Autism and B-Vitamin Deficiency Linked to Alcohol and
Sugar Intake and the WIC Program
Raymond J Shamberger*
Emeritus Laboratory Director, King James Medical Laboratory
Raymond J Shamberger, FACN, Emeritus Laboratory Director, King
James Medical Laboratory, Kirtland, Ohio 44094, Tel: 440-256-1223; E-mail:
Received:November21,2016 Accepted: December30,2016 Published: January10,2017
Citation: Raymond J Shamberger (2016) Autism and B-Vitamin Deficiency Linked to Alcohol and Sugar Intake and the WIC Program. J Nutrition Health Food Sci 4(6): 1-6.
Objective:The CDC has warned against drinking
while pregnant noting in guidelines this year that no
amount of alcohol is advised. The CDC has also previously
recommended abstention in regard to Fetal Alcohol
Syndrome (FAS) whose alcohol intake varies with
the amount of binge drinking. The objective is to compare
autism rate to alcohol consumption.
Method:The Institute for Health Metrics at Seattle
Washington has listed the average alcohol consumption
for 48 states. For 2009 the autism rates are known and
the average alcohol consumption are listed. In addition,
the alcohol rate is also known for all counties. These
results were compared to previously reported WIC rates
and autism rates that had been previously reported in
the counties of three states.
Results:Comparison of the autism rate to the alcohol
consumption rate showed a strong positive relationship.
In the counties of three states there was also a
strong direct relationship of alcohol consumption to the
autism rate. These counties showed an inverse relationship
to the WIC rates.
Conclusions:The results of a positive correlation
between alcohol consumption and the autism by states
and counties is consistent with the precautions cited by
Autism; Binge Drinking; WIC; Alcohol; Fetal Alcohol and
The rate of autism is increasing 10-15 % per year. The autism
spectral disorder is a group of developmental disabilities that
can cause significant social communication and behavioral challenges.
The cause of autism is unknown. Autism usually appears
in children ages 2-4. The child may have no speech or it might be severely delayed. The children may be socially awkward and
ritualistic behavior may be followed. Some of these symptoms
may appear by the time the baby is about nine months. Boys
have a 4 to 1 chance of developing autism over girls. About 1.5
million children have some form of autism with 500,000 of these
cases under age 21. The cases include several types of autism
including Asperger’s Syndrome, Rett’s syndrome, disintegrative
disorder and pervasive developmental disorder. Some postulated
causes of autism include consumption of certain foods; infectious
disease; heavy metals; solvents; diesel exhaust; phenol plastics;
PCB’s; pesticides; brominated flame retardants; glyphosate applied
to corn and soy; alcohol; smoking; illicit drugs; rainfall;
watching television and vaccines. The vaccine issue was of interest
for awhile because parents became aware of autism around
the time of inoculation. A mercury preservative, thimerosal,
was suspected, but when the mercury was removed the autism
rates seemed to become greater. In addition, there was no
evidence that MMR-Measles, Mumps, and Rubella vaccines increased
autism and the original vaccine study was discredited.
Because of the wide-spread occurrence of autism and its increase
in almost epidemic proportions, some more obvious unexpected
causes may be responsible for the rapidly increasing rate
of autism. The Center for Disease Control and Prevention warns
against drinking while pregnant noting in guidelines this year that
no amount of alcohol consumed is advised during pregnancy no
matter how small. Many doctors recommend that women avoid
alcohol for the entire nine months of pregnancy. The CDC has previously
recommended similar abstention in regard to Fetal Alcohol
Syndrome (FAS) whose concentration varies with the amount
of binge drinking. The reason for possible increased damage is
that the alcohol titer or level can arise to levels which can damage
organs. Binge drinking is a dangerous form of alcohol consumption
which is more prevalent in households with incomes of
$ 75,000. Binge drinking is a pattern of drinking that results in a
blood alcohol concentration (BAC) to 0.08 gram per cent or more.
In the United States  the overall prevalence of binge drinking
was 17.1%. The frequency of binge drinking was 4.4 episodes
per month and the intensity was 7.9 drinks on occasion. The CDC
analyzed data for women and found  10% of pregnant women
used alcohol and about 2% engaged in in binge drinking or fre-quent alcohol Use. About 12.4% reported some binge drinking.
Excessive Alcohol Use
Excess alcohol use, including binge drinking is responsible for
80,000 deaths annually in the United States. Excess drinking
cost the American economy about $ 223.5 billion in 2006. Binge
drinking increases the risk of getting injured or injuring others.
