In the past two days, I’ve had two e-mails from the Food for the Brain (FFTB) e-mail list, advertising a seminar by Michael Ash on ‘The Gut Brain link in Autism, Depression and Mental Health’. They certainly seem keen to encourage attendance, and at £49 for the seminar, I can understand why bookings might be a little sparse. Naturally, as FFTB are so keen to promote Ash’s speech, I thought I’d look at some of his previous work on these subjects. What seemed especially notable was Ash’s role in Nutri Link: a “Practitioner Group” which offers information on a dizzying range of interventions for children on the autistic spectrum.
A first thing to note about Nutri Link’s ‘Information for Parents’ document [PDF link] on treatments for Autistic Spectrum Disorders (ASDs) is that it is explicitly aimed at parents and carers. One wonders why – is the Nutri Link treatment meant to ‘cure’ those with ASDs before they reach adulthood? Or would adults on the autistic spectrum be unlikely to appreciate the type of interventions suggested?
A second thing to note is how many interventions are suggested. There are seven pages of relatively dense text, suggesting a dizzying range of things to do to children with ASDs. As the author(s) of the document are clearly aware, they suggest that children with ASDs take so many supplements that it will be hard to get all these pills and powders down their throats. To deal with this, they suggest (p.6) that carers
o Blend drinks
o Divide doses during day
o Small capsules can be swallowed from age 5.
o Tip the child’s head face down and the capsules
will float to the back of the throat to swallow.
I find this slightly disturbing in itself. If these were evidence-based interventions, this might be worth a try. However, I have looked for evidence that taking all these pills is useful: for most of the supplements recommended, I could not find good evidence of efficacy (or find anywhere where Ash provides references).
I won’t be able to address all my concerns about this document here: that would take far too long. However, I should also note that one can see what Holford (who is introducing Ash at the aforementioned seminar) approves of his work. Holford and Nutri Link hold a number of shared beliefs (many of which have already been critiqued on Holford Watch and elsewhere). For example, both believe – contrary to the evidence – that secretin is an autism treatment worth considering (p. 5), that hair mineral analysis is worthwhile (p. 2), and that IgG blood tests are valuable (p. 4). Nutri Link, of course, adds many problematic treatment suggestions of their own; I might come back to look at these another day.
Given the number of – in some cases pretty radical – interventions proposed, I find it especially worrying that Ash states that “[i]n many cases it is not necessary for you to actually attend a practice as a treatment plan can be undertaken through e mail and telephone consultations.” I feel that some of these treatments – for example, the gluten free casein free diet that Nutri Link recommends, or the dairy-free diet that is recommended for all children with ASDs (p. 2-3) – should be carried out under competant medical supervision (in order to avoid, for example, the failure to thrive that such diets can cause if badly implemented). When vulnerable children are involved, I just don’t think that e-mail or telephone consultations (often with ‘healthcare practitioners such as nutritionists, who may be operating without adequate qualifications or regulation) is good enough.
While I haven’t yet had time to look at much of Ash’s work – more posts on this will follow – I would argue that his role with Nutri Link raises a number of troubling questions. It would be tempting to raise some of these questions at Ash’s September seminar, but I don’t want to spring for the £49 fee.