, 2010
                    Nutrition for Optimal Wellness
                                                          ___________________________________

                                                          ___________________________________

                                                          ___________________________________

                                                          ___________________________________

Slide 2                                                   ___________________________________
          The Major Consideration in ASD
          •   Immune dysregulation (NFOW July 2010)       ___________________________________
          •   Oxidative Stress (NFOW July, September)
          •   Mitochondrial Deficits (September 2010)
          •   Toxicity (NFOW September, October)          ___________________________________
          •   Inflammation (July, September)
          •   Diet and Nutrition (NFOW October,
              November, January 2011)                     ___________________________________

                                                          ___________________________________

                                                          ___________________________________

                                                          ___________________________________

Slide 3                                                   ___________________________________
                  What is Detoxification?
          •   Defecation                                  ___________________________________
          •   Sweating
          •   Exhaling
          •   Internal detoxification reactions           ___________________________________

                                                          ___________________________________

                                                          ___________________________________

                                                          ___________________________________

                                                          ___________________________________
Slide 4                                       ___________________________________
              Factors in ASD Detoxification
          •   Genetic polymorphisms           ___________________________________
          •   Age
          •   Gender
          •   Diet and lifestyle              ___________________________________
          •   Environment
          •   Co-existing conditions
                                              ___________________________________

                                              ___________________________________

                                              ___________________________________

                                              ___________________________________

Slide 5                                       ___________________________________
               What Needs Detoxification?
          • Exogenous                         ___________________________________
              – Heavy Metals
              – Chemicals
          • Endogenous
              – Metabolites
                                              ___________________________________
                • Bacterial and fungal
              – Neurotransmitters
              – Hormones                      ___________________________________

                                              ___________________________________

                                              ___________________________________

                                              ___________________________________

Slide 6       Which Tissues Are Involved?     ___________________________________

                                              ___________________________________

                                              ___________________________________

                                              ___________________________________

                                              ___________________________________

                                              ___________________________________

                                              ___________________________________
Slide 7                                  ___________________________________
           Which Organs Are Involved?

                                         ___________________________________

                                         ___________________________________

                                         ___________________________________

                                         ___________________________________

                                         ___________________________________

                                         ___________________________________

Slide 8                                  ___________________________________
          Detox Through Surface Organs

                                         ___________________________________

                                         ___________________________________

                                         ___________________________________

                                         ___________________________________

                                         ___________________________________

                                         ___________________________________

Slide 9                                  ___________________________________
           Through Elimination Organs

                                         ___________________________________

                                         ___________________________________

                                         ___________________________________

                                         ___________________________________

                                         ___________________________________

                                         ___________________________________
Slide 10                           Liver Detoxification I
                                                                                                                                      ___________________________________
                                  Phase I                                                  Phase II
                            Nutritional support                                      Nutritional support
                               antioxidants                                          conjugating agents
                            vitamin & mineral
                                 cofactors
                                                                                      vitamin & mineral
                                                                                          cofactors                                   ___________________________________
                                  Free
                                radicals


                                                                                                                                      ___________________________________
                  Toxins                                   Toxic                                         Conjugated
                                    Phase I                                          Phase II
                                                      Intermediates                                      Metabolites

               Xenobiotics,      Cytochrome P450
                endotoxins        Mixed oxidase
                fat-soluble
              Poorly excreted
                                      system
                                                      Secondary tissue
                                                          damage
                                                                             Enzymatic conjugation         Less toxic
                                                                                                          Water-soluble
                                                                                                         Readily excreted
                                                                                                                                      ___________________________________
                                                                       Adapted from Kenneth Bock, MD “Clinical Approaches to
                                                                   Detoxification in ASD” ARI conference Long Beach CA 10/10/2010




                                                                                                                                      ___________________________________

                                                                                                                                      ___________________________________

                                                                                                                                      ___________________________________

Slide 11                                                                                                                              ___________________________________
                                  Liver Detoxification II
              Toxins                                                                                          Waste products
           (fat soluble)
                                                 Step 1

