What did the most comprehensive double-blind study of nutrition in autism reveal and what are the potential downsides? W.If you read in alternative medicine magazines, there is “a lot of evidence that foods containing casein or gluten” contribute clearly to ASD [autism spectrum disorder] and should be removed from the diet ”and that“ the implementation of a strict casein and gluten-free (CFGF) diet almost always leads to an improvement in symptoms ”, the authors are presumably pre talk about the published anecdotes and case series claiming wild success but not having a control group. However, there were two year long controlled trials that also showed notable benefits but couldn’t rule out placebo effects. The double-blind studies that controlled placebo effects found no benefit, but only lasted a few weeks.
As I discuss in my video Pros and cons of a gluten-free, casein-free diet for autism, Researcher then guided the study that was supposed to break the traffic jam: a month-long, double-blind, controlled study. Fourteen children with autism were placed on a gluten- and casein-free diet for four to six weeks. Then the researchers challenged them with double-blind, placebo-controlled food tests every week for the next three months, secretly giving them “foods that contained only gluten, only casein, both gluten and casein, or none of them (placebo)”. every week, month after month.
The researchers analyzed what happened to each of the 14 children in terms of their social relationships and language skills during each of the challenges you can see at 1:13 in mine Video. And what about the findings? Nothing. There was no apparent influence of the “GFCF Diet” found to behavioral disorders or autism-related behaviors. Does that mean the case is closed? Autism diet advocates “may find the 4-6 week implementation period before the challenges to be too short to take full advantage of the GFCF diet.” In other words, it could be argued that this was yet another double-blind study, which did not give the diet enough time to take effect. Could it be that the children were still feeling the effects of gluten and casein, which they had consumed more than a month earlier before the study started, which could possibly explain why? extra Didn’t gluten or casein make it worse? It is possible, I think, which is why you will see systematic reviews of the total number of evidence from time to time finally that although some studies “evaluating gluten / casein-free diets” showed benefits, the data are “insufficient” to draw conclusions in both cases. In other words, the weight of evidence is considered insufficient to support such diets.
But what’s the harm in trying it out? “Given the hassle, time, and money the GFCF diet requires requiresKnowing whether this investment pays off “- that is, whether a gluten- and casein-free diet actually works -” would be valuable. “There are disadvantages. “A special diet can have unwanted negative social consequences if children are unable to traditionally attend birthday parties and treats in class, or eat in restaurants or at other people’s homes.” Autism can be isolating enough as it is.
The general “evidence of the effectiveness of GFCF diets in children with autism” is weak and therefore these diets cannot be generally recommended as a treatment ”- but the parents keep trying and think,“ Since the medication is not working on the core symptoms, why not just try the diet and leave no stone unturned? ”I can understand, but there are potential downsides such as further “stigma, treatment diversion, and nutritional deficiency”. Nutritional deficiency?
The concern is about bone health, as people with autism are at increased risk of fractures. Now, lower bone mineral density in people with autism can be due to a variety of factors, such as a lack of vitamin D, chronic use of drugs that can weaken bones, and lack of exercise. Dietary restrictions can also play a role.
Do children with autism have lower calcium intake on gluten-free and casein-free diets? Yes, actually, they to have nine times the chance of missing your recommended calcium intake. Does this lead to reduced bone mass? Perhaps like those on a casein-free diet appear have less bone development. Now there is controversy over whether dairy products are the best source of calcium, but this is is where most kids get their calcium. So if you eliminate dairy products from the menu, you will have to replace them with other foods rich in calcium. Like research did shown, There are many sources of non-dairy calcium available, but they will only provide calcium when you actually eat them.
THE CENTRAL THESES
- Recommendations on eliminating foods containing casein or gluten to improve symptoms of ASA are often based on published anecdotes and uncontrolled case series.
- In response, researchers conducted an extensive double-blind, controlled study of children diagnosed with ASD and placed them on a gluten and casein-free (GFCF) diet for four to six weeks, followed by three months of weekly double-blind challenges, Placebo-controlled food tests – gluten only, casein only, both gluten and casein, or none.
- No apparent influence of the GFCF diet on behavioral or autism-related behavior was found, but critics have suggested that the length of the study was not long enough and that many parents and caregivers continue to try a GFCF diet in children with autism despite the lack of evidence of its Effectiveness.
- The disadvantages of a GFCF diet in children with autism include unintended negative social consequences such as increased isolation and further “tuning, treatment diversion, and nutritional deficiencies.”
- People with ASA are at increased risk of broken bones, lower bone mineral density, which may be due to a lack of vitamin D, chronic use of drugs that can weaken bones, and lack of exercise.
- Children with autism have been found to have lower calcium intake on a GFCF diet, but this may be the result of calcium from dairy products not being replaced once milk and other dairy products are removed from the diet.
- When dairy products are removed from the menu, they must be replaced with other calcium-rich foods, such as non-dairy sources of calcium.
This is the final article in my six-part video series on the role of gluten and dairy-free diets in treating autism. If you missed any of the others, check out:
Stay tuned to all of my autism related videos Here.
Please wait. Milk doesn’t protect against broken bones? See Is Milk Good For Our Bones?.
What about calcium supplements? Check out Are Calcium Supplements Safe? and Are Calcium Supplements Effective?.
For more information on nutrition and autism, see:
In health,
Michael Greger, MD
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