Excess drinking increases the risk of unplanned pregnancies and
the spread of Sexually Transmitted Diseases (STD) due to unprotected
sex. Most may stop drinking when they realize they are
pregnant. Poor dietary habits as well as impaired absorption of
nutrients from the blood stream due to alcohol-induced digestive
changes may lead to vitamin deficiencies. A deficiency of
folic acid can lead to anemia. In emergency room situations folic
acid should be administered usually as a multivitamin for a few
weeks following alcohol withdrawal. Also, thiamine 100 mg daily
should be given for a minimum of 3 days to all patients hospitalized
with alcohol withdrawal. Thiamine, which plays a major role
in energy metabolism is often deficient in people with alcohol dependence.
If thiamine is continuously deficient, then a more serious
deficiency of Wernike-Korsakoff syndrome may arise. This
is characterized by paralysis of certain eye muscles, an abnormal
gait, and severe confusion which might lead to irreversible dementia.
Thiamine should be administered before glucose in any
form is given in order to prevent the depletion of stored thiamine
and the onset of Wernicke-Korsakoff syndrome. Sometimes patients
are brought into the emergency room unconscious and cannot
help with their treatment. If It is suspected that that are intoxicated
they are not given glucose, but instead are administered
a mixture of thiamine and folic acid. Glucose administration in
these cases might be fatal.
Alcohol Intake Problem and Autism
The CDC has compared the average female age 18-44 binge drinking
rate per state  to the autism rate of 8 year olds in that
state. The results showed a direct relationship r=0.360, P< 0.05.
Comparisons of the United States total breast feeding per year
 to the autism rate of 8 year olds for the years 2007 to 2010
showed a direct relationship to autism in the United States. Similar
results have been observed for the years 2000-2004. The data
suggests that some components of breast milk may be deficient in
some nutrient or which may be affected by nutrition. The CDC
(Communicable Disease Center) has stated that 1 in 6 American
adults is a binge drinker.The problem is more widespread
than thought, because alcohol drinking has been linked to car
crashes, violence , STD’s and death. The binge drinker does so
an average of four times per month, sometimes downing eight
drinks at one sitting. Binge drinking is defined as consuming four
or more drinks on one occasion for a women and five or more
drinks for a man. This pattern may bring the BAC level to 0.08%
or more. The rate of binge drinking in the U.S. is the highest in
the world. Despite the U.S. drinking age, binge drinking is the
greatest problem for people under the age of 21. About 50% of
the alcohol is consumed in the United States by adults and about
90% by young people is consumed during a binge drinking sessession.
European binge drinking levels reveal a different trend. In
general, Europeans consume more alcohol than people on other
continents. Drinking in moderation is an important part of European
culture and social interaction. In these countries it is legal
for teenagers older than 16 to enjoy alcohol in the privacy of their
homes. Binge drinking is overwhelmingly absent from most European
cultures. Britain is very high in binge drinking and may be
the binge-drinking capitol of Europe. Britain’s drinking pattern is
different in that its drinkers consume alcohol less regularly than
other European states. When they do drink they may drink the
most at a single sitting. About 12% have reported that they have
consumed up to ten drinks in a single night. English women who
binge drink during the second trimester are more likely to have an
underweight baby or a small gestational weight.  The babies
born underweight have a greater risk of having neonatal complications,
include breathing problems, respiratory infections, hypothermia
and impaired neurodevelopment. In the United States
women  showed a much faster escalation in binge drinking
than men with rates rising 7.5% between 2005 and 2012. In contrast
men saw rates of binge drinking increase 4.9%. Binge drinking
is commonly associated with a higher risk of bodily harm such
as alcohol poisoning and acute adult organ damage. The South
Koreans are ahead of other ethnic groups in alcohol consumption
and they have a very high rate of autism compared to the Americans.
South Korean emigrants to the United States have a 24.6%
incidence of binge drinking which is two or three times greater
than other Asian countries . In the urban areas of South Korea,
about 46% of Korean men and about 9% of Korean women
are heavy drinkers (more than 6 drinks per day). In contrast, only
about 3.5% of the United States population are heavy drinkers. In
Korean Society they understood that drinking is an essential part
of networking which is needed to succeed in the workplace. Many
Koreans are first introduced to alcohol at universities and thereby
develop unhealthy binge drinking habits. The Korean Alcohol Research
Foundation in 2010 conducted a poll of 4061 students.