                                           Required nutrients
                                                                                  Step 2
                                                                                                              (water soluble)
                                                                                                                                      ___________________________________
                                              B vitamins               Required Nutrients
                                              Folic acid                   Amino acids                        Eliminated from
                                             Glutathione              (glutamine, glycine,                        the body
                                           N-Acetyl cysteine            taurine, cysteine)
                                              Lipoic acid
                                             Antioxidants
                                             Carotenoids
                                                                     Sulfur phytochemicals
                                                                   (garlic, onions, cruciferous
                                                                            vegetables)
                                                                                                              Gall
                                                                                                                                      ___________________________________
                                                                                                            bladder
                                              Vitamin C
                                              Vitamin E                                                                     Kidneys

                            Toxin List
                                                                                                              Bile
            Metabolic end products, Micro-organisms
           Contaminants, pollutants, insecticides, food
                    additives, drugs, alcohol
                                                                                                                                      ___________________________________
                                                                     Kenneth Bock, M.D. DAN                                  Urine
                                                                                                            Bowel
                                                                    conference, Long Beach CA
                                                                                                            Actions
                                                                             10/9/10



                                                                                                                                      ___________________________________

                                                                                                                                      ___________________________________

                                                                                                                                      ___________________________________

Slide 12                                                                                                                              ___________________________________
                                      Phase I Reactions
              Reactions
              •    Oxidation
                                                                         Enzymes, Cofactors
                                                                         •   Riboflavin; B2
                                                                                                                                      ___________________________________
              •    Reduction                                             •   Niacin; B3
              •    Hydrolysis                                            •   Pyridoxine; B6 (P5P)
              •    Hydration                                             •   Folic Acid (tetrahydrofolate)                            ___________________________________
              •    Dehydrogenation                                       •   Vitamin B12 (methylcobalamin)
                                                                         •   Glutathione; GSH
                                                                         •   Branched-chain aminos
                                                                         •   Flavonoids                                               ___________________________________
                                                                         •   Phospholipids
                                                                   DeAnn J. Liska, Ph.D. The Detoxification Enzyme Systems Altern
                                                                                      Med Rev 1998;2:187-198



                                                                                                                                      ___________________________________

                                                                                                                                      ___________________________________

                                                                                                                                      ___________________________________
Slide 13       Preventing Toxic Intermediary                                                  ___________________________________
                        Metabolites
           • Antioxidants (plant         • Co-enzyme Q10
             derivatives)                • Thiols                                             ___________________________________
           • Carotenes (vitamin A)          – Garlic
           • Ascorbic acid (vitamin C)      – Onions
           • Selenium                       – Cruciferous
           • Copper                           vegetables                                      ___________________________________
           • Zinc                        • Bioflavonoids
           • Manganese                   • Silymarin (milk thistle)
                                         • Oligomeric
                                           proanthocyanidins                                  ___________________________________
                                           (Pycnogenol™ OPCs)
                                            Liska, DJ; “The Detoxification Enzyme Systems”
                                                    Altern Med Rev 1998;3:187-198.



                                                                                              ___________________________________

                                                                                              ___________________________________

                                                                                              ___________________________________

Slide 14                                                                                      ___________________________________
                        Phase II Reactions
           •   Sulfation                   • Amino acid
           •   Glucuronidation               conjugation
                                                                                              ___________________________________
           •   Glutathione conjugation     • Glycine
           •   Acetylation                 • Taurine
           •   Methylation                 • Glutathione                                      ___________________________________
                                           • Ornithine
                                           • Arginine
                                                                                              ___________________________________
                                                                         Liska, DJ; Op Cit.




                                                                                              ___________________________________

                                                                                              ___________________________________

                                                                                              ___________________________________

Slide 15                                                                                      ___________________________________
                              Elimination
               •   Bacterial endotoxins
               •   Yeast overgrowth                                                           ___________________________________
               •   Parasites
               •   Gut inflammation
               •   “Leaky” gut                                                                ___________________________________
               •   Inefficient intestinal motility
               •   Ammonia
               •   Biofilm                                                                    ___________________________________

                                                                                              ___________________________________

                                                                                              ___________________________________

                                                                                              ___________________________________
Slide 16                                                                                            ___________________________________
                      Phase III Elimination
           •   Fiber
           •   Probiotics                                                                           ___________________________________
           •   Prebiotics
           •   Saccharomyces boulardii
           •   Digestive enzymes                                                                    ___________________________________
           •   Proteolytic enzymes
           •   Botanical antifungals, antimicrobials
           •   Modified citrus pectin (Pectasol™)                                                   ___________________________________

