Autism and Gluten- free Casein-free diet Rebecca Clyde

Autism Spectrum Disorder O Autism spectrum disorders (ASDs) are pervasive developmental disorders (PDDs) characterized and diagnosed by social interaction and communication impairment and restricted, stereotyped, and repetitive patterns of behavior and language

The Claim Autism Diet

The Reality O Gluten Free Diet Gluten Free Diet O Undesirable side effects: O Possible decreased intake of O Iron O B vitamins O Calcium

The Research: Theories O Researchers have found that children with autism have higher proinflammatory cytokines following consumption of food proteins from gluten, casein, and soy than control groups.

Research: Theories O Autistic symptoms of: O Stereotypical and ritualistic behaviors O Perseveration O Excess activity O Speech and language delays …may result from opioid peptides formed from the incomplete breakdown of gluten and casein. “Leaky gut syndrome” allows these peptides to enter bloodstream and cross the BBB affecting their CNS.

Research: O One study: 387 participants O 92.7% had GI symptoms (specifically diarrhea, constipation) O 61.3% suspected food sensitivity O 93.4% allergy symptoms O 68.3% diagnosed food allergy

Research: Theories O With resolved GI symptoms/implementation of diet: O Reported improvements in speech, communication skills O Decreases in hyperactive behavior O Improvements in their ability to focus O Decreases in sleep problems O No independent screening for Celiac disease or food allergies

Number of improved ASD behaviors, physiological symptoms, and social behaviors by gluten and casein elimination (mean ±SEM)

Number of improved ASD behaviors, physiological symptoms, and social behaviors by frequency of diet errors during parental care (mean ± SEM)

Number of improved ASD behaviors, physiological symptoms, and social behaviors by child’s GI and allergy symptoms (mean ± SEM)

Research: Theories O Inability to express their pain or GI discomfort O They may react with extreme behaviors common to ASD children O Screaming O Aggression O Self-abuse

Conclusion: O Unknown cause of ASD O Inconclusive research about the connection between ASD and “Leaky gut syndrome”

Conclusion: AND Position O Proponents of the diet believe people with autism have a "leaky gut," or intestine, which allows parts of gluten and casein to seep into the bloodstream and affect the brain and central nervous system. The belief is, this may lead to autism or magnify its symptoms. O To date, controlled scientific studies have not proven this true. However, some people report relief in symptoms after following a GFCF diet. If you are considering a GFCF diet, talk with your health-care team, including a registered dietitian. There can be side effects and potential nutrient shortfalls when a GFCG diet is self-prescribed.

Now What? O To help parents with decision making: O Does the family have the resources to purchase foods in the GFCF diet that are often more expensive, and are these foods readily available? O Has the family considered the extra time and effort that may be needed to prepare the diet? O Is there a commitment by at least 1 family member to keep accurate daily records of food intake and behavioral changes?

Now What: continued O Are there adequate plans regarding how to ensure dietary compliance at home and, when applicable, at school? O Is there another parent or professional who has implemented the diet and who can offer practical advice for preparing and implementing the GFCF diet? O Are there clinicians and/or researchers in the family's geographical area who might assist in systematically evaluating the GFCF diet?

Strategies O Be prepared for pickiness O children w/ autism are sensitive to tastes, colors, smells, & textures which are barriers to having a balanced diet. O Tip: O Take your child to the grocery store-let them choose a new food & experiment w/ it then research it’s home. Even if they don’t want to eat it after, becoming more familiar with it can make help them be a more flexible eater O make mealtime routine O keeping routine in time/place can reduce stress for the child O seek guidance for special diets

Questions?

References O Ansel K. Nutrition for your child with autism spectrum disorder. ism%20diet. Accessed 16 May ism%20diet O Academy of Nutrition and Dietetics. Nutrition and autism. autism%20diet. Accessed 16 May autism%20diet O Pennesi C, Klein L. Effectiveness of the gluten-free, casein-free diet for children diagnosed with autism spectrum disorder: based on parental report. Nutritional Neuroscience. 2012;15(2):85-91 O Whiteley P, Haracopos D, Shattock P, et al. The ScanBrit randomised, controlled, single-blind study of a gluten- and casein-free dietary intervention for children with autism spectrum disorders. Nutritional Neuroscience. 2010;13(2): O Elder J. The gluten-free, casein-free diet in autism: an overview with clinical implications. Nutrition In Clinical Practice: Official Publication Of The American Society For Parenteral And Enteral Nutrition. 2008;23(6):