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Gluten-free Casein-free Diet: A Cure for Autism?

Author: Jenny Garcia

April 3, 2010

 

Introduction

        Autism is a disability that causes challenges in communication and behavior. Billion of dollars and experiments have been put into autism research, but a definite cure has yet to be found. One of the more recent popular ideas of treatment is a gluten-free casein-free diet. It is a diet that is said to increase the communication skills of those diagnosed with autism. Although for the most part there is little scientific evidence to prove that this diet works, there are many testimonies that this diet has “cured” autistic children.

 

What is Autism?

        Autism Spectrum Disorders are a group of mental disabilities that are found in 1 in 110 children on average. It ranges greatly in severity, from mild to severe. The most known of these disorders is the Autistic Disorder, or the “classic” autism. Most symptoms of autism occur before the age of three and include delays in communication, abnormal behaviors, and avoidance of eye contact. As children with autism grow older, they begin to repeat words, move their hands around, and are disturbed by change. The only way to diagnose this disorder is by observance of these symptoms, which makes diagnosis very difficult. Furthermore, there is no cure for autism, although therapy can help lessen the severity of symptoms. The cause of autism is also unknown, but some theories are genes, drugs taken during pregnancy or vaccines. In summary, very little is known about this disability. (http://www.cdc.gov/ncbddd/autism/facts.html)

 

Image From: http://repairstemcell.files.wordpress.com/2009/06/autism-ribbon2.jpg

 

What is a Gluten-free Casein-free Diet?

        Gluten is a type of protein that is found in substances such as rye, wheat and barley. Therefore, it is found in most products that are grain based, such as bread, pasta and cereal. A “gluten-free diet” consists of removing foods containing gluten from your daily diet. This diet can sometimes be very difficult to enact because gluten is hidden in many foods, such as salad dressing, potato chips and some chocolates. However, it is a diet that is becoming easier to enact with many food companies creating “gluten-free” products. (http://www.wisegeek.com/what-is-gluten.htm)

 

Image from: http://www.juvela.co.uk/questions/images/gf_img.jpg

 

        Casein is a protein that is found in milk products. Typically, casein is broken down in the body by peptides and the formation of amino acids occurs. However, in some cases, the body is unable to break down this casein. To follow a casein free diet, all milk products must be eliminated, such as ice cream, chocolate and cheese. (http://www.wisegeek.com/what-is-casein.htm)

 

Image from: http://legacy.co.mohave.az.us/WIC/images/Dairy.jpg

 

Gluten in Autistic Children- “Leaky Gut Syndrome”

        There is much speculation about the ability of autistic children to fully digest foods containing gluten or casein, resulting in the formation of peptides, which are just protein molecules that have not been completely broken down. The theory is that in autistic children, the intestine is more permeable than it is supposed to be. This allows the peptides to leave the intestines during digestion and go into the blood stream, eventually reaching the nervous system. This problem is called the “leaky gut syndrome”. Its symptoms include constipation, diarrhea, and abdominal pain. These are symptoms that occur in many autistic children, so many have linked autism with the “leaky-gut syndrome”. Since autistic children have difficulty expressing themselves, they may react with extreme behavior such as excess activity. (Elder 2008)

 

Claims of Effectiveness

        The thought of a gluten-free casein-free diet “curing” autism is fairly new, so not much research has been done. Furthermore, the research that has been done consists of very small test groups and a very short time of study. However, there have been many studies that show the diet has worked for children with autism. Since most of these claims are not scientific, and are simply claims by parents, it is difficult to say that this diet works.

        A research group in Norway headed one reliable study to prove that the gluten-free casein-free diet was successful in minimizing autistic symptoms. This study was a randomized, double blind design, which is one of the most reliable ways to study a group. Twenty subjects were chosen and matched based on their autistic symptoms and age. Before and after the yearlong study, urine samples were taken to measure the level of urine peptides. These urine peptide levels are higher due to food containing gluten.  In the end, the children on the gluten-free diet experienced a significant improvement in autistic behavior compared to the control group, who was not on a gluten-free diet. (Knivsberg, Reichelt, HØien, & NØdland, 2002) Although this study shows that the gluten-free diet helped some children decrease their autistic symptoms, this study is somewhat unreliable because of the smaller sample size and lack of strict diet control.