                                                                                                    ___________________________________

                                                                                                    ___________________________________

                                                                                                    ___________________________________

Slide 17                                                                                            ___________________________________
                       Chelation Therapy
           •   Most controversial in detoxification for children
           •   Heavy metal detoxification
                                                                                                    ___________________________________
           •   ARI: 324 reports: 2% worse, 22% nc, 76% better
           •   Treatment
               – DMSA (Dimercaptosuccinic acid) oral treatment                                      ___________________________________
               – DMPS (Dimercaptopropane sulfonate)
               – TTFD (thiamine tetrahydrofurfuryl disulfide)

                                                                                                    ___________________________________
                                        Adams, JB; “Summary of Biomedical Treatments for Autism:
                                                DAN conference Long Beach, CA Oct 2010
                                        Lonsdale D; “Treatment of ASD with TTFD” Neuro Endocrinol
                                                           Lett. 2002;23:303-8.




                                                                                                    ___________________________________

                                                                                                    ___________________________________

                                                                                                    ___________________________________

Slide 18                                                                                            ___________________________________
                Other Suggested Therapies
           • Hydrotherapy/temperature                                                               ___________________________________
               – Sauna/steam
               – Soaking tubs (epsom salts)
           • FIR sauna detoxification
               – Enhance mobilization of fat-soluble
                                                                                                    ___________________________________
                 xenobiotics
               – Compounds release through sweat (bromide,
                 chloride, antimony, cadmium, lead, mercury,                                        ___________________________________
                 nickel, urea, lactate, PCBs
                                                               Bock, K; “Clinical Approaches to
                                                             Detoxification” DAN conference Long
                                                                      Beach CA Oct. 2010




                                                                                                    ___________________________________

                                                                                                    ___________________________________

                                                                                                    ___________________________________
Slide 19                                                                 ___________________________________

                                                                         ___________________________________
                  How Do I Protect My Child,
                           Myself?
                                                                         ___________________________________
                   It’s a crazy toxic world, but there is
                     much you can do. Be observant
                       and extremely diligent in this
                                 endeavor.                               ___________________________________

                                                                         ___________________________________

                                                                         ___________________________________

                                                                         ___________________________________

Slide 20                                                                 ___________________________________
                      Steps You Can Take
           • Clean up your home environment                              ___________________________________
           • Clean up your child’s diet
           • Work with a qualified doctor (DAN doctor;
             www.autism.com)
           • Get help from autism groups
                                                                         ___________________________________
             www.tacanow.org, http://www.nvic.org/resource-
             center/autismsupport.aspx. www.theautspot.com.
           • Exclusion diets
                                                                         ___________________________________

                                                                         ___________________________________

                                                                         ___________________________________

                                                                         ___________________________________

Slide 21                                                                 ___________________________________
                  Reduce Exposure to Toxins
              •   Household chemicals, bleach
              •   Arsenic treated wood (pressure treated)                ___________________________________
              •   Avoid mercury contaminated fish
              •   Avoid corn products, HFCS
              •
              •
                  Flu vaccine with thimerosal, spread out vaccinations
                  PCBs, pesticides, PDBEs, plasticizers
                                                                         ___________________________________
              •   Lead in water, soil, dust
              •   Plastics in cooking, non-stick pans
              •   Avoid antibiotic use
                                                                         ___________________________________

                                                                         ___________________________________

                                                                         ___________________________________

                                                                         ___________________________________
Slide 22                                                    ___________________________________
                       Exclusion Diets
                            Start slowly
                  The whole family participates             ___________________________________
                     Get guidance and help!
                      Do your own research
                  Check out www.tacanow.org
                                                            ___________________________________
                    (talk about curing autism)
                         www.autism.com
                   (Autism Research Institute)
                                                            ___________________________________

                                                            ___________________________________

                                                            ___________________________________

                                                            ___________________________________

Slide 23                                                    ___________________________________
                  Dietary Modifications
              • Buy organic foods
              • Buy range meat, poultry                     ___________________________________
              • No refined carbs (white stuff)
              • No trans fats
              • Avoid reactive foods
                 – Food allergens/sensitivities
                                                            ___________________________________
                 – High phenolic foods
              • All food additives and preservatives
              • Avoid buying any food in a box or plastic   ___________________________________
                bag


