Efficacy of Special Diets for Autism

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This page contains a collection of Peer-Reviewed Articles on the topic of the use of special diets in the treatement of ASD's.  When a family asks for guidance it is important to have the data from evidence-based studies such as these to start your conversation with.

 


 Buie T, etal. 

Evaluation, Diagnosis, and Treatment of Gastrointestinal Disorders in Individuals With ASDs: A Consensus Report, Pediatrics 2010;125:S1–S18

http://www.pediatrics.org/cgi/content/full/125/Supplement_1/S1

Autism spectrum disorders (ASDs) are common and clinically heterogeneous neurodevelopmental disorders. Gastrointestinal disorders and associated symptoms are commonly reported in individuals with ASDs, but key issues such as the prevalence and best treatment of these conditions are incompletely understood. A central difficulty in recognizing and characterizing gastrointestinal dysfunction with ASDs is the communication difficulties experienced by many affected individuals. A multidisciplinary panel reviewed the medical literature with the aim of generating evidence-based recommendations for diagnostic evaluation and management of gastrointestinal problems in this patient population. The panel concluded that evidence-based recommendations are not yet available. The consensus expert opinion of the panel was that individuals with ASDs deserve the same thoroughness and standard of care in the diagnostic workup and treatment of gastrointestinal concerns as should occur for patients without ASDs. Care providers should be aware that problem behavior in patients with ASDs may be the primary or sole symptom of the underlying medical condition, including some gastrointestinal disorders. For these patients, integration of behavioral and medical care may be most beneficial. Priorities for future research are identified to advance our understanding
and management of gastrointestinal disorders in persons with ASDs.


Senel HG.  Parents' Views and Experiences About Complementary and Alternative Medicine Treatments for Their Children with Autistic Spectrum Disorder.   J Autism Dev Disord. 2010 Apr;40(4):494-503.

Use of complementary and alternative medicine (CAM) treatments have been increasing for children with autistic spectrum disorder (ASD). In this study, 38 Turkish parents of children with ASD were surveyed related with their use of CAM treatments, experiences, and views for each treatment. They mentioned "Vitamins and minerals", "Special Diet", "Sensory Integration", "Other Dietary Supplements", and "Chelation" as five frequently used CAM treatments. Communication, learning, health, and behavior were the main four areas rated as "improved" after five CAM treatments. Negative sides of treatments were listed as being expensive, difficult to apply, or harmful. The parents' views on some treatments have varied from great improvement to worse. Reported improvements were considerably higher than the negative sides of the treatments.

PMID: 19904598 [PubMed - as supplied by publisher]

 

Millward C, Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD003498.
P L A I N  L A N G U A G E   S U M M A R Y

It has been suggested that peptides from gluten and casein may have a role in the origins of autism and that the physiology and psychology of autism might be explained by excessive opioid activity linked to these peptides.
An extensive literature search was carried out to identify any randomised control trials of gluten and/or casein free diet as an intervention to improve behaviour, cognitive and social functioning in individuals with autism. Only three papers reporting on two randomised control trial were identified, two small scale trials the first with ten participants in each arm of the trial and the second with fifteen participants recruited into the trial. The results for the first study indicated that a combined gluten and casein free diet reduced autistic traits and the second study showed no significant difference in outcome measures between the diet group and the control group. This is an important area of investigation and large scale, good quality randomised control trials are needed. None of the studies reported on adverse outcomes or potential disbenefits.
There is evidence of widespread use by parents of complementary and alternative therapies (CAM) including exclusion diets for their children with autism. Despite this, there is a lack of evidence to support the use of gluten and/or casein free diet as an effective intervention for persons with autism and also a lack of research on potential harms and disbenefits of such diets.Despite the problems of maintaining the integrity of such diets in the community it is possible to carry out randomised control trials to address these questions and more and adequately powered trials are needed in this area.
 

Marcason W. J Am Diet Assoc. 2009 Mar;109(3):572.What is the current status of research concerning use of a gluten-free, casein-free diet for children diagnosed with autism?
Key Points: 
  • Widespread use of complementary and alternative medicine including supplements and gluten and casein free diet (GFCF).
  • Drawbacks to GFCF diets: difficult for parents to follow, extra costs, extra time for preparation, risk of nutritional inadequacies, especially in children who self-restrict diets
  •       “….at this time more research is needed” – two studies with GFCF diets currently underway
  •  Implications: “nutrition professionals have an important role to play in ensuring the health and safety of autistic children whose families have chosen to pursue dietary approaches…….it’s important to urge families to regularly evaluate the pros and cons of all dietary approaches to treatment."

 

 
Goday P. Whey Watchers and Wheat Watchers: The Case Against Gluten and Casein in Autism. Letter to the Editor. Nutrition in Clinical Practice Nutr Clin Pract. Nutr 2008 Dec-2009 Jan?
“Given the present state of the literature, it is hard to find evidence to support the GFCF diet. We do not believe that parents of children with autism are likely to agree; however, we are on the side of the autistic children, and we first wish to do them no harm.”
 
 
Jyonouchi H. Food Allergy and Autism Spectrum Disorders: Is There a Link? Current Allergy and Asthma Reports 2009;9:194–201
OBJECTIVE: Gastrointestinal (GI) symptoms are common comorbidities in children with autism spectrum disorders (ASDs). Parents often attribute these GI symptoms to food allergy (FA), although an evaluation for IgE-mediated FA is often unrevealing. Our previous studies indicated a high prevalence of non–IgE-mediated FA in young children with ASDs. Therefore, non–IgE-mediated FA may account for some but not all GI symptoms observed in children with ASDs. This raises the question of what treatment measures are applicable to ASD children with GI symptoms. A wide variety of dietary supplements and dietary intervention measures for ASD children have been promoted by medical professionals practicing complementary and alternative medicine despite the lack of rigorous scientific c validation in most instances. This review summarizes possible (or proposed) etiologies of GI symptoms in ASD children and discusses risks and possible benefits of intervention measures promoted by complementary and alternative practitioners, with emphasis on FA.
RESULTS: In summary, convincing data support the presence of chronic GI inflammation in ASD children, but the etiology of this GI inflammation is not well understood and is likely affected by multiple genetic and environmental factors. NFA can partially explain the GI symptoms and apparent beneficial effects of dietary interventions in some ASD children, especially young ASD children. Apparent effects of oral vancomycin and altered commensal flora reported in ASD children may be explained partially by dysbiosis, which is likely associated with multiple environmental and, possibly, genetic factors. Further studies are required to understand the etiology of GI symptoms observed in ASD children.

Page last Updated 4/5/2010 -- Yvette Fierce