        Another reliable study done at the University of Florida showed that symptoms of autistic children decreased when the children were placed on a gluten-free casein-free diet. Fifteen children of all ages were studied in a randomized, double blind study. Data on symptoms of autism and urinary peptide levels were collected for 12 weeks in the homes of the subjects. While in general the findings did not show any statistically significant findings as a whole, 81% of the families claimed that the symptoms of their autistic children had improved. (Elder 2006) While this study was reliable because of its time length, the conclusions were based on parents and teachers who knew that the children were on a gluten-free casein-free diet. Since parents of autistic children are greatly motivated to find a cure, they may be very biased in whether the improvements were significant. Therefore, the results could have been biased.

 

Claims of Ineffectiveness

        The Pediatric Journal performed one of the most extensive, reliable studies of the gluten-free casein-free diets effect on autism. The study consisted of 124 autistic children and 248 children without autism. The scientists found there was no statistically significant difference in gastrointestinal function between the group of children with autism and the control group. It did conclude that autistic children were likely to have constipation, but this may have been due to the larger amount of autistic children who were picky eaters. In the end, the conclusion of the study was that the gluten-free casein-free diet was ineffective. (Campbell, et al., 2010) This is the only study on this subject that has consisted of such a large sample size, and therefore is very reliable.

 

Summary

        In general, there are many claims for and against the gluten-free casein free diet. One of the most extensive research projects ever done proved that the diet does not have any effect on children with autism. However, there are many of personal accounts from parents of autistic children claiming the amazing change in their autistic children’s behavior after putting their children on a gluten-free casein-free diet. These parents, however, are so motivated to find a cure that their results may be biased. In general, there is little research on the effectiveness of the gluten-free casein-free diet, and the research that has been done includes arguments for and against the gluten-free casein-free diet. Therefore, more research must be completed to make a final conclusion.

 

Recommendations

        Autism is a disorder that is not very well known and concrete answers based on research have yet to be developed. However, there are many proven techniques that help decrease the symptoms of autism. To help with communication, sign language can be taught to the children to express basic needs such as hunger or pain. A speech therapist can be hired to help patients learn how to speak. Applied behavior analysis(ABA) can be used to treat aggressive behavior. This involves highly structured activities that are based on the individual child’s needs and generally involved on-on-one therapy. Play therapy can be used to increase social skills and the ability to learn. These treatments have been used for many years and are proven to be effective. 

 

 

Image from: http://www.masternewmedia.org/images/autistic_child.jpg

 

Image from: http://z.about.com/d/autism/1/0/5/0/-/-/balltherapy1BarrosandBarros.jpg

 

        The gluten-free casein-free diet seems to work for some children and not for others. The best way to test this diet on a child is to first find a nutritionist who can monitor the child’s food intake and make sure they are getting ample amounts of nutrients. Often, without gluten or casein products in a diet, children can have bone density loss or vitamin deficiencies. Next, put the child on the diet for a certain period of time, observe changes, and then remove the diet for a while. Record the changes that occur when the child is removed from the diet. When the diet is reintroduced, see if there is an improvement in symptoms. The results should be recorded and compared when the child is on and off the diet. This is the most effective way to determine if the diet truly works for the individual.

 

Bibliography

Buie, T., Campbell, D., Fuchs, G., Furuta, G., & Levy, J. (2010). Evaluation, diagnosis, and treatment of gi disorders in children with autism. Journal Watch Pediatrics and Adolescent Medicine, 125, S1-S18.

 

Elder, J.H. (2008). The Gluten-free, casein-free diet in autism: an overview with clinical implications. Nutrition In Clinical Practice, 23(6), 583-588.

 

Elder, J.H., Shankar, M, Shuster, J, Theriaque, D, & Burns, S. (2006). The Gluten-free, casein-free diet in autism: results of a preliminary double blind clinical trial. Journal of Autism and Developmental Disorders, 10.

 

Knivsberg, A.M., Reichelt, K.L., HØien, T., & NØdland, M. (2002). A Randomised, controlled study of dietary intervention in autistic syndromes. Nutritional Neuroscience, 5(4), 251-261.

 

Sutter, C. (2009, August 19). Diet and autism: parents swear by dietary interventions, but study finds them unlikely to help . McClatchy - Tribune Business News.

 

 

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