More than 71% said they drank more than 5 shots of Soju in one
sitting. This amount of alcohol consumption is defined as binge
by WHO (World Health Organization). The large prevalence of
binge drinking in South Korea may be associated with its high
rate of autism with a prevalence of 2.6%. In contrast, the American
rate at the time was about 1%. Fetal alcohol syndrome is also
associated with binge drinking.
Fetal Alcohol Syndrome
Fetal alcohol syndrome refers to a group of physical behavioral
and cognitive abnormalities. Children of binge drinking mothers
have problems with distractibility, restlessness and lack of persistence.
They also have the classic dysmorphic, facial features, prenatal
and postnatal growth abnormalities and mental retardation.
About 80% of affected children show poor coordination, hypotonic,
attention-deficit hyperactivity disorder, decreased adipose
tissue, facial abnormalities, maxillary, hypoplasia, cleft palate and
micrognathia. Cardiac defects, hemangiomas and eye or ear abnormalities
are also common. Clinicians describe children with a
variety of problems, including growth deficiency, behavioral man-nerisms and delays in motor and speech performance. The Research
Society on alcohol has defined it as any condition thought
to be secondary to alcohol exposure in utero. Fetal alcohol syndrome
usually occurs when a pregnant woman has more than
four standard drinks per day. However, two drinks per day in the
early part of pregnancy may result in milder symptoms. Among
those who are alcoholic about a third of their children have FAS.
Streisguth et al  have found children had abnormal cognitive
functioning which manifests itself as poor attention and concentration
skills, memory defects, impaired comprehension and abstract
reasoning. Their IQ scores average around 70. FAS is estimated
to occur at the rate of 5.2/1000 live births in the United
States. Mills et al  have studied 31,000 pregnancies and the
alcohol that women drank. Consumption of 1 or more drinks (a
drink is defined as 1.5 ounce of distilled spirits, 5 ounces of wine
and 12 ounces of beer was associated with an increased risk of
having an infant with retardation. The potential damage to the
fetus may cost the United States from 75 million to 9.7 billion.
The total lifetime cost of caring for a typical child with FAS maybe
as high as 1.4 million. Mental retardation related to FAS may account
for as much as 11% of the annual cost of caring for all mentally
institutionalized residents of the United States and about 5%
of all congenital abnormalities. The only way to prevent FAS is
to avoid drinking alcohol during pregnancy. The Surgeon General
 recommended in 1981, and again in 2005 that women
abstain from alcohol use while pregnant or while planning a pregnancy.
The latter way to avoid damage even in the earliest stages,
even weeks, as the woman may not be aware she has conceived
. Mukherjee et al has also reported that drinking while pregnant
can give babies FAS . He compared autism as well as
autistic traits in people exposed to heavy prenatal alcohol traits
in a clinical series of 21 individuals in a nested case control study.
The controls had not experienced prenatal alcohol exposure. The
21 with fetal alcohol spectrum disorders were assessed and 16
(72%) met ICD-10 criteria for childhood autism.
The WIC program
The Special Supplemental Nutrition Program for Women, Infants
and Children (WIC) is a federal assistance program of the Food
and Nutrition Service (FNS) for low income families by the United
States Department of Agriculture . The eligibility requirement
is between 100% but not more than 185% of the Federal
Poverty Guideline. Effective from July 1, 2016 to June 30, 2017
the yearly allowance is $21,978 for a family of 1, with increases
of $ 7,696 for each additional member of the household. The program
allows monthly purchases of healthful food stuffs. Purchase
of alcoholic beverages is not subsidized by the program. The program
is unrelated to the USDA’s Supplemental Nutrition program
(SNAP). Currently the WIC serves 53% of all infants born in the
United States. Applicants must have a nutritional assessment by
a qualified professional (physician, nurse, or nutritionist). The
nutritional evaluation is based on height, weight, and growth assessment,
hematocrit or hemoglobin levels, general health history
or a diet assessment, The applicants are given an EBT card
which is exclusively used for purchasing WIC approved items. A wide variety of foods is allowed such as milk, breakfast cereal,
cheese, eggs, fruits and vegetables. Some culturally appropriate
food packages such as tortillas, brown rice canned salmon may
also be provided. WIC has dramatically reduced health care costs
by (a) providing prenatal services (b) promoting breast feeding.
