Autism and diet

Here are resources for the 2020-21 Global Autism Summit presentation by Sue Dengate

22 min video presentation where Sue Dengate summarises latest research on food and autism for the Global Autism Summit - see references below


Free gifts

Booklets: Ethan's recipes and Failsafe eating (pdf)

Fed Up with Children’s Behaviour  Sue Dengate's famous personal presentation about the effects of food on children's health, learning and behaviour (1hr 12mins) FREE on Youtube!


flagUK English subtitles

flagDutch Dutch subtitles

flagFrench French subtitles

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flagItalian Italian subtitles

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Buy the DVD if you want an extra hour of entertaining and insightful bonus material of an advanced workshop, behaviour management and interviews with parents in depth, plus subtitles in 6 languages ($A25.50 posted in Australia; NTSC version available).

BlogteenJ Jemma, a teenager with autism and depression, speaks about "massive improvements" using failsafe eating (9:25)

Scientific references

1. Scientists do not agree about diets for autism

Sathe N et al, Nutritional and Dietary Interventions for Autism Spectrum Disorder: A Systematic Review, Pediatrics. 2017 Jun;139(6):e20170346.  “There is little evidence to support the use of nutritional supplements or dietary therapies for children with ASD”

Peretti S et al, Diet: the keystone of autism spectrum disorder? Nutr Neurosci. 2019;22(12):825-839.  “…the role of maternal diet during gestation and diet of ASD children as modifiable risk factors at the base of development or worsening of symptoms of autism”

Piwowarczyk A et al, Gluten- and casein-free diet and autism spectrum disorders in children: a systematic review, Eur J Nutr. 2018 Mar;57(2):433-440.  “Overall, there is little evidence that a GFCF diet is beneficial for the symptoms of ASD in children”

Omnia El-Rashidy et al, Ketogenic diet versus gluten free casein free diet in autistic children: a case-control study, Metab Brain Dis. 2017 Dec;32(6):1935-1941. “…modified Atkins diet and gluten free casein free diet regimens may safely improve autistic manifestations and could be recommended for children with ASD”

2. From the video Fed Up with Children’s Behaviour

3. Increasing prevalence of autism

1 in 54 according to Centers for Disease Control and Prevention, Data and Statistics on ASD - accessed Feb 2021

1 in 35 for New Jersey pre-schoolers CDC Morbidity and Mortality Weekly Report Surveillance Summaries: Shaw KA et al, Early Identification of Autism Spectrum Disorder Among Children Aged 4 Years - Early Autism and Developmental Disabilities Monitoring Network, Six Sites, United States, 2016, MMWR Surveill Summ, 2020 Mar 27;69(3):1-11.

These New Jersey preschoolers have the highest autism rates ever measured in the US. New Jersey is the most densely populated state in the US and urbanicity has been related to autism - Lauritsen MB et al, Urbanicity and Autism Spectrum Disorders, J Autism Dev Disord. 2014 Feb; 44(2): 394–404.

City living and high population density has also been related to consumption of ultra-processed foods - Elizabeth L et al, Ultra-Processed Foods and Health Outcomes: A Narrative Review , Nutrients, 2020 Jun 30;12(7):1955.

4. Animal model of autism

MacFabe DF et al. Neurobiological effects of intraventricular propionic acid in rats: possible role of short chain fatty acids on the pathogenesis and characteristics of autism spectrum disorders. Behav Brain Res. 2007 Jan 10;176(1):149-69.

Lobzhanidze G et al, Behavioural and brain ultrastructural changes following the systemic administration of propionic acid in adolescent male rats, Further development of a rodent model of autism, Int J Dev Neurosci, 2020 Apr;80(2):139-156.

5.  From The Autism Enigma documentary video, 2011,

7. Propionate preservatives in common foods -

9. Autism prevalence in China - Sun X et al, Autism prevalence in China is comparable to Western prevalence Mol Autism. 2019 Feb 28;10:7.

11. Behavioural effects of propionate preservative

S Dengate, A Ruben, Controlled trial of cumulative behavioural effects of a common bread preservative, J Paediatr Child Health, 2002,Aug;38(4):373-6.   

OBJECTIVE: Many anecdotes and one scientific report describe cumulative behavioural effects of bread preservative on children. METHODOLOGY: Twenty-seven children, whose behaviour improved significantly on the Royal Prince Alfred Hospital diet, which excludes food additives, natural salicylates, amines and glutamates, were challenged with calcium propionate (preservative code 282) or placebo through daily bread in a double-blind placebo-controlled crossover trial. RESULTS: Due to four placebo responders, there was no significant difference by ANOVA of weighted placebo and challenge Rowe Behaviour Rating Inventory means, but a statistically significant difference existed in the proportion of children whose behaviours 'worsened' with challenge (52%), compared to the proportion whose behaviour 'improved' with challenge (19%), relative to placebo (95% confidence intervals 14-60%). CONCLUSIONS: Irritability, restlessness, inattention and sleep disturbance in some children may be caused by a preservative in healthy foods consumed daily. Minimizing the concentrations added to processed foods would reduce adverse reactions. Testing for behavioural toxicity should be included in food additive safety evaluation   Download this paper (6Mb pdf)

Children’s behavioural reactions to propionic acid had already been reported in Swain et al, Salicylates, oligoantigenic diets, and behaviour, Lancet, 1985;2(8445):41-2. 

