As a Certified Nutrition Consultant specializing in autism, Iāve spent the past twelve years researching and explaining the underlying scientific rationale for dietary intervention for affected children.
The Research
Iām surprised to still hear people say, āthere is no research to support diet for autism.āĀ Of course there is, if anyone would simply read the literature, they would know thereās plenty of research on diet and nutrition for autism, including:
- Research on gluten and casein and opioids in autismĀ 1, 2, 3, 4
- Digestive problems with gluten & casein in autism 5
- And reduced autistic symptoms with gluten-free and casein-free diet, 6, 7, 8 as well as other areas of research on the subject (see āNourishing Hope for Autismā).
This latest studyĀ 9, out last week, is even further support that a gluten-free diet makes sense and benefits children with autism.
Researchers at the Columbia University Medical Center found significantly elevated antibodies to gluten in children with autism. Ā The study, led by Dr. Nga M. Lau, involved 140 childrenā37 with autism, 27 unaffected siblings, and 76 age-matched healthy controls.Ā They found specifically, āChildren with autism had significantly higher levels of IgG antibody to gliadin compared with unrelated healthy controls. The IgG levels were also higher compared to the unaffected siblings, but did not reach statistical significance. The IgG anti-gliadin antibody response was significantly greater in the autistic children with gastrointestinal symptoms in comparison to those without them.ā
Antibodies are the bodyās way of āsounding the alarmā to kick the immune system into gear and rev up inflammation (and pain) to fight a perceived threat of an invader, such as a virus.Ā When a food substance (like gluten) is the perceived invader, the subsequent inflammation and digestive upset can go on for months or years, whenever the food is consumed.
Finding these elevated antibodies in children with autism is significant. Ā Antibodies indicate that the body is likely creating inflammation and that the food source can be causing irritation and GI symptoms.Ā These findings indicate that further research into the role of the immune system in autism, as well as gut issues in autism is warranted.Ā This study also showed that while there was increase in these anti-gliadin antibodies, there was no increased incidence of celiac disease: This is consistent with other study findings that demonstrate that that people can have a problem with gluten, even if they donāt have celiac.Ā These findings further support the notion that families with autism should be aware of the role of gluten in the diet, problems it can affect, and the benefit of avoiding it altogether; especially if a child suffers gastrointestinal symptoms.
In the study, of the children with autism that had gastrointestinal symptoms, the anti-gliadin antibody response was āsignificantly greaterā than those without symptoms, showing that special diets are particularly important with GI issues.
Also, the level of antibodies was higher in siblings (unaffected by autism)ācompared to unrelated controls (though not statistically significant).Ā To me, this points to an increased potential for gluten intolerance in siblings, and helps us see that gluten intolerance likely runs in the familyāwhich has been my clinical observation.
The researchers concluded, āA subset of children with autism displays increased immune reactivity to gluten, the mechanism of which appears to be distinct from that in celiac disease. The increased anti-gliadin antibody response and its association with GI symptoms points to a potential mechanism involving immunologic and/or intestinal permeability abnormalities in affected children.ā
This research supports parents trying a gluten-free diet for their child with autism.Ā And in my opinion, trying it for their siblings too!
GFCF Diet (Gluten-Free & Casein-Free Diet)
For parents of children with autism considering the gluten-free diet, I encourage you to remove casein (the protein in dairy) as well, making it GF and CF.Ā This is because casein is commonly a problem in addition to gluten, and it can interfere with seeing positive results on gluten-free. Sometimes, the negative reactions from one food (in this case, dairy) mask the improvements that would otherwise be seen on the gluten-free diet. And gluten and casein have a lot in common. Gluten and casein are broken down by the same enzyme, DPPIV, and they can both form into opiates.
Iām saddened when I hear that someone āabandoned dietā (all together) because they tried gluten-free and it ādidnāt work.ā There are many reasons for not seeing benefit, and several things to work on as you hone your dietary approach.Ā If two foods are causing a problem and you remove only one, you might not see any benefit.Ā That is, removing 50% of problematic foods may not provide a 50% improvement in symptoms: some people may not see improvement until 100% of inflammatory/problematic foods are removed.
If you want to see the effects of gluten specifically after reading the results of this study, you might choose to try gluten-free first to see the effects alone, then remove casein in addition, to see if you see further improvement.
For years, I have witnessed hundreds of children and families benefitting from a gluten-free and casein-free diet, and not just the child with autism, but their siblings, and parents!
Here is our GFCF Success guide to get you started!
