GLUTEN AND CASEIN-FREE
DIET FOR AUTISM
The causes of Autism Spectrum Disorders such
as Autism and
syndrome are the subject of much debate and research. Although
a genetic cause is well established, many argue there are environmental
causes as well. Gastrointestinal
problems such as bowel disturbances, diarrhea or constipation
are a common feature of Autism and Asperger's. According to one
theory, some children are unable to digest the protein in many cereals
(gluten) or in milk (casein) completely. Casein and gluten proteins
aren't properly broken down and lead to a build up of opioids in
the body, leading to high pain tolerance, repetitive
behaviors and lack of concentration. A gluten and casein-free
diet is believed by some parents of autistic children to aid in
reducing symptoms of Autism, Asperger's syndrome and other Autism Spectrum Disorders.
History of the gluten and casein-free diet
Dr. Karl Ludwig Reichelt claims to have found
peptides from casein and gluten that worsen the symptoms of autistic
children, many of whom have gastrointestinal
disorders. These peptides are casomorphines and gluten exorphins,
which influence the brain. The primary proponent of the possible
link between digestive disorders and autism is Dr. Andrew Wakefield,
a United Kingdom gastroenterologist who has described the disputed
condition as autistic enterocolitis. According to Dr. Reichelt,
significant improvement has been seen in the symptoms of some of
his patients with Autism or Asperger's who had been put on a diet
that omits these peptides. The diet is called the gluten-free, casein-free
diet. Some physicians see diet as a central part of the treatment,
but in addition to many other treatments at the same time.
Theory behind the gluten and casein-free diet
The molecular structure of the partially undigested
proteins, known as peptides, resemble opiates. It is thought that
such peptides have an effect much like opiates (ie. morphine, heroin)
in the brain and nervous system. From this premise it follows that
long-term exposure to these opiate peptides can have many damaging
effects on the developing brain and also affects behavior, just
as any narcotic would. The opioid peptides involved are identified
as casomorphines from casein, and gluten exorphines and gliadorphin
Gastrointestinal problems are a common comorbid
disorder on the autism spectrum and some people see this as proof
for the "leaky
gut" theory as a cause of Autism, while others see the
gluten and casein-free diet as treating symptoms, not causes, of
Autism Spectrum Disorders.
The "leaky gut" theory remains controversial
with no rigorous scientific studies done as yet. A recent study
of the role of diets in Autism Spectrum Disorders noted that significant
design flaws in all the current studies make it difficult to rely
on an conclusions reached ( Christianson & Ivany 2006).
Benefits claimed for the gluten-free casein-free diet
Anecdotal evidence suggests that some parents,
though not all, find that removing casein and gluten from their
child's diet increases eye contact, attention span, and general
mood while decreasing problems like tantrums, self-stimulatory behavior
(such as hand-flapping and rocking) and aggression. Others have
reported that providing a diet free of casein and gluten aids children
in successfully learning daily living skills like dressing, using
the toilet as well as improving coordination and imaginative play
activities. In a small number of cases, such dietary changes have
been claimed to have a dramatic effect, enabling the child to attend
mainstream educational programs in a matter of months. It should
be noted that to date there has not been the rigorous research that
would qualify the diet as an evidence-based
The gluten-free casein-free diet and Autistic children
Beginning the diet can be difficult but not impossible.
Gluten is most commonly found in wheat, rye, and barley and may
sometimes contaminate oats grown nearby or processed on the same
equipment as gluten-containing cereals.
Casein is found in dairy products; wheat and dairy
frequently make up a large proportion of the Western diet. One of
the biggest obstacles parents face is that individuals needing gluten-free,
casein-free diets often crave these foods much the same as an addict.
In fact, parents often report withdrawal symptoms when gluten and
casein are eliminated that are similar to addicts experiencing withdrawal
from narcotic drugs.
Many parents worry about removing wheat and dairy
because these foods are the only ones their child will eat, and
because prevailing attitudes in Western culture consider them an
essential staple. However, children who eat only or mostly wheat
and dairy products may show remarkable improvement once a gluten-free,
casein-free diet is underway. Many families have found from experience
that their children's menu options actually increase after the effects
of eating gluten and casein have subsided.
Some people experience immediate improvement although
it may take as long as six months for gluten to clear out of the
system and one month for casein to clear. Advocates of the diet
recommend trying it for at least a year as it can take this long
for some children to show improvement. The diet claims to make changes
in the body at a cellular level and promote healing of the stomach
and intestinal lining, both of which can take time.
DEBATE OVER the diet
The specifics of the gluten-free, casein-free
diet were introduced to the general public through the combined
publications of two women who researched interventions and crusaded
for autism recovery. Information about the gluten-free, casein-free
diet has since spread around the world and anecdotal evidence suggests
it has helped some families.
Although this diet has been questioned by the
medical community, many doctors and university research centers
are suggesting to parents that they see if any results emerge from
using the diet, but usually alongside the more proven behavioral
and developmental interventions.
The gluten-free, casein-free diet has been supplemented
with a number of new innovations. These include incorporation of
the Feingold diet, the Specific Carbohydrate Diet, diets with reduced
salicylates and phenols, etc. There are as yet few studies that
prove or disprove the gluten-free, casein-free diet or other diets,
but there is growing acceptance in the medical community that restrictive
diets can affect pediatric and adolescent behavior in some cases.
The gluten-free casein-free diet and other disorders
Those suffering from celiac disease and/or dermatitis
herpetiformis are instructed to avoid all forms of gluten, though
their metabolic disorders are apparently distinct from the autism-related
metabolic disorder hypothesized by gluten-free, casein-free proponents.
There are anecdotal reports of this diet also being beneficial to
sufferers of multiple sclerosis, schizophrenia, Tourette
chronic fatigue syndrome and attention deficit disorder. However,
in some of these cases (e.g.; Tourette syndrome), there is no evidence
that a gluten-free diet has any impact upon symptoms.
Should my child try the gluten-free casein-free diet?
A common problem in interventions for Autism and
Asperger’s syndrome is the lack of rigorous research on new therapies.
Anecdotal evidence for beneficial effects can be accurate, or in
other cases mistaken by a wide range of confounding factors. Understandably
parents will look at therapies such as a diet free of gluten and
casein for their autistic child to see if it could have some benefit,
even if it is not currently seen as an evidence-based
Autistic children can be notoriously fussy eaters,
this diet may be very difficult to implement. Also, some supporters
of this diet suggest parents stick with the diet for a year ideally,
which can be a long time simply to evaluate this type of intervention,
and children will usually make developmental advances over this
time frame regardless of diet. Other pediatricians such as Dr Antony
Underwood believe that three months of a strict trial is sufficient
to see if a gluten and casein-free diet will reduce the symptoms
of Autism and Asperger's syndrome.
Further reading: Brain
chemistry and Autism
Click here for the full
range of Asperger's and Autism fact sheets at www.autism-help.org
to read the Allergies and Food Sensitivities fact sheet
This autism fact sheet is licensed under the GNU
Free Documentation. It is derivative of an Autism and Asperger's
syndrome-related articles at http://en.wikipedia.org