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Pros and Cons of Gluten-Free, Casein-Free Diets for Autism

Pros and Cons of Gluten-Free, Casein-Free Diets for Autism


“Pros and Cons of Gluten-Free,
Casein-Free Diets for Autism” When you read in
alternative medicine journals that there’s “a great deal of evidence that foods containing casein or gluten contribute significantly to [autism]
and should be eliminated from the diet”, almost always leading to
symptomatic improvement, they’re presumably talking
about the published anecdotes and case series that claim wild
success, but had no control group, though there were two
year-long controlled trials that also showed remarkable benefits,
but couldn’t discount placebo effects. The double-blind studies that
did control for placebo effects failed to find benefits, but
they only lasted a few weeks. This was to be the study
to break the logjam, a months-long, double-blind
controlled study. They put 14 kids with autism on a gluten-free, casein-free
diet for 4 to 6 weeks and then, for the next three months,
challenged them every week with double-blind, placebo
controlled food tests, secretly giving them gluten, just gluten, or just casein—or both, or neither, every week, month after month. Here’s what happened
to each of the 14 kids in terms of their social relationships
and their language skills throughout each of the challenges. And, bottom-line? Nothing. No apparent impact on
behavioral disturbances or autism-related behaviors. So, does that mean case closed? Well, proponents of autism diets “might regard the 4–6 week
implementation phase prior to the challenges as too short for the gluten-free, casein-free
diet to take full effect.” In other words, one could
argue this is yet another double-blind
study that didn’t give the diet long enough time to work. And so, maybe the kids were
still feeling the effects of gluten and casein they consumed
more than a month previously. And so, no wonder extra gluten or
casein didn’t make them even worse? It’s possible, I guess,
which is why you’ll see systematic reviews of
the sum total of evidence, like this one published 2017 in the journal of the American
Academy of Pediatrics, concluding that although
some studies showed benefits, the data are inadequate to
make conclusions either way, in other words, the “SOE”—
the strength of evidence — is considered insufficient
to endorse such diets. What’s the harm in
giving it a try, though? Well, given the effort,
time, and money that a gluten-free,
casein-free diet requires, knowing whether it actually works,
would kinda be a good thing to know. I mean, there are downsides. “Being on a special diet
can have unintended negative social consequences, when children are not able
to participate conventionally in birthday celebrations
and class treats or eat in restaurants or other people’s homes.” Autism can be isolating
enough as it is. The overall evidence for the
effectiveness of these diets is weak. And thus, these diets cannot be
generally recommended as a treatment. Yet, parents continue to give it a try figuring, “Look, the drugs don’t work, in terms of helping the core symptoms. So, why not just give it a try
and leave no stone unturned.” I can understand that; however, there are
the potential downsides, like further stigmatization, diversion of resources
away from other treatments, and, they suggest, a concern
about nutritional deficiency. What they’re worried
about is bone health. Those with autism are at
elevated risk for bone fractures. Now, lower bone mineral density
in individuals with autism may be due to a variety of factors: lack of vitamin D, chronic use of medications
that can weaken bones, lack of weight-bearing exercise— but, maybe dietary restrictions
play a role. Do children with autism on
gluten-free, casein-free diets have lower calcium intake? Yes, in fact, 9 times the odds of failing to meet recommended calcium intakes. Does this translate out to
reduced bone mass? Maybe so, as those
on casein-free diets appeared to have less
bone development. Now, there’s controversy
over whether dairy products are the best source of calcium, but that is where most
kids are getting their calcium. And so, if you remove dairy, you have to replace it with
other calcium-rich foods. As the study they cited points out, there’s lots of nondairy sources of calcium— but, they only provide calcium
if you actually eat them.

51 Replies to “Pros and Cons of Gluten-Free, Casein-Free Diets for Autism”

  • The long wait is over!!! The final study results and …now we know. 😉 Thanks Dr Greger!

  • Totally anecdotal, but I’m an adult with aspergers & on a vegan diet with no sugar, processed foods, or gluten my sensitivity to sound and chronic tinnitus/irritability/anxiety has drastically improved. Maybe the studies are only looking at kids who are really non-verbal, but no one seems to be asking them how they feel. I can’t imagine a placebo can get rid of overt neurological symptoms.

  • Ask not where you get your protein, but what your protein is doing to you.
    Spoiler: humans don't use protein. They use amino acids to make it.

