Gluten-Free, Casein-Free Diet for ASD

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Hi there, Mamas!  So I am (of course) super behind on everything lately, like staying current on posts, but also on my DVR collection.  My sister and I have watched NBC’s Parenthood from the start (mainly because Lauren Graham was in it; Gilmore Girls is my favorite show of all time!), but… life got in the way and we are still about 10 episodes out from finishing the series.  No spoilers, please!

However, we got a chance to get together last Monday to get a few episodes in.  We watched “Happy Birthday, Zeek”, which includes Adam teaching a culinary arts elective at the charter school he and Kristina opened, mainly because they can’t get a food vendor to comply with their students’ wide range of dietary needs.  {Earlier in the episode we see Kristina getting a call from a parent stating that her son now needs a gluten-free, casein-free diet.}

How interesting it was the next day when I saw this article in my Academy of Nutrition and Dietetics Newsletter.  Basically, it recaps a double-blind, placebo-controlled study in which 14 kids (ages 3-5) were put on a gluten-free, casein-free diet.  Once the kids were established on the diet, a snack was added in containing either gluten, casein, both gluten and casein, or neither.  After 12 weeks of this added snack, there was no difference found in children’s behavior, sleep patterns, or bowel movements.

Decoding the Study

As far as research goes, the double-blind, placebo-controlled model is pretty top of the line.  “Double-blind” means that neither the researchers, parents, or children knew which treatment (in this case, snack) the individual children were receiving.  This is beneficial because no one’s reactions or observations will be skewed, as they may have been if the parents, researchers, or children knew for sure that a particular child’s snack contained gluten or casein.

A placebo is important, as well.  If all of the snacks contained gluten, casein, or both, we wouldn’t be able to see how the children reacted by a continued avoidance of these proteins.

It should be taken into account that this is a very small study, so it may not have shown results as well or as accurately as a larger group may have.

What Does this Mean?

There wasn’t really so much evidence prior to this study regarding the efficacy of a gluten-free, casein-free diet as a treatment for autism.  This well-designed (albeit, small) study somewhat reinforces that this diet is not an evidence-based treatment.  

So does that mean it’s unsafe?

Not necessarily, if under the guidance of a Registered Dietitian Nutritionist.  {Find one near you here.}  The dangers would lie particularly in the form of nutrient deficiencies, especially calcium and vitamin D.

However, just because it’s not dangerous doesn’t mean it’s not inconvenient.  While many naturally gluten-free, casein-free foods are very healthy (think fruits and vegetables), gluten-free replacement foods (like pastas, breads, and baked goods) or alternative milks (fortified almond or soy milks) are much more expensive than their gluten-containing counterparts.  In many cases, this also means that the child with autism will be eating differently than the rest of the family (especially if there are other children in the house), which can cause problems in itself.  Plus, many children with autism have selected tastes anyways.  It seems an unnecessary hassle to limit foods they like because of a non-evidence based theory.

Take-Home Point

With any treatment for any medical condition, it is important to look at the evidence.  Ask your doctor what the research says about the treatment and what the risks are.  Also, if possible, try to keep up with the latest research yourself.  The thing about science is that we are learning new things all the time!  Because of the small sample size and the wide range of differences of children with autism, I am sure that this study will be replicated with a larger sample size to verify the results.  Most importantly, if it is a diet-based treatment, be sure to enlist the help of an RDN.  This can help ensure that you or your child will not develop nutritional deficiencies, which can lead to additional problems.

Have you tried this diet with your kids, Mamas?  What were your experiences?

Fore more reading on supplements with ASD, check out this article.

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