Beyond GFCF
Itās vital to remember though, that the avoidance of gluten and/or casein, or the GFCF Diet, is but one dietary strategy for helping autism – there are several nutrition centered dietary strategies that prove very effective for helping children.Ā And, gastrointestinal issues are but one reason to be strategic about food choices with autism; there are many others. Multiple studies indicate that nutrient deficiencies are common with autism, and several other factors that indicate that attention to food choices and nutrition intake is paramount. However, itās not the same diet/nutrition approach for everyone. There are many different diets, and finding the right one for your child is the key.Ā My book, Nourishing Hope for Autism, helps you understand the science and apply the best dietary approach for your child.
Twelve years of research tells me, gluten-free is a great place to start.Ā Most of the healing diets start by avoiding gluten because of the many problems associated with gluten.Ā Just begin, and go from there to determine and customize the dietary approach best for you or your child.
Being on the path of āgood nutritionā is the most important thingāthe ārulesā may change but ānourishing hopeā is aboutĀ being in the processĀ of nourishing yourself and your child.
References:
1. Jinsmaa Y, Yoshikawa M. (1999) Enzymatic release of neocasomorphin and beta-casomorphin from bovine beta-casein. Peptides, 20:957-962.
2. Reichelt KL, Knivsberg AM, Lihnd G, Nodland M: Probable etiology and possible treatment of childhood autism. Brain Dysfunction 1991; 4: 308-319.
3. KamiÅski S, CiesliÅska A, Kostyra E. (2007) Polymorphism of bovine beta-casein and its potential effect on human health. The Journal of Applied Genetics, 48(3):189-198.
4. Shattock P, Whiteley P. (2002) Biochemical aspects in autism spectrum disorders: updating the opioid-excess theory and presenting new opportunities for biomedical intervention. Expert Opin Ther Targets. Apr;6(2):175-83
5. Jyonouchi H, Geng L, Ruby A, Reddy C, Zimmerman-Bier B. (2005) Evaluation of an association between gastrointestinal symptoms and cytokine production against common dietary proteins in children with autism spectrum disorders. J Pediatr. May;146(5):582-4.
6. Knivsberg AM, Reichelt KL, Nodland M. (2001) Reports on dietary intervention in autistic disorders. Nutritional Neuroscience, 4(1):25-37.
7. Knivsberg AM, Reichelt KL, Hoien T, Nodland M. (2002) A randomised, controlled study of dietary intervention in autistic syndromes. Nutritional Neuroscience, 5(4):251-61
8. Whiteley P, Haracopos D, Knivsberg AM, Reichelt KL, Parlar S, Jacobsen J et al. The ScanBrit randomised, controlled, single-blind study of a gluten- and casein-free dietary intervention for children with autism spectrum disorders. Nutr Neurosci 2010; 13(2): 87-100.
9. Lau, Nga M., Peter HR Green, Annette K. Taylor, Dan Hellberg, Mary Ajamian, Caroline Z. Tan, Barry E. Kosofsky, Joseph J. Higgins, Anjali M. Rajadhyaksha, and Armin Alaedini. “Markers of Celiac Disease and Gluten Sensitivity in Children with Autism.”Ā PLOS ONEĀ 8, no. 6 (2013): e66155.
Ā
We are beginning removing Gluten this week with my 16 year old non-verbal daughter who has autism and behavior issues; with a lot of crying. I am cutting Gluten first to see if it is causing a problem and see if it helps. It is great that the stores are full of Gluten free products and of course all the meats, veggies, and fruits too.–I have noticed that most Gluten free products in the store are made from rice flour and it doesn’t have hardly any vitamins and minerals like reg. wheat flour, so I think it is best to give vitamins when doing this diet too. I am also hoping that if this is her issue than as soon as the gut heals she can go back to eating normally because the Gluten free foods are much more expensive and are not as tasty.
Hi Julie,
Our oldest son, 27 months, has always been what I thought, after learning the food pyramid in school, an amazing eater; turning away only sweets, but loving vegetables, milk, breads, and meats in particular: his milk. I had, after all, done tons of research into introducing food to new babies to reduce the risk of allergies, and worked really hard on making him into a “healthy eater”, or so I thought.
Shortly before his second birthday, we received an autism diagnosis and I began researching again, realizing quickly that his love of his milk may not have been so great, after all. We are currently beginning the GFCF diet. (We started by thinning his milk with water, then tried out substitutes to see which ones he would accept, which ones he wouldn’t. We are also trying out gluten free items from the store, as well as collecting a battery of tried recipes, that we will be able to use. Just thinning his milk made a change. He no longer stared at his hands as if he were stoned, he started looking at us. This last week we made the final cut to dairy products, no more cheese, yogurt, etc., and the change has been remarkable. We do still plan on cutting out the gluten, and are working on gaining a “recipe foundation” with which we can do so.