  • GUHHH I was thinking that it was going to be a double blind placebo-controlled trial of like a year or something.

    Like how it can take a year or a year and a half for the villi to return and stomach lining to repair in people with Celiac Disease, could it not take a year or a year and a half for brain tissue to repair on a [gluten+casein] free diet?

    What about this?

    1. You take people who have recently experienced brain damage via trauma.
    2. You measure the damage to the parts of their brain that people with autism may have damaged/inhibited.
    3. You measure the brain damage patients' recovery rates of those parts of the brain related to communication/autism-associated parts.
    4. You draw conclusions about how long the repair process takes, then design a gluten-free casein-free diet double blind placebo controlled study for that length of time.

    Seems a lot better than an arbitrary few weeks… I think autism should be looked at as a chronic illness/disorder. A chronic disease can take a long time to heal…

    Idk, fuck it, broccoli

  • If the placebo effect is so powerful maybe the parents of the autistic children should just be better, more positive parents.

  • Population study where you get half the people to do GFCF and half to do soy free, nightshade free. Then everyone has to read labels and have a nightmare feeding their kids.

  • It's fascinating to hear the narrative of the thought process of a doctor's analysis of studies. Listening to it helps me understand how I can better evaluate studies myself.

  • Eventhough the result is not what i expected, i am relief to know the answer. A lot of times, people only believe what they want to believe. Thank you Dr. Greger and NF team for putting the time and effort to make this a public knowledge 🙏

  • I am not a doc, but my limited understanding of Autism is that there is a pathological manifestation. And if that is true, that any short-term dietary intervention would be insufficient to correct it. It' like getting an oil change when your engine is already has bad bearings. I would suggest backing up and studying the morbidity of autism in breast milk kids vs formula kids, And the impact of the timing of being switched from B to F. The hypothesis is that the longer you delay the switch of B to F, the less impact there will be. Similarly, the longer on F, the longer it will take to reverse the symptoms.

  • I dunno, my son showed remarkable improvement after going GF when he was 3. His daycare was stunned. He suddenly stopped throwing things at other kids, could stand in line quietly, and actually started talking to the other kids. I was shocked when I took him in one morning and he turned to another little boy and said "Good morning, Noah." It took 2 months for me to stop reacting to gluten after I stopped eating it, so it could very well be that a longer study is needed. Still, celiac runs in our family, so maybe that has something to do with it. I had the family go GF because it was making my son and I sick. The autism benefits were just a nice side effect. We haven't noticed a difference since going milk-free more recently, tho. Maybe it affects some kids more than others, or genetics or age plays a role? Dunno.

  • Maybe what can be taken away from this is if parents decide they want to give this GFCF diet a try on their autistic child, they should make sure they substitute with foods that cover for possible deficiencies.

  • Israel is running a clinical trial with cannabidiol for autism right now. I have had my gut motility issues greatly reduced by it. Clinical evidence states that I can expect this as one benefit from using cannabidiol. https://www.ncbi.nlm.nih.gov/pubmed/28276820

  • Aren't humans only supposed to eat fruit and maybe some raw leafy greens and nothing else? We're not really supposed to eat any grains, beans, nuts, and seeds, and definitely no animal foods. We should really just be eating fruit meals.

  • So, three months[plus the 4-6 week prep phase(why the range?)] is considered sufficient by researchers, in spite of breadth of anecdotal cases suggested one year's minimum dietary intervention to discern effects? I wonder why a longer period was not employed in such a rigorous trial? Cynically, I wonder what excuses mentioning this shortcoming would elicit from researchers . . . TFP!

  • no change in behaviour…why?
    gluten free pasta or pasta pasta
    both shit food

    stop the starch train – its hurting everyone

  • Children raised as VEGANS are perfectly normal, so autistic kids raised vegan should be the same – normal in every bodily function. If diary and meat are NOT NECESSARY for any BODY, why would an autistic BODY need dairy and meat? Raise any one vegan and reap the benefits………

  • But milk- and wheat-free diet is not same as Casein- and Gluten-free diet 🙂 same as lycopene alone is not anti-cancer but tomatoes paste is ( from previous video)

  • Gluten-free may not be enough. Getting rid of the grains entirely may do it. White flour causes mucus, since complex carbohydrates are harder to digest.
    Just eat a lot of fruit and salads. Fruit sugar won't be an issue. Check Dr. Morse for more details. "Open debate on fruit sugar" is a good video by him that explains most of the stuff.

