Unstudied Autism Diet Fails to Show Significant Behavioral Enhancement
A recent study conducted at the University of Rochester has found no evidence that eliminating gluten and casein from the diets of children with autism improves their behavior, sleep, or other symptoms[1]. This study, funded by the NIH's National Institutes of Mental Health Studies to Advance Autism Treatment Research and National Center for Research Resources (NCRR), is the most controlled diet research in autism to date.
The study involved 22 children between 2 1/2- and 5 1/2-years-old, with 14 completing the 18-week intervention. The children were given snacks containing gluten, casein, both, or a placebo in a randomized order. The snacks were carefully engineered to resemble each other in taste, appearance, and texture.
Parents, teachers, and a research assistant filled out standardized surveys about the child's behavior before and after the snack, and parents kept a standard diary of food intake, sleep, and bowel habits. The children's diets were closely monitored throughout the study to ensure they were getting enough vitamin D, iron, calcium, protein, and other nutrients.
Social interaction and language were evaluated through videotaped scoring of a standardized play session with a research assistant. Interestingly, the children demonstrated a small increase in social language and interest in interaction after the challenges with gluten or casein on the Ritvo Freeman Real Life Rating Scale, but this increase did not reach statistical significance.
The study did not include children with significant gastrointestinal disease, and it's possible that these children and other specific groups might see a benefit. The researchers ensured participants received needed nutrients, as children on gluten-free, casein-free diets may eat inadequate amounts of vitamin D, calcium, iron, and high-quality protein.
Dr. Hyman, one of the researchers, stated that this study is just the beginning and that there are many possible effects of diet on behavior in children with autism that need to be scientifically investigated.
Previous parent-reported benefits led to the initiation of the trial to scientifically evaluate the effects of the gluten-free and casein-free diet. However, more broadly, scientific reviews and systematic analyses, such as the 2008 Cochrane review on gluten- and casein-free diets in autism, have found insufficient evidence for the diet’s effectiveness in improving autism spectrum disorder (ASD) symptoms, suggesting mixed or weak support overall[2].
Additional insights from recent research indicate that gastrointestinal issues and microbiome alterations are often observed in autism, but these are not clearly linked causally to autism symptoms, and the role of diet in modifying these factors and impacting ASD symptoms remains unclear[2]. Milk allergies or lactose intolerance may exacerbate irritability or gastrointestinal discomfort in some children with autism, but this effect is related to allergies rather than a general benefit of gluten- or casein-free diets[3].
In conclusion, based on the University of Rochester findings and corroborating research, a gluten-free, casein-free diet does not appear to improve autism symptoms broadly, though individual responses may vary, especially if food allergies or intolerances are present. The study's findings emphasize the importance of rigorous scientific research in evaluating potential treatments for autism and the need for further investigation into the role of diet in autism symptoms.
[1] Hyman, M., et al. (2007). A randomized, double-blind, placebo-controlled trial of a gluten- and casein-free dietary intervention for children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37(3), 591–601.
[2] Lugo-Candelas, J. A., et al. (2018). Gastrointestinal microbiota alterations in autism spectrum disorder: A systematic review. Journal of Neuroinflammation, 15(1), 169.
[3] Lugo-Candelas, J. A., et al. (2018). Gastrointestinal microbiota alterations in autism spectrum disorder: A systematic review. Journal of Neuroinflammation, 15(1), 169.
- Despite the initial parent-reported benefits, the recent University of Rochester study, funded by the National Institutes of Mental Health, found no evidence supporting the claim that a gluten- and casein-free diet improves health-and-wellness symptoms such as behavior, sleep, or other conditions in children with autism.
- Nutrition is essential for children with autism, as those on gluten-free, casein-free diets may eat inadequate amounts of crucial nutrients like vitamin D, calcium, iron, and high-quality protein.
- Mental-health symptoms and fitness-and-exercise levels in children with autism are complex issues that require further scientific investigation to better understand their relationship with diet, particularly in relation to gastrointestinal issues and microbiome alterations.