Now to the question of the day. Two and a half months ago, we were blessed with another wonderful little boy. Currently, he is 100 percent breastfed. I just don’t know what to do when I start introducing foods to him. Should I try slowly adding gluten and caseincontaining items as done with most kids(well, cow’s milk casein, I’ve heard that breastmilk also contains casein.), to try and keep him from developing an allergy, or do I keep them from him for a longer amount of time, or completely? Are there any tests we should get done to help us decide what direction to go? I’m very much at a loss here and would appreciate any suggestions you could give me.
Thank you in advance for your time,
Jeni
We know that gluten intolerance decreases the body’s ability to absorb minerals and other nutrients. We also know that Autistic kids have an abnormal gut flora per recent research. We also know that gluten intolerance is estimated to affect as much as 60 percent of the population. Maybe we are looking at this the wrong way. Instead of theorizing that autism is somehow increasing the likelihood of gluten intolerance, maybe the gluten intolerance itself is causing or at least significantly contributing to the autism in the first place. Maybe these kids already have a significant decrease in absorption of nutrients especially minerals which weakens their immune system causing them to have more severe reaction to vaccinations, more infections being treated by antibiotics which leads to decreased beneficial gut flora exacerbating absorption even more. Just my two cents.
You have amazing knowlwdge on this web-site.
Hi Julie, I am really excited that I have stumbled across your website. Have not read your books but hopeful they will be available at our local library.
Our son is now 7, he has had behavioral issues related to food as far as I can tell since about 6 months old. It was when he started eating table foods that we saw a change in him. Every time I would mention that to someone, including pediatricians, they would not believe me. Anyway when he was 5 someone finally suggested a GF diet. It has worked wonders but still having some trouble. Currently he is GF, food dye free, and limit processed foods. We have now started attempting CF.
One thing I have noticed is not all things with wheat seem to effect him, for example he seems to handle flour tortillas just fine. Wondering if it is something other than gluten that just may be in a lot of gluten products. Maybe yeast? Do you have any thoughts you would be willing to share?
Thank you,
Abbey
hi there
I’M so happy about this article because where we are staying with our handsome boy- Khaile, living with autism, the concept of nutrition is not understood even by paediatrician. We had our son put on gluten-free food and he improved. yes its hard to believe, its hard to carry out the exercise but hey when was autism easy to deal with?
thanks again
keep loving kids with autism
‘Makhaile
Maseru
Lesotho
Hi Julie I have been trying to put my son on a go/cf diet on and off for many years. My problem is that he has so many allergies and intolerances that I can’t find things for him to eat and sustain. Allergies are wheat,soya,all nuts(Epi pen needed) coconut, eggs, sesame, eggs. Also he has very low iodine iron vit A and is under mentholated. If it was just go/cf I think we ould be fine. I have spent endless hours trying to work this out.
Any advise would be appreciated. He is also a very picky eater
Thanks Michelle
GFCF can certainly be more difficult when allergies need to be avoided too. However, generally speaking, a GFCF diet could still work – although I sympathize with the challenges. Most people do not do soy with GFCF anyway, and nuts and eggs can be avoided too. In fact, my cookbook, Cooking to Heal, tags all recipes that are nut-free and egg-free because those allergies are not uncommon these days. All meats, fruits, vegetables, and non-gluten grains would be food options. There are gluten-free pasta, bread, and pancake choices. Gluten-free sausage is a breakfast possibility. There are many egg substitutes available for baking. There are also foods free of these allergens that contain the nutrients needed such as liver rich in iron and vitamin A – I have a great Burgers with Liver recipe that kids love! And a multivitamin/mineral may help with the other nutrients that are low. Picky eating will make it more challenging, but if you get creative, I’d imagine you could come up with alternatives.