  • Dr Greger, we need your help. The EU just approved a 5 year extension on Monsanto's glyphosate, and people don't understand what this vote means. It's going to be in our food supply, even the water supply. Please, can you discuss the literature on this?

    Yours Truly,

    Concerned EU Citizen

  • This whole casein-free diet doesn't seem to make sense. All baby humans drink casein from their mother's milk. What's wrong with casein?

  • Endless equivocation… as usual ….. if science can’t falsify.or prove something, what good is it. In the lack of evidence, Desperate parents will cling to anecdotal reports…

  • I have Aspergers and I am NAET treatments to eliminate sensitivities and allergies to foods/chemicals which has eliminated symptoms of autism/Asperger syndrome. For more info I would recommend www.naet.com or http://www.naetautismtreatmentcenter.com or read the book NAET: say goodbye to allergy related autism by dr Devi

  • I have Aspergers and I am NAET treatments to eliminate sensitivities and allergies to foods/chemicals which has eliminated symptoms of autism/Asperger syndrome. For more info I would recommend www.naet.com or http://www.naetautismtreatmentcenter.com or read the book NAET: say goodbye to allergy related autism by dr Devi

  • I am a 44 yr old female with autism and I personally have had an at least 80% reduction in stimulative behaviors since going fully unprocessed plant based. However, the first several weeks of this new way of eating were so stressful I felt absolutely NO change. Getting used to eating completely new foods, and dealing with the addictive cravings of my old foods was easily enough stress to cause major breakdowns in my behaviors. Around my 4th or 5th month of eating this clean, I began to notice I wasn't stimming AT ALL. **However** when I cheat and eat garbage or when I consume alcohol, the next 3-4 days my stimulative behaviors are OFF THE CHARTS. Head & eye movements mostly, which are incredibly painful phsyically (anyone who lives with autism knows just how painful our stims can be). I would like to add that I was vegan for 3 years before going fully unprocessed, and I did NOT notice an improvement, so removing casein had zero effect for me personally. I do still eat foods with gluten, although in very natural forms of whole grains, and I don't have a problem with it. What causes me to melt down seems to be overly processed junk food or fast food &/or alcohol. Even high end vegan restaurant food causes a change for the worse – the more processed the food though, the greater my consequences. I hope this helps someone.

  • I'm curious if anyone has compared the number of autistic kids born to vegan moms vs the general pop – a fetus spends 9 months getting exposed to everything the mom eats, drinks, smokes – maybe this could explain why 'detoxification' takes a couple of years instead of a couple of months…..I'll have to search nutritionfacts.org to see – maybe Dr. Greger has already cover this topic

  • What does the research suggest for gluten and hypothyroidism (Hashimoto's)? I have a family hx and I'm concerned I should be eliminating gluten from my diet.

  • Celiac disease is caused by the use of glyphosate, and not caused by gluten. Gluten is good for you. Chinese and Japanese eats pure gluten (aka seitan) for thousands of years.

  • Changing diet worked very well for my son. Ten years ago we put him on a strict gluten free casein free diet and saw improvements in a few months.

    Over time we have also gotten rid of artificial food colorings, artificial flavorings, and artificial preservatives, and pesticides. In our home, we avoid artificial perfumes in air fresheners, cleaning supplies and laundry detergents. Yellow dye was the worst offender.

    He's had multiple other interventions over the years. It takes time to heal from diet changes.

    My son was part of early research on Autism, so his case is well documented.

  • As someone with gut problems so bad they were causing hallucinations, I can tell you it took restricting a hell of a lot more than just casein and gluten to fix the problem. And more than a year. I would like to see a study using the AIP diet.

  • im trying the gluten,diary,spinach and soy (exorphine)free diet right now. 3 weeks in. and i feel like stopping with drugs that i took for years. very tired and slow. I do take vit D3, K2, 250 mg magnesium malate, activ forms of B12 with B11 and enough calcium re placers. and im also already taking these supplements for about a year without side effects. so it sure does something to me, not positive yet.

  • My family did it for my brother for at least like two years and it didn't really do anything. In fact, he's had a lot more improvement way later than that time period which is most probably due to therapy and special education.

  • casein and gluten have less of a detrimental effect than those diets restricting the cholinergic pathways

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