Yes, you read the title of this blog correctly. My colleague Katrina forwarded me an article with this headline: Broccoli Extract May Reduce Autism Symptoms. Being the discerning parent/provider that I am, I thought it was just another wacky autism-treatment idea so I didn’t run out to buy a boatload of broccoli, but I did go to one of my most trusted sources for all things autism to get his read on things. Here’s what the good doctor Raphe Bernier had to say.
Lynn: Tell us Dr. Bernier, what is your first impression of this study?
Dr. Bernier: Well, many of the intervention studies in autism have methodological flaws that make drawing conclusions difficult. This makes sense, conducting studies is costly and difficult. I’m not excusing, just explaining. However, this study addresses many of those methodological flaws: there is random assignment to a treatment or control group, there is a placebo condition, there are outcome ratings that are judged by raters who are naïve to group membership to reduce bias. In addition, standardized, well-used measures were employed pre and post intervention and there was follow up after the removal of the intervention. All of these things are important to make sure we can draw appropriate conclusions from the study.
Lynn: What did this study look at?
Dr. Bernier: This was a small study that looked at boys/men with autism between 13-27 years of age. For 18 weeks, 26 of the participants received sulforaphane (a broccoli extract) while the remaining 14 participants received a placebo.
Lynn: What led them to want to study this broccoli compound as a treatment for autism?
Dr. Bernier: Well, as a starting point the authors were focused on the reported finding that some individuals with autism show a slight reduction in symptoms during a fever. So, the authors used a treatment that might build on that finding. The particular compound the authors used regulates the heat-shock response similar to when one has a fever. So, in essence, they were trying to mimic the effects that a fever has on autism symptoms in some individuals. Oh, and also the compound has reported low toxicity. Considering side effects and harmful effects of treatment is important.
Lynn: What did the researchers find in this study?
Dr. Bernier: Well, they found overall improvements in ASD symptoms for individuals in this small sample receiving the treatment but did not see a change in the small group receiving the placebo.
Lynn: What do you make of the findings? Any caveats for parents eager for new treatments?
Dr. Bernier: Yes. Here are some things to keep in mind:
- So, 80% of the study sample reportedly showed improvement during fevers prior to participating in the study. This is relevant in that the improvements may not generalize to others with autism who do not have the “fever response.”
- This is also very important. While there were gains on average for the broccoli extract group, a third of the individuals receiving the treatment did not show improvement. That is, the improvement in the 2/3 who did respond to the treatment accounted for the group’s improvement.
- Two of the kids in the treatment group had seizures during the course of the treatment. They had seizures prior to treatment but none of the control group had seizures, so just something to think about.
- While this particular broccoli compound, sulforaphane, is not commercially available, there are supplements out there, but they are not monitored or regulated so it’s unclear what sort of dosage is being consumed.
- A final thing to note is that the institution where the scientists work are entitled to royalties from the sale of the extract that is used in the study, so just something to think about.
Lynn: What is the take-home message then?
Dr. Bernier: The take-home is that this is an important preliminary study because the authors employed a lot of methodological rigor that is needed for intervention studies. It’s only the first one and so replication is absolutely needed before any conclusions can be drawn, but it shows potential promise for at least a sub-sample of individuals with ASD. The other take home is that when mom says eat your broccoli…I guess mom is right.
Lynn: Isn’t she always?
Dr. Bernier: Of course!
References:
Sulforaphane treatment of autism spectrum disorder (ASD).
Singh K, Connors SL, Macklin EA, Smith KD, Fahey JW, Talalay P, Zimmerman AW.
Proc Natl Acad Sci U S A. 2014 Oct 13. pii: 201416940. [Epub ahead of print]
Behaviors associated with fever in children with autism spectrum disorders.
Curran LK, Newschaffer CJ, Lee LC, Crawford SO, Johnston MV, Zimmerman AW.
Pediatrics. 2007 Dec;120(6):e1386-92.
This analysis is EXELLENT, it really breaks it down for you. I think the important points are that the group was selected from those who had shown improved symptoms from a fever (this isn’t true for all autistic children) , that the compound isn’t readily available, and that the researchers may stand to benefit from the sale of this supplement.
I think we need to do more of this type of analysis for all autism research. There’s a few really good analysises of studies on autism here: http://www.truthlyapp.com/popular?timeframe=month but I think we need more.
I wonder if adding cheese sauce to the broccoli detracts from its effectiveness.
Thank you for such a nice, simple breakdown of the methodology of this study. I feel it’s so important to educate the public on what makes a study rigorous, what conclusions you can justifiably draw vs. the ‘grains of salt’, etc, and this gives a lovely introduction to that type of critical thinking. Well done!
For those with ASD, a snapshot: You can’t eat enough broccoli to get the desired effect and more testing needs to be done on the safeness of the supplement at these levels.