May 4

Autism and the Glycemic Index

“Autism, or autism spectrum disorder, refers to a range of conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication, as well as by unique strengths and differences. We now know that there is not one autism but many types, caused by different combinations of genetic and environmental influences.” —Autism Speaks

I’m on the autistic spectrum. As a child, I was hopeless in social situations, always saying the wrong thing and unable to read body language. I also grew up on Tang, Frosted Flakes, Milky Way bars, and Kool-Aid. In my late twenties, I cut sugar out of my diet because I found that when I ate sugar, I couldn’t talk. It was like my brain locked up and wouldn’t process input. Recently, I ate a muffin that had a reduced amount of sugar in it. Within minutes, I began stuttering and floundering for words. This was during a discussion in a seminary class, so the timing was poor.

Is there a link between autism symptoms and sugar intake? A 2015 study suggests there is, and anecdotal stories from parents of autistic children abound. Other parents of ASD kids say their kids aren’t affected–and maybe they aren’t, though often the parents say their kids don’t “get hyperactive” from sugar. My own experience indicates that hyperactivity is not the only visible response. From the outside, I look like I’ve been sedated after I eat sugar. Someone who didn’t know better might think this is a good thing. But inside, I’m churning, trying unsuccessfully to process and respond to the stimulus coming in. It’s miserable.

But I do like something sweet now and again. Can you imagine going through life never having another dessert? Sugar-free commercial products are an option, though almost all contain artificial sweeteners, which I try to avoid. And the ones with sugar alcohols (like sorbitol and maltitol)– well, I won’t gross you out by describing the intestinal symptoms they cause me.

For home-baking, stevia is an option. It’s a natural plant extract with no sugars and no calories, but it’s a little too sweet and has a weird aftertaste when used alone. Stevia requires just a tiny amount, so it doesn’t bulk up a recipe like sugar does. That doesn’t matter if you’re sweetening fruit, but a cake requires the bulk and consistency of sugar to come out right. Ask me how I know. There is a 1:1 stevia product, which is stevia mixed with maltodextrin so it performs in recipes like sugar. The only store I’ve found in my area that carries it is Walmart. Amazon carries an equivalent, Stevia in the Raw, which is a bit more expensive but delivered to your door. Like stevia itself, I find the 1:1 mix has that weird aftertaste.

(Also beware of baking mixes that contain stevia and sugar, like Truvia or SugarLeaf for example, because they sort of defeat the purpose.)

So what’s the answer?

Enter the glycemic index.

“The Glycemic Index (GI) is a relative ranking of carbohydrate in foods according to how they affect blood glucose levels.” —University of Sydney

In other words, the higher the glycemic index ranking, the faster the food item causes blood sugar to rise. Glucose is rated 100. The Glycemic Index website recommends a rating of 55 or less for general health. A Harvard website ranks table sugar (sucrose) at 65, honey at 61, and fructose at 15. Clearly fructose is better for those sensitive to sugar. (Studies have shown that excessive use of fructose can raise triglyceride levels, particularly in men, so it’s not something one should eat all the time.)

The other day I was looking at a carrot cake recipe that called for a total of four cups of sugar (including the cream cheese frosting). Even using fructose, that’s a lot of sugar. But it’s easy to cut that in half while still making the recipe work. I use half fructose and half 1:1 stevia. The stevia provides sweetness with no calories or glycemic effect, and the fructose is a slow-absorbing sugar that moderates the flavor of stevia. I see the 50/50 mix as a “best of both worlds” approach.

In the frosting, I substituted neufchatel for cream cheese. That’s just a lower-fat version made with milk instead of cream. I did that not because I’m autistic, but because I’m trying to eat healthier. I also added an extra package of cream cheese to the frosting to increase the protein and further cut back on the sugar concentration. I also thought the cake might need more frosting than the recipe called for, as is sometimes the case, but I had frosting left over.

Herein lies another helpful hint: A lot of recipes can be modified a little, or sometimes a lot, to reduce the sugar content. For pies, the volume of sweetener can be cut in half and a 50/50 stevia-fructose combination can be used instead. So if your pie calls for 1 cup of sugar, skip the sugar completely and try it with 1/4 cup 1:1 stevia and 1/4 cup fructose instead. Imagine: where a recipe calls for a whole cup of brain-scrambling sugar, you may find it works just as well with 1/4 cup of slow-absorbing fructose bolstered with stevia.

If my experience is any indication, your autistic loved will thank you!

 

April 16

Thoughts on the Resurrection

Sometimes skeptics ask me if I believe in the literal Resurrection– that Jesus’ body actually came back to life on the third day after he was executed. Here’s the honest truth: I’m autistic, and I have trouble believing things I haven’t seen. I used to look at the Resurrection as figurative, symbolic of the idea that death is not the end, and that the Spirit of Christ is still among us even after his death. (Why did the people who had traveled with Jesus for three years fail to recognize him at the tomb, John 20:14, and on the road to Emmaus, Luke 24:15-16, for example?)

Lately, though, I’m inclined to take the Resurrection more literally. Why? Let me tell you a story…

About ten years ago, when we were raising goats and making cheese, we had a goat named Wind. She was one of the first two goats we bought, and she was a real character. But because of her breeding (part Nigerian), she tended to have kids that were too big for her. The first year, she threw a kid we named Luna, who was born with her front legs all curled up. She started life walking on her elbows. We splinted her, and her legs straightened out, and she grew up to be the strongest goat in the yard.

Wind with her fist kid, Luna, before splinting.
Luna in splints.