Several controlled evaluations showed that in 1992 prenatal WIC
enrollment was estimated to have reduced first year medical costs
for United States infants by $1.19 billion, more than offsetting the
government costs of WIC. Prenatal use of WIC also decreases the
odds of having a low-weight newborn by 25 percent and reduces
the very low birth-weight births by 44%. Having a higher birthweight
newborn has the potential to decrease costs of hospitalization
in the first year. Infants with lower birth-weights have higher
costs for initial hospitalization. Each dollar spent results in nearly
three dollars saved by the federal and state governments. Because
of these savings WIC is often cited as being one of the most costeffective
food assistance programs in the nation . In addition,
WIC numbers are available for the county, states and all of
the counties. Perhaps some relationship could be found between
WIC nutrition and the autism rates. Although autism is thought to
be caused by some types of mutations and not nutrition, perhaps
some insight and direction could be found by looking at nutrition
The WIC program and Nutrition
Because the autism rates were becoming known in some counties,
states as well as the country, comparisons could be made
to the WIC program to see if there could be a possible nutritional
link. Autism is more likely to occur in families and mutagenic
cause has been postulated. However, families also share
the same food. Certainly, a nutritional cause of autism cannot be
overlooked.Certainly a relationship could be explored between
autism, nutrition and alcoholic consumption in the various states
The Institute for Health Metrics at Seattle, Washington has studied
the average drinking patterns in the United States. The year
2010 was selected. Data from two states Hawaii and Alaska were
not available. The average drinking level in 48 states was compared
to the 2009 autism rate using excel statistics. Trend lines
were also compared visually to the alcohol consumption rates
and the autism rates. In three states the county rates of WIC
and autism were compared to the average alcohol intake of that
county and to each other using excel statistics.
Materials and Methods
The Institute for Health Metrics at Seattle, Washington has studied
the drinking patterns in US counties from 2002-2012 in 48
states (6). In 2012 6.2% of all Americans were considered heavy
drinkers and 12.3% were considered binge drinkers. Two states
Hawaii and Alaska were not included. There was considerable
variance between the counties in each state. However, each state
was given an average drinking level in that state. They divided
the people of each county into three levels: level 1: no drinks;
level 2; 1 drink per month and level 3: more than 1 drink per
month. They compared no drinking to 1 or more drinks combined.
The average drinking level per state was compared by
correlation to the State 2009 autism rate using excel statistics.
The results are indicated in Figure 1. The % WIC recipients ,
and autism rates using Excel statistics in Washington, New Jersey,
Oregon and in all 50 states or the counties of Washington, Oregon
or New Jersey [4,13] are listed in Table 1. The counties that
were used for the WIC study also had average alcohol intake for
that county calculated from the Health Metrics Seattle study .
These results were also included in the Table 1 for comparison
Table 1: The WIC Program and the WIC/Autism and
All 50 states
Results and Discussion
When the average drinking level by state was compared to the
autism rate using Excel statistics by state for 2009 [6, 13], the
result was r ¯0.52 p< 0.001. There was also horizontal trend
lines when the alcohol consumption were compared to the autism
rates. Similar trend lines were found in 45 of 48 states. Even
though the number of drinks was small compared to the final result
In this study there was a large positive correlation to autism.
The result may be compared with the CDC’s caution of no alcohol
during pregnancy. In the Table the counties of Washington, New
Jersey and Oregon as well as all 50 [4, 13] states show an inverse
relationship between the WIC infants and the rate of autism. In
contrast WIC incidence to alcohol consumption in the same states
showed that there was a direct relationship to alcohol consumption.
Significantly, those on the WIC program had lower autism
rates. Low-income mothers who qualify for the free milk formula
from the WIC program seem to have an important source for their infants. In contrast, payment for alcoholic beverages is not supported
by the WIC. Surgery items are also not supported by the
WIC .Sugar is not a necessary nutrient for the body. The WIC
families qualify because of lower income. However, individuals
with higher income should be able to purchase more nutritious
food and afford better health care and have a lesser incidence
of diseases such as autism. It is well known that people with
income over $75.000 have a greater incidence of binge drinking
which might explain higher autism rates in this population.
Respondents with household income greater than $ 75,000 had
the highest binge drinking prevalence (20.2%). This may explain
why lower income people on WIC have less autism. Higher income
people should be able to afford better health care.