                                                            ___________________________________

                                                            ___________________________________

                                                            ___________________________________

Slide 24                                                    ___________________________________
              Special Diets Used in ASD
           • Gluten-free and casein-free (GFCF)             ___________________________________
           • Gluten-free, casein-free, soy-free
             (GFCFSF)
           • Specific carbohydrate diet (SCD)
                                                            ___________________________________
           • Low oxalate diet (LOD)
           • Yeast-free diet
                                                            ___________________________________

                                                            ___________________________________

                                                            ___________________________________

                                                            ___________________________________
Slide 25                                                  ___________________________________
                       The Exclusion Diet
           •   Allergy/food sensitivity diet              ___________________________________
           •   No additives, preservatives, food colors
           •   Organic as much as possible
           •   No sugary beverages                        ___________________________________
           •   No processed foods
           •   30-Day Plan
           •   Complete guide – “Families with Autism”    ___________________________________
                  • www.tacanow.org.



                                                          ___________________________________

                                                          ___________________________________

                                                          ___________________________________

Slide 26                                                  ___________________________________
                 Food Excitotoxins AVOID!
           •   MSG                                        ___________________________________
           •   Nitrates/nitrites
           •   Colors/dyes (Yellow # 5,6)
           •   Preservatives (BHA, BHT, TBHQ)             ___________________________________
           •   Phenols/salicylates
           •   Pesticides sprayed on food
           •   Aluminum-lined containers                  ___________________________________

                                                          ___________________________________

                                                          ___________________________________

                                                          ___________________________________

Slide 27                                                  ___________________________________
                   Non-Food Excitotoxins
           •   Fluoride                                   ___________________________________
           •   Chlorine
           •   Tylenol (acetaminophen)
           •   Dental fillings                            ___________________________________
           •   Inhaled household chemicals, pesticides


                                                          ___________________________________

                                                          ___________________________________

                                                          ___________________________________

                                                          ___________________________________
Slide 28       Case for Gluten & Casein Free                     ___________________________________
                            Diet
           • Food sensitivity to gluten (wheat, barley, rye,
             teff, spelt, oats) corn gluten usually O.K.
                                                                 ___________________________________
           • Food sensitivity to casein (milk, cheese, yogurt,
             ice cream)
           • Food sensitivity to soy                             ___________________________________
           • Chronic gooey stools
           • Gas and bloating
           • Frequent infections (ear, tonsils, sinus)
           • Casomorphin or gliadorphin in urine
                                                                 ___________________________________

                                                                 ___________________________________

                                                                 ___________________________________

                                                                 ___________________________________

Slide 29               How do I do This?                         ___________________________________
           • Buy special foods (most expensive)
           • Mixes to prepare foods (cook yourself)
           • Do it from scratch (least expensive, better         ___________________________________
             control over ingredients, no boxes!)
           • www.gfcf-diet.tacanow.org/meal-plans-gfcf.htm.
           • Frequent farmer’s markets                           ___________________________________
           • Buy what’s in season
           • Read labels carefully
           • Foods & supplements to treat ASD are partially
             tax-deductible                                      ___________________________________

                                                                 ___________________________________

                                                                 ___________________________________

                                                                 ___________________________________

Slide 30                                                         ___________________________________
                   Sample of Gluten Foods
           •   Barley (flour, malt)
           •   Bulgur                                            ___________________________________
           •   Caramel coloring
           •   Hydrolyzed plant or vegetable protein
           •   Miso
                                                                 ___________________________________
           •   MSG
           •   Spelt, triticale, wheat (ingredient listed)
                  • www.tacanow.org.                             ___________________________________

                                                                 ___________________________________

                                                                 ___________________________________

                                                                 ___________________________________
Slide 31                                                        ___________________________________
           Some Casein Containing Foods
           •   Butter (butter flavor, butter fat, buttermilk)
           •   Margarine                                        ___________________________________
           •   Cheese
           •   Milk, cream, sour cream, malted milk
           •   Sausage                                          ___________________________________
           •   Pudding
           •   Tagatose (derived from whey)
           •   Chocolate                                        ___________________________________

