As a Certified Nutrition Consultant specializing in autism, I’ve spent the past twelve years researching and explaining the underlying scientific rationale for dietary intervention for affected children.
I’m surprised to still hear people say, “there is no research to support diet for autism.” Of course there is, if anyone would simply read the literature, they would know there’s plenty of research on diet and nutrition for autism, including:
- Research on gluten and casein and opioids in autism 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 “Nourishing Hope for Autism”).
This latest study 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. The study, led by Dr. Nga M. Lau, involved 140 children—37 with autism, 27 unaffected siblings, and 76 age-matched healthy controls. They found specifically, “Children 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.”
Antibodies are the body’s way of “sounding the alarm” 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. 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. Antibodies indicate that the body is likely creating inflammation and that the food source can be causing irritation and GI symptoms. These findings indicate that further research into the role of the immune system in autism, as well as gut issues in autism is warranted. 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 don’t have celiac. 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 “significantly greater” 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)—compared to unrelated controls (though not statistically significant). To me, this points to an increased potential for gluten intolerance in siblings, and helps us see that gluten intolerance likely runs in the family—which has been my clinical observation.
The researchers concluded, “A 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.”
This research supports parents trying a gluten-free diet for their child with autism. 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. 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.
I’m saddened when I hear that someone “abandoned diet” (all together) because they tried gluten-free and it “didn’t work.” There are many reasons for not seeing benefit, and several things to work on as you hone your dietary approach. If two foods are causing a problem and you remove only one, you might not see any benefit. 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!
It’s 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. 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, it’s not the same diet/nutrition approach for everyone. There are many different diets, and finding the right one for your child is the key. 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. Most of the healing diets start by avoiding gluten because of the many problems associated with gluten. Just begin, and go from there to determine and customize the dietary approach best for you or your child.
Being on the path of “good nutrition” is the most important thing—the “rules” may change but “nourishing hope” is about being in the process of nourishing yourself and your child.
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. Kamiński S, Cieslińska 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.” PLOS ONE 8, no. 6 (2013): e66155.