Autism Linked to Sugar Intake
The USDA has measured the B-vitamin content of human breast
milk from 279 mothers . After calculating the average
amount that the babies drink, comparisons can be made to
the MDR (Minimal Daily Requirement) Because of the exclusive
breast feeding that is recommended for the first six months it is
possible that there could be a B-vitamin deficiency. In general,
all of the B-vitamins were at acceptable levels except thiamine
which was well below the MDR for the first four months. Part
of this deficiency may be caused by the excess sugar intake in
America. The historical increased sugar consumption from 1822
to2005 was examined for a possible connection to autism. In
1822 the per capita sugar consumption was about 8 lbs per person
per year and by 2006 consumption reached over 100 lbs per
year. Landon  constructed a graph from which a equation was
derived, y=0.573x1041 where x= years. Total autism numbers
can be calculated from the total national rate of autism from 2010
from the ADDM network (The Autism and Developmental Disabilities
Network). These numbers are compared to the increasing
rate of sugar consumption in the same years 2002-2012. Calculation
of this relationship using excel statistics shows a formula
result of r=0.976 or P>0.001. Thiamine is needed for the first
step of the Krebs cycle and excess sugar demand could cause a
thiamine deficiency. However excess alcohol intake may also contribute
by decreasing thiamine absorption from the gastrointestinal
tract. Children are more likely to develop autism if their mothers
were diagnosed with diabetes early in pregnancy  in this
study. Woman newly diagnosed by the 26th week of pregnancy
were 42% more likely to have a child diagnosed with autism. The
study included more than 322,000 children born between 1995
and 2009. However, mothers with type 2 diabetes, did not have
children with increased rates of autism. This may have happened
because the mothers may have already had their diabetes under
control. The author of this study suggests that high blood sugar
may have a lasting effect on a fetal organ development and brain
function. Gardener et al  have studied prenatal risk factors
for autism using a comprehensive meta-analysis. They also found
that the maternal gestational diabetes was associated with a 2
fold increased risk of autism. The maternal age at birth if over
30 was associated with an increased risk of an autistic child. A
five year increase in maternal age was associated with a 7% risk. Increased paternal age was also found to be a significant risk.
The latter observation may not be as important because an older
woman is probably married to an older man. Other studies have
found an increased risk of autism for children who are born prematurely
or very small. Genetics may be a risk factor if one child
in a family has autism, the next child may have a 20% greater
chance of having autism. In a large study  involving 1000
mother child pairs it showed that over a third of US women in
their child bearing ages are obese and nearly one-tenth have gestational
or type 2 diabetes during pregnancy. The percentage of
children born to women with type 2 diabetes or gestational diabetes
was 9.3%. The developmental disability found was 11.6%
higher than the 6.4% of children born to women without these
metabolic conditions. Over 20% of the mothers of children with
autism or other developmental disability were obese compared
with 14% of the mothers of normally developing children. The
authors concluded that the events of a poor regulated maternal
glucose level and maternal inflammation may cause certain proteins
involved in cell signaling to cross the placenta and adversely
affect fetal development but that more studies are needed to verify
Does Sugar Directly Cause Autism?
It would be very difficult to directly calculate autism from sugar
intake because of the many types of sugar available for consumption.
In addition, autism occurs in different rates in many states.
However, we know the rates of sugar consumption have increased
and we also know the rate of autism increase. The evidence linking
high sugar and alcohol intake to increased autism was unexpected,
however, both substances are known to decrease the
amount of thiamine. In one case sugar reduces the absorption of
thiamine into the intestine and alcohol directly reduces the absorption
of thiamine by the intestine.
The advice given pregnant women to avoid alcohol is probably
correct. The relationship between FAS and alcohol is fairly
well established. In this study there is a substantial correlation
between alcohol consumption and autism. In addition, the WIC
results based on low alcohol intake had a negative correlation to
autism. In contrast, the alcohol consumed in the counties of three
states had a direct relationship to autism. This may mean that
autism is directly enhanced by alcohol. The people in the counties
on WIC had lower incomes and probably could not afford to
binge drink whereas individuals with higher income could afford
to binge drink.The mechanism by which binge drinking may be
related to autism is unclear. However in another study  we
showed that mother’s milk was quite low in thiamin. In addition,
alcohol lowers thiamine by decreasing thiamin absorption from
the gut. High sugar intake can further decrease thiamine by
reducing its concentration. Although evidence seems to point
toward autism being a thiamine deficiency, more studies are
needed to determine this possibility.
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