The second year, Wind got toxemia. Her legs swelled up to where she couldn’t even stand. We made a sling to keep her from having to lie on the ground all the time, but it was clear she wasn’t doing well. As her due date approached, in consultation with our vet, we decided to induce labor so she could (hopefully) deliver her kids and get healthy again. She went into labor, but she didn’t dilate. The contractions weakened her, and we finally decided we had to take stronger measures. About midnight one night, I began massaging her cervix according to directions my wife found on the internet. By 4:00 am my fingers were exhausted, but her cervix had finally dilated enough for the first kid to come out. It was a boy, and he was born alive and breathing, but died within minutes. This was our first loss, and it hurt–especially before dawn after several sleepless nights.

Wind in a sling.

The second kid was born soon after, a girl, but she wasn’t breathing. Something came over me, and I somehow knew “This one will live.” I rubbed her down, swung her around by her feet to clear her lungs, and then breathed into her nose and mouth.

She began breathing.

Brisa was born not breathing on April 6, 2009.

We “bumped” Wind to see if she had any more kids in her, but didn’t feel any. Wind wasn’t producing milk, so we put one of the other recent mothers in the milking stand so the baby could nurse and get colostrum. Then we went to bed.

The next night, Wind developed a high fever. The vet came out and discovered that she did indeed have one more kid in her, but it was dead and had gone septic. She removed the dead kid– our second loss– and treated Wind for infection. We tended Wind night and day, but she was just too weak to recover. As her body temperature dropped, I lay down next to her with a blanket over us both, but there was nothing to be done. At about 3:00 am, we called the vet and told her, “We’re losing her!” Ten minutes later, we called the vet and told her to go back t sleep. Wind was gone, having died in our arms.

But her one kid, the one born not breathing, survived. We named her Brisa (“little wind”). She grew up to be the best milker we ever had, producing twice as much as our next best milker. At eight years old, she’s still going strong, and is now living at Red Acre Farm, where I’m told she delivered two healthy kids this year. (Luna is also there with her.)

Brisa as a doeling. She become our best milker.

What does this have to do with the Resurrection?

Any goat farmer will tell you that a kid not breathing isn’t going to survive. But Brisa did.

One day it occurred to me: If God can do that through my hands, who am I to say what he can’t do?

I still have trouble believing in what I haven’t seen. But I’m no longer going to say it didn’t happen.

 

February 20

Enter Autism

I’ve posted in the past (here and here) about my struggles with mental health. During my adult life, I’ve been diagnosed with anxiety disorder, attention deficit disorder, obsessive compulsive personality disorder, major depressive disorder, bipolar, and psychotic episodes. All of these conditions “required” medication, which in every case made the problem worse. (Not to mention ten years of self-medication with alcohol, cocaine, and opiates, which nearly killed me.)

A year ago, our toddler (then 18 months old) was diagnosed with autism. It was too early then to assign a severity; he’s now been diagnosed Level 2 & 3– pretty severe. At the time, neither my wife nor I knew anything about autism.

My wife is quite the researcher, so she went to work. She would come back with these “revelations.”

Her: “Did you know that people with autism often can’t see faces?”

Me: “Wait, I can’t see faces.”

Her: “No, I mean they can’t read nonverbal cues, like even body language.”

Me: “Yeah, I can’t read body language.”

Her: “Did you know that people with autism often see the world in patterns or pictures?”

Me: “Um, that’s not normal?”

The more she learned the more I realized that there was something going on with me that I had never realized. In fact, I have most of the symptoms of autism (though some of them I’ve learned to manage fairly well).

For example, I’m face-blind. I recognize people by their voices, shapes, contexts, and hairstyles. I don’t read nonverbal cues. I have trouble identifying and expressing my emotions. I don’t read emotions well in others. I’m extremely sensitive to audio and visual chaos. (My wife says that what I call “chaos,” most people call normal sensory input.) I struggle with being aware of social appropriateness– I have a tendency to say the wrong thing at the wrong time and have no idea why it’s inappropriate. I tend to understand verbal expressions literally. (“Look at my face!” “OK, I did.”) I have no idea how to navigate a conversation with more than one person at a time.

It’s better now than it was when I was a child. I’ve learned to compensate in basic social situations. Still, when I read the DSM-V description of communications difficulties, I felt like they were writing about me:

A.      Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive, see text):

1.       Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.

2.       Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.

3.       Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

I remember, when I was in elementary school, planning out conversations before I approached someone. I would think, “I’ll say this, and they’ll say that, and I’ll respond like this…” and so forth. I could never understand why conversations went off the rails or what to do about it. And I couldn’t understand why, in the middle of a softball game, the other kids didn’t want to hear about dinosaurs or math.

And yes, I do have repetitive behaviors, but they’re subtle. I didn’t even realize I was doing them until I learned what “stimming” was. I fidget with my fingers, play computer solitaire, and pace.

My mind sees the world in processes, so I strive to understand why something is true. That makes it difficult for me to learn disconnected facts, like vocabulary or names, but easy to learn grammar and dates. If I can fit it into a “system,” I can learn it. Abstract ideas tend to make my head hurt.

I often look at a situation and see patterns that are not obvious to other people. The most obvious example of this was my response to the civil war in Sri Lanka. It was the most written-abut war since World War II, and yet no one ever seemed to ask what made it tick. To me, that was the obvious question. I spent a year studying, interviewing, and analyzing, and came up with a paradigm that explained the political relationships that drove the war. This became the basis for the Peace Initiative that started in 1999, and eventually led to a Cease Fire Agreement in 2002 that lasted for six years.

I think this helps me be a good writer. I “see” the story that I’m writing before I begin. I may not have all the pieces yet, but I know where it needs to go. And I can see how the plot elements contribute to the whole (and what’s missing).

As I’m learning, autism offers challenges that have greatly affected my life. My adolescence was an extremely painful experience of isolation and feeling different from everyone else.

But it also offers some unusual benefits. I see the world differently than most other people, and that means I have something unique to offer.