As many of you know, my three-year old son has been dealing with a host of developmental delays and sensory issues for the past year or more. He has speech and/or occupational therapy three days a week, and is making progress a little at a time. We also started giving Nolan cod liver oil and raw dairy for their nutritional benefits, and visited a DAN!-trained naturopath in June to learn more about what sorts of supplements and natural treatments might be most helpful to a little boy on the autism spectrum. The tests he ordered—hair, urine, and blood—took several months to obtain samples for, but we finally got back the last of our results this past week, and had a very interesting conversation with the naturopath about what they could mean for Nolan.

Chicken stirfry with tahini and oyster sauce (both rich in zinc), over soaked brown rice

The hair test checked for heavy metal toxicity and mineral deficiencies. Nolan tested high for antimony, which is not especially surprising since the fire retardants sprayed all over children’s clothes, bedding etc. are full of antimony; we were told that this level will likely even out as Nolan gets older, and isn’t too worrisome. He has no problems with aluminum, lead, or mercury, which can cause developmental delays in high concentrations. Thanks to the cod liver oil and raw milk, his vitamin-D level is high normal, so we will actually need to ease back on those somewhat.

On the deficiency side, Nolan is lacking in calcium, magnesium, iron and zinc; the blood tests confirmed that he is both zinc-deficient and has iron-deficiency anemia. This is much more problematic, and is likely caused by a combination of poor absorption and a poor diet—Nolan has gotten increasingly picky since we moved to Colorado, and eats very little meat despite our encouragement. Although I was able to sneak vitamins into his morning smoothie for several months, he has started refusing to drink them and now views even plain milk with a suspicious eye.

Sourdough cheese pizza with sauce of ground beef, spinach and tahini

Consider for a moment just how hard it is to hide supplements and non-preferred nutritious ingredients in the diet of a child who rejects most meats, nearly all mushy foods, and all drinks except water. Since Nolan likes cheese pizza, I tried making one with a whole wheat sourdough crust with toasted wheat germ (for zinc), and doctored up the sauce with finely ground beef (iron), spinach (iron) and tahini (zinc). He ate all the crust and a few bites of the pizza itself, not nearly enough to get a full serving of beef or sufficient doses of iron and zinc. We broke down and bought a liquid iron supplement that contains whole foods, mostly juices like grape, but I have to force it into Nolan’s mouth with an eyedropper—traumatic for all involved. He has also so far rejected the orange-flavored gummy multi-vitamins and omega-3 fishies we purchased to assist his iron absorption and D-free DHA.

On top of these nutritional deficits, the urine test revealed that Nolan was excreting casomorphin opioid peptides, which means that his body is treating the casein in dairy products like an opiate. This does not mean that Nolan is lactose-intolerant; his trouble is not lactase production, but the lack of another digestive enzyme. Thus, rather than eliminating dairy altogether (along with its healthy fats, proteins, and vitamins), we have opted to start Nolan on a DPP-IV enzyme therapy that will help his body compensate for the digestive malfunction. Yes, something else to try to sneak into his diet on a daily basis—with every meal, no less! We are very much looking forward to seeing whether this will positively impact Nolan’s behavior regarding everything from his sense-seeking needs, lack of attention to auditory stimulus, uncertain balance, and even his general lack of curiosity about the world around him! Our naturopath suggested that the enzyme treatment has been so successful with similar autistic patients in the past that he never sees them again except for refills.

Of course, providing a digestive enzyme is no reason to expose Nolan to unnecessarily high levels of casein beyond the nutritional powerhouses of raw milk and dairy, so I will be checking our food labels even more closely now than I have in the past, seeking out dairy-free options among our grocery store purchases—who needs a box of granola containing powdered skim milk that is all casein and oxydized cholesterol, when I can make it dairy-free at home? Looking for the pareve label will be particularly helpful, I suspect. I will probably also put ghee on the list of pantry essentials since clarifying renders it casein-free, and bring home some local goat’s milk and cheese from the farmer’s market to see if Nolan will tolerate its flavor, since the casein in goat’s milk is less problematic for digestion.

Soaking containers of pumpkinseeds and brown rice, next to homemade coconut butter and LF pickled eggs

All this talk of enzymes and supplements does not mean I am going to compromise the way I cook for my family. I am more determined than ever to follow traditional real food methods in the kitchen because they improve digestibility and nutrient absorption. In fact, as I was researching whole food sources of iron, I came across a tidbit I know I have read several times but had forgotten: the phytic acid in grains, legumes, seeds, and nuts binds up nutrients like iron, zinc, calcium and magnesium, preventing them from being absorbed by your body.

Seeing that list of everything Nolan’s diet is lacking was like a slap to the face! The vast majority of his preferred foods are carbs and nuts, and now that I know he doesn’t have trouble digesting gluten, I can soak and/or sprout all of these items to increase the bioavailability of nutrients my little guy needs before I even consider ways to sneak supplements into his food. It is such an elegant, natural solution to some of our concerns, really an answer to prayer, and it was the final nudge I needed to put it into practice after a year of hemming and hawing.