13. Effects of propionate preservative in breastmilk  - from report 1594

14. “My 3yo son was going to be assessed for autistic disorders …but since taking him off all commercial bread, the change in 4 months has been amazing …”  from report 357

15. Not just children – “On diet, my ex-husband [Aspergers] was a lot more emotionally and socially connected … bread with 282 was his major addiction” – from report 1231

16. Propionates linked to autistic-type changes in brain cells

Abdelli A et al, Propionic Acid Induces Gliosis and Neuro-inflammation through Modulation of PTEN/AKT Pathway in Autism Spectrum Disorder, Sci Rep. 2019 Jun 19;9(1):8824.

…as well as weight gain, diabetes and Alzheimer’s Disease, all conditions that occur more frequently in autistics

Tirosh A et al, The short-chain fatty acid propionate increases glucagon and FABP4 production, impairing insulin action in mice and humans, Sci Transl Med. 2019 Apr 24;11(489):eaav0120. Quote: chronic consumption of propionate leading to an increase in insulin levels might in turn lead to an increase in food intake, weight gain, and insulin resistance

Killingsworth J, Propionate and Alzheimer's Disease, Front Aging Neurosci. 2021 Jan 11;12:580001.

17. "Trickers" - “Almost all the bread in the UK has 282 in it. They call it calcium propionate and everyone thinks it's calcium. Trickers!!!” – from report 381

18. “Clean label” – the food industry is now working to hide these additives by removing chemical names and numbers - and instead using innocent-sounding ingredients such as cultured or fermented dextrose/whey/wheat flour/rice flour or anything with a claim of “all natural” or “no artificial preservatives” as suggested by Bonita Glatz, professor of food science at Iowa State University  (below) BUT it is exactly the same chemical with the same effects.

Glatz, B. "The classical propionibacteria: their past, present and future as industrial organisms" American Society for Microbiology News, 1992, vol 58, no 4, 199-200. "The pure acid or propionic salt must be labelled as a preservative when added to a food, thus precluding the use of the desirable term 'all natural' ... Alternatively, the propionibacteria may be grown in a natural medium such as milk or cheese whey and the entire medium ... may be dried and used as a natural preservative". More information  

Asioli D et al, Making sense of the "clean label" trends: A review of consumer food choice behavior and discussion of industry implications, Food Res Int, 2017 Sep;99(Pt 1):58-71.

21. A recent review of 6 GFCF diet studies found “little evidence that a GFCF diet is beneficial”

Piwowarczyk A et al, Gluten- and casein-free diet and autism spectrum disorders in children: a systematic review, Eur J Nutr, 2018 Mar;57(2):433-440. 

22. Effects of artificial colours on children

McCann D et al, Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial. Lancet. 2007;370(9598):1560-7

24. About 50 additives have been identified…

Additives most likely to be a problem, Australian Dept Health and Ageing, National Healthy School Canteens Guidelines, 2011, p43

Additives list with “clean label” names Additives to avoid

27. Dr Benjamin Feingold was the first to link…

Feingold BF, Hyperkinesis and learning disabilities linked to the ingestion of artificial food colours and flavours, J Learn Disabil,1976;9(9):19-27.

29. The diet we support –

In an open trial of a diet free of additives, low in salicylates, amines and glutamates with 140 children, nearly two thirds improved significantly. DBPC challenges showed reactions to salicylates, preservatives, artificial colours, synthetic antioxidants, amines and MSG. Swain et al, Salicylates, oligoantigenic diets, and behaviour, Lancet, 1985;2(8445):41-2.  

Introduction to food intolerance

30. The RPAH diagnostic elimination diet - RPAH elimination diet handbooks, 2021

31. Symptoms that can improve on this diet

Loblay RH and Swain AR "'Food intolerance'. In Wahlqvist ML, Truswell AS, Recent Advances in Clinical Nutrition. London: John Libbey, 1986, pages 169-177.

Reported by failsafers - Autism/Aspergers  success story collection of over 80 reports

35. Environmental chemicals

Slimak K, Reduction of autistic traits following dietary intervention and elimination of exposure to environmental substances, In Proceedings of 2003 international symposium on indoor air quality and health hazards, National Institute of Environmental Health Science USA and Architectural Institute of Japan, January 8-11, 2003, Tokyo, Japan, vol 2, pp206-216. “A broad spectrum of severe and chronic autistic symptoms appear to be …  fully reversible in the proper environment”

37.  “when on FS he was back to all normal development ... (until he had something not on the diet) ….  then he would (literally) be in the corner of the room banging his head on the wall … and no speech at all” – Tallara from report 1231

Further information and support

Introduction to food intolerance

How to start failsafe eating

Failsafe dietitians world-wide

Factsheet Autism, ASD (Autism Spectrum Disorders) & Asperger

Story collection on Autism (52 page pdf, January 2021)