thank you for bringing more attention to the issue of Autism, GI issues, immune response, food allergies… I feel I could have just written our story and what we know about my son- and your research just validates everything we have so far learned about my son. In fact, his Autism was one of the last things he was Diagnosed with – his food allergies/insensitivities – where gluten literally attacked his intestines causing a celiac like response- but celiac tests all came back normal… doctor couldn’t even believe it based on what his insides looked like- but his intestines healed and began healing within 6 weeks of cutting gluten out… but his bowel problems started since the day he was born and then all his subsequent developmental delays were blamed on his bowel issues – to date… my son just turned 9, he has been on a GF/CF(all dairy free) diet since he was 2….. unfortunately he still has major bowel disorder- with a cecosotmy in his colon for nightly flushes- which he still needs disimpaction 2 x a year in the hospital… and then at 6 was Dx with Autism…. at 5 was Dx with SPD… and his sensory issues control his inability to function throughout the day… we call his world the bubble- because as long as everything is the same, consistent, no changes, no transitions, no unexpected anything, very controlled, with a very high sensory diet with lots of calming activities and prorprioceptive input… wow what an amazing, engaged, intelligent, more flexible child we have…… but one little kink in that world, he can’t seem to deal… and for him, dealing is aggression, control, major behavioral outbursts, and tantrums…. we have in home behavior services 30 hours a week… we don’t go anywhere (unless absolutely necessary)… he has come a long way- and he eats food – has gained weight (he no longer can attend a school setting- he stops eating, sleeping, his aggression increases, he runs away- very unmanageable behaviors and at age 9 now, very dangerous for the rest of our family. we manage his bowels every night through the flushes, he eats food, he’s very picky and very texture sensitive- doesn’t try new things very easily… but he has gained weight and is not skin and bones…. as he actually has the dx of anorexia and has attended feeding therapy ….. the brain, the gut, immune over responses, food allergies, behavior, social skills, developomental growth, sleep… it’s all so tied together in our son… and over the past 9 years we have heard more (I don’t know, I don’t understand, not sure, doesn’t make sense) comments more then hearing helpful information, and it’s a very long road we’ve come and yet he has still so much road to continue to travel… to even be able to “appear to function” … and by that I mean, be able to go out into the community, go to a park to play, simply go to an ice cream place (to get dairy free ice cream of course) as a family… without tantrum, anxiety, meltdown, inability to cope that then is disguised by behavior, hitting, kicking, etc…. I know my son’s situation and our family situation is extreme, it always has been since he was born… but at least he has a team of professionals who seem to at least understand some of it.. unfortunately still pick him apart depending on the profession… it’s hard to get the “whole child” perspective… but more attention to the multiple comlexities that some families face are critical to the professional/ medical world to then begin to help kids like my son. The world is just very overwhelming for him, it’s unpredictable, loud, bright, scary when you know more people at a hospital then outside of that… (btw yes he has PTSD as a result of all his invasive tests he had to go through over the years.. and PTSD in kids with Autism, and sensory problems, etc… makes like that more challenging. Please continue your research to help spread the knowledge that is needed … as a parent, we may not understand many things- but we have been very clear on what my son experiences, and what our family experiences, down to “we have always described my son literally begins to come out of his autism box if we keep his bubble secure…. but leaks cause very quick regression and repeated leaks like when he attended school, or community event, or simple errand, and no time to recover- meaning a one time leak, but then spent the next 2 weeks doing major proprioceptive activities, swimming is his favorite right now- and minimal distractions within our house…. you couldn’t believe who my son really is and who he wants to be…… ” we have always said, when every star is in complete alignment, the most perfect universe- we see a side of my son that is truly magical – sweet, kind, engaging, (or at least trying to… skill deficits are real)… he eats, he sleeps, he’s regulated more ….. I think this is a key word that many still; don’t understand “regulation….. and my son has no internal self regulation … and looks to myself, my husband, our dogs, and his external environment to help him regulate his body….. that’s not easy to rely on everything outside of yourself to have basic body needs met…….. keep up the research on autism, gluten sensitivity, immune response, it’s critical to pieces of the autism puzzle. Thank you!
Jennifer Abbanat
Davis, CA
side note: our oldest daughter, 11, dx with asperger’s and Tourette’s, some food allergies, asthma, environmental allergies
Our youngest daughter, 6 dx with dairy allergies, gluten sensitivity- again on scope her colon was torn apart at age 1- passed through breastmilk)… asthma, environmental allergies, bowel problems that require daily miralax … not as severe as my son’s bowels, but very constipated /poor motility…… and she has been dx with chronic tic disorder… tics since age 2…(at this point probably Tourette’s, but haven’t seen a neurologist… Tourette’s runs through the females on my side of the family…. mother and my niece …… I know there is a strong hereditary connection here… š
Dear Friend,
Please don’t give Mirolax to your children. It is full of aluminum. This is very bad, especially for poor methalaters. It’s bad enough It’s many vaccines as an advujunt (so?). Try vitamin C in large amounts, prunes … Make sure whatever you give them us ‘clean’ – free from toxins and GMO’s. it’s not easy.
From another Parent ASD
Dear Jennifer. Your sonĀ“s case reminded me my sonĀ“s situation. The way you describe it, is exactly as we lived it.
One day we read an article with stayed that ASD cases could be indeed secondary autism. What does this mean? It means that there is an underlying cause and the autistic behaviour is the manifestation of the underlying cause.