Brown rice, after 24 hours of soaking

Soaking grains will definitely take some getting used to, since I am not good at pre-planning meals like some people are, but I feel like I have done quite a bit in the past week already. I tried soaking short grain brown rice with whey and saving the soaking water as an inoculant for the next batch; that seems to work well and gave me some very satisfying bubbles as proof of fermentation. I also made some soaked blueberry muffins for breakfast one day, using white whole wheat flour and almond milk; the results tasted pretty good fresh from the oven (if a little under-sweet for our tastes) but they were so tough and leathery by the next day that I couldn’t choke one down. I got some raw pumpkinseeds to make granola bars for Nolan, being rich in zinc; they have been soaked in salt water and dehydrated again, ready to use. And of course I have been nurturing my whole wheat sourdough starter: yesterday I made an enormous batch of sourdough oatmeal sandwich bread with soaked oats.

There are always going to be occasions when I just don’t have time to wait for something to soak. Pre-sprouted grains and legumes will not be hard to come by: I can do it myself during downtime and then throw the germinated seeds in the dehydrator for storage, or purchase a variety of different options in the bulk bins at Whole Foods. Sprouted flours are harder to come by and expensive to order due to their weight, and I don’t own a grain grinder yet to make it myself, but I was able to find a small bag of sprouted wheat flour from Arrowhead Mills, something like two pounds. The way I bake, that is just a drop in the bucket.

As I explored further options, I came across this very informative post at The Nourishing Gourmet, sharing lots of good information about phytic acid and the effects of soaking, sprouting and fermenting on various grains. One study suggested that sprouted flour could be used in small amounts (a 1:10 ratio, or less, of sprouted to unsprouted) to inoculate non-sprouted flour with activated phytase. Shaking up the flour every so often and keeping it in a warm environment (86F), they were able to reduce phytic acid by an astounding 98% in just two hours! Following this lead, I now keep a container of flour that has been inoculated in a similar manner, replacing 1-2 T from every cup of all-purpose or whole wheat flour with the same amount of sprouted flour; I can keep it on the stovetop while I am baking, for warmth and a visual reminder to shake up the jar every so often. Of course, I have no way of testing the phytic acid levels or the bioavailability of nutrients, but at the very least, even my basic all-purpose flour has some sprouted grain included now, for those inevitable occasions when I don’t have time to soak, as when I made zucchini spaetzle a few nights back.

Well, that was quite a tome. And be prepared to see a lot more references around here to soaking, casein-free foods, and foods rich in iron or zinc—most of my thoughts right now are revolving around how to get Nolan’s deficiencies amended without traumatizing the poor kid and destroying his already fragile relationship with food. I’ll be sure to post updates if we see noticeable improvements in his physical well-being, sensory needs, and social interactions. Wish us luck!

Update 8/30/11: I have been busy figuring out ways to incorporate Nolan’s dietary enzyme powder into each of his meals. Removed from the capsule, it is a gray powder that mostly just tastes like dust. We started by stirring it into peanut butter, which gives the latter a slightly dingy cast and doesn’t affect flavor, but but we can’t give Nolan a PB sandwich for every meal. Justin’s Chocolate Hazelnut spread is a nice change of pace that does’t contain dairy like Nutella; it also fills a gap since hazelnuts are more expensive in Colorado than Oregon. Short of nut-based spreads, any thick spread seems to work just fine; we have used butter and/or honey successfully, and if Nolan liked jam more, it would be perfect as well. I have even stirred it into his milk a few times, which seems counter-intuitive, but seems to work alright; it clumps up a little, but we add a little chocolate syrup to cover the taste and put it in a sippy.

My most exciting discovery, however, was the fact that I can actually hide Nolan’s enzyme in candy! He loves marzipan, which is mostly almonds, and when I am kneading in goodies like dried fruit and spices, I can also incorporate doses of enzyme. They aren’t ever heated, and end up being quite firm, not a sticky mess—once I try adding the soaking component to the almonds, they may be the perfect enzyme delivery system! In addition, I can make doctored chocolate bark by melting dark chocolate at low temps (80-90F), dosing a tablespoon or so at a time with enzyme, spreading onto waxed paper, and loading it up with goodies Nolan likes: raisins and other dried fruit, chopped nuts, coconut, etc. My next enzyme “candy” will be non-baked or dehydrated chewy granola bars, one of Nolan’s favorite snacks, and if he ever shows interest in chewy fruit snacks like leathers, I can stir Serenaid into the puree and dehydrate it at a low enough temp not to damage the enzyme.

Update 9/2/11: I made no-bake granola bars with soaked and dehydrated oats, soaked pumpkinseeds (a good source of zinc), walnuts, puffed brown rice, and a butter-honey syrup; the amount I made filled two wax-paper lined loaf pans, and I made 6 freeform bars, each incorporating a diced-up omega-3 gummy fish. If I had thought of it, I might have added some toasted wheat germ and chia seeds as well.