                                                                ___________________________________

                                                                ___________________________________

                                                                ___________________________________

Slide 32            Soy Containing Foods                        ___________________________________
                       (GFSFSF Diet)
           •   Gum arabic
           •   Carob                                            ___________________________________
           •   Bulking and emulsifying agents
           •   Miso
           •   Lecithin                                         ___________________________________
           •   MSG
           •   Textured vegetable protein (TVP)
           •   Edamame                                          ___________________________________

                                                                ___________________________________

                                                                ___________________________________

                                                                ___________________________________

Slide 33                                                        ___________________________________
                    Major Food Allergens
           •   Milk                                             ___________________________________
           •   Egg
           •   Fish
           •   Crustacean shellfish                             ___________________________________
           •   Tree nuts
           •   Peanuts
           •   Soybeans                                         ___________________________________

                                                                ___________________________________

                                                                ___________________________________

                                                                ___________________________________
Slide 34                                                                            ___________________________________
                Sweeteners as Excitotoxins
           •   Aspartame (NutraSweet, Equal, Spoonful)                              ___________________________________
           •   Sucralose (Splenda = chlorinated sugar)
           •   Acesulfame K (Sunnette)
           •   High fructose corn syrup (Dufault et al. 2009,                       ___________________________________
               NFOW Feb. 16, 2009)



                                                                                    ___________________________________

                                                                                    ___________________________________

                                                                                    ___________________________________

                                                                                    ___________________________________

Slide 35                                                                            ___________________________________
                 Specific Carbohydrate Diet
           • Eliminates complex sugars and starches                                 ___________________________________
           • Uses simple sugars (monosaccharides)
           • Consists of meats, fish, eggs, vegetables,
             fruits, nuts, and seeds
                                                                                    ___________________________________
           • Used to control yeast overgrowth
           • Symptoms include chronic diarrhea,
             constipation
           • Originally used for IBS and Crohn’s
                                                                                    ___________________________________

                                                                                    ___________________________________

                                                                                    ___________________________________

                                                                                    ___________________________________

Slide 36                                                                            ___________________________________
                    Introducing New Foods
           •   Concentrate on one food at a time                                    ___________________________________
           •   Introduce one bite of same food – 2 weeks
           •   Give child a choice on only 2 foods to try
           •   Choose for them if they will not                                     ___________________________________
           •   Offer choices similar to what they have
               been eating.
                                                                                    ___________________________________
                                            Kelly Dorfman MS, DAN conference Long
                                                       Beach CA 10/09/10




                                                                                    ___________________________________

                                                                                    ___________________________________

                                                                                    ___________________________________
Slide 37                                                                          ___________________________________
                          When:Then
           • Your child is stuck; not bad                                         ___________________________________
           • Cannot development to move if no reason
             or consequence
           • Key is to stay calm; provide safe constant
             structure
                                                                                  ___________________________________
           • When . . . (you finish your carrot): Then . .
             (we can finish our video game)
                                                                                  ___________________________________
                                          Kelly Dorfman MS, DAN conference Long
                                                     Beach CA 10/09/10




                                                                                  ___________________________________

                                                                                  ___________________________________

                                                                                  ___________________________________

Slide 38                                                                          ___________________________________

               Thank You for Attending and
                                                                                  ___________________________________
                your child thanks you too!
                     Next month, November 15th
                 The Autism Spectrum IV – Food                                    ___________________________________
                Sensitivity Challenge, Overcoming
                        Nutritional Deficits
                    www.marciazimmerman.com
                                                                                  ___________________________________

                                                                                  ___________________________________

                                                                                  ___________________________________

                                                                                  ___________________________________

Slide 39                 Picky Eaters                                             ___________________________________
           • Address oral motor/sensory issues
           • Assume you will be successful
           • Explain expectations in simple terms
                                                                                  ___________________________________
           • Offer 2 choices of how to accomplish goal
           • Control your response – give yourself time
             out if child unravels
                                                                                  ___________________________________
           • All feedback is positive
           • Natural consequences of child
             uncooperative
                                                                                  ___________________________________
                                          Kelly Dorfman MS, ARI conference Long
                                                    Beach CA 10/09/10




                                                                                  ___________________________________

                                                                                  ___________________________________

                                                                                  ___________________________________

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:28
posted:10/2/2011
language:English
pages:13