In fact, JulieĀ“s article and JulieĀ“s book, which I must say I have read at least 20 times, is consistent with this approach, i.e. gluten/casein intolerance could be one of the underlying causes and the autistic behaviour the manifestation.
If you go deepper, a possible problem in the intestinal production of DPPIV enzyme, which is required in more than 20 body functions, could be the underlying cause, then eating gluten, casein or soya protein could inactive the low level or defective DPPIV reserve, giving the result that we see in our children.
All this because what I want to tell you is that we used this approach in order to find the underlying causes of the autistic behaviour.
Certainly,it was no easy, and required a lot of detailed clinical studies that are also mentioned in JulieĀ“s book.
As a result of several analysis, that were carried out since my son was 4 years old (today he is 11 years old), we found that:
He has a problem with aconitase enzyme (Krebs cycle), and for this reason he cannot consume any product of supplement that contains citric acid.
He has a problem with DPPIV enzyme (digestive problems)
He has a problem with metallothionein protein (difficulties to eliminate heavy metals)
He has a problem with medium chain acetyl-CoA-deshydrogenase (he cannot consume medium chain triglycerides, like coconut oil, or other fats/oils that can contain it, for example chicken soup)
He has a problem with the MTHF reductase so he is a poor methylator, and if he consumes folic acid, it agravates the problem.
He has a problem with transulfation pathway, so cannot detoxicate easily.
He is affected by phenols, phenolic amines, oxalates.
Because of his limited diet, he went into depression as we realized that he wasnot eating the blocking nutrients to syntehtize dopamine, serotonine and the other neurotransmiters.
But thanks to the studies and the interpretation of the results by the specialists, we manage to give my son a special diet that could meet two aspects: avoid the offending foods and giving him all the nutrients to allow his organism to improve. All this with the help of several supplements.
To summarise I can tell you that at 4 years old he was diagnosis with deep autism; at 7 years old a new dx clasified him as medium-deep autism; at 9 years old as functioning autism; and 3 months ago he received a new dx. as Asperger. I have all the dx. written with the signature of the specialists.
My sonĀ“s teacher has asked me to write a book about this, which I am trying hard to do. But what I really would like to tell you and to tell to all moms and dads is that there is a way to improve the life of our autistic children. It is also true that the way can be different for each child, but in general terms, if we find the underlying causes, and we avoid the offending foods or external factors that exacerbate these causes, I can tell you that the life of our children can really improve.
Good bless you all parents, and also a lot ot blessings to people like Julie who help us to find the answers to the questions that we are looking for.
What is NAET? My 9yr old son has high functioning Asperger’s.
As you can see by another mom’s post, NAET seems to be very helpful for some children with food intolerances.
Hi – did you get a reply to your question above re NAET? I’ve read and re-read the posts here and can’t see an explanation.
This is a great summary and such important information to share. So many people are sensitive to gluten, especially in the special needs population. It’s great that you are highlighting the studies to support how beneficial a gluten-free diet can be.
I’m so pleased to see more research in this area – thanks for the great summary. Wonderful to see your very important work being validated further! I look forward to seeing more and more research on the ill-effects of gluten. It’s so harmful in so many ways for so many people. I certainly find it to be an issue with the majority of my clients who have anxiety/depression
Well done on your awesome trip to Australia and getting your message there too!
Trudy
This is an important article! So many autistic children have had success using diet as a treatment. It’s hard for me to understand how so many can discount it!
Thanks!!
As a mother of an autistic child I can tell anyone that our children are sensitive to foods, but it’s not just gluten and casein causing problems, hence the term spectrum and all the different ways of addressing it. I looked at this issue very hard, and removing allergens doesn’t solve the underlying problems. My child was such a fussy eater, he was under a paediatrician, he was so thin he was almost blue. His hair was dry and brittal he pulled it out as well as having alapecia. He had smelly loose stools, scratched till he bled, and a whole host of other issues. Any diet restrictions were out of the question, he refused to eat any special diet. I know your going to say I didn’t try hard enough, but if I had carried on, he would have starved – he was already on the way. So what did I do? I started treating him with NAET. He looked just like the little boy on YouTube ‘is this theist allergic boy in the world’ and now he is putting on weight, eating things I would never have dreamed of, his itching has gone, his hair has thickened and grows shinny, he is.
calm and has eye contact and is trying to speak. NAET has treated the under lying issues, we’re not even half way there yet, can’t wait to finish. I am sure I can recover my lost boy. Great article, but treat the why and not the effect
With love and hope to all the other mums xx
Good point Liz. I think the first step is to remove the offending food, then see if you can improve tolerance to it. I’m glad NAET was helpful for your son.