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Gluten-free Diet Does Not Help Kids with Autism

Celiac.com 09/21/2015 - A gluten-free diet does nothing to improve behaviors or symptoms of children with autism, according to the results of a study that, though small, is being called the most comprehensive and carefully controlled diet research in autism to date. The study results appear in the Journal of Autism and Developmental Disorders.

Photo: CC--hepingtingThe study was conducted by Dr. Susan Hyman and colleagues at the University of Rochester Medical Center. Dr, Hyman is the division chief of neuro-developmental and behavioral pediatrics at the University of Rochester's Kirch Developmental Services Center, which sees some 1,200 children with autism each year.

For the study, a group of preschool children with Autism Spectrum Disorders (ASD) received a gluten-free, casein-free (GFCF) diet.

Hyman's study enrolled 22 children between 2 ½- and 5 ½-years-old. Fourteen children completed the intervention, which was planned for 18 weeks for each family. The families had to strictly adhere to a gluten-free and casein-free diet and participate in early intensive behavioral intervention throughout the study. Children were screened for iron and vitamin D deficiency, milk and wheat allergies and celiac disease. One child was excluded because of a positive test for celiac disease and one was excluded for iron deficiency. Other volunteers who were excluded were unable to adhere to the study requirements. The children's diets were carefully monitored throughout the study to make sure they were getting enough vitamin D, iron, calcium, protein and other nutrients.

After four weeks of being established on diet, the children continued on the diet and were given snacks weekly that contained gluten, casein, neither or both.

In addition to administering a gluten-free casien-free diet, the research team received a full complement of nutrients, such as vitamin D, calcium, iron and high quality protein, which can be lacking in children on gluten-free, casein-free diets.

The kids were given a snack once weekly with either 20 grams of wheat flour, 23 grams of non-fat dried milk, both, or neither until every child received each snack three times. Snacks were carefully engineered to look, taste and feel the same, and were given randomly with no knowledge by staff, families or children.

Parents, teachers and a research assistant filled out standardized surveys about the child's behavior the day before they received the snack, at two and 24 hours after the snack.

However, none of the diet and snack combinations affected children's sleep, bowel habits, or activity.

The team did observe a small increase in the number of times children engaged in social interaction after eating food containing gluten or casein, but this increase did not reach statistical significance. A similar small increase in social language seen after the gluten challenge also did not reach statistical significance.

The team cites the need for larger studies that appropriately monitor for diet and other interventions to determine whether gluten or casein affects social interaction or language among other children with ASD, such as children with gastrointestinal (GI) disease.

For families who wish to eliminate gluten and casein from their child's diet need, the team points out the importance of carefully monitoring the autistic child's nutritional status.

Sources:

Department of Pediatrics and Clinical Research Center, Golisano Children's Hospital, University of Rochester Medical Center, Rochester, New York

Research Supported By: National Institutes for Mental Health (Studies to Advance Autism Research in Treatment) NIMH U54 MH077397 and the National Center for Research Resources (NCRR) NIH UL1RR024160

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7 Responses:

 
Sophie
Rating: ratingfullratingfullratingfullratingfullratingfull Unrated
said this on
28 Sep 2015 5:58:18 AM PST
An 18-week study of a tiny cohort - - less than a typical classroom size, with nearly 1/3 failing to complete the study - - cannot conclude ANYTHING about whether a gluten-free diet helps autistic children. Your article not only implies that it does, but your headline implies that the results are conclusive.

You--and the researchers - - completely ignored an important finding : even in that tiny sample size, 2 children were excluded for issues that clearly indicate intestinal malabsorption (celiac and iron deficiency). To find a rate of nearly 10% in an autism cohort is huge, as prevalence in the general population is recognized as around 1%. This suggests that a significant subset of autistic children DO benefit from a gluten - free diet.

This is also supported by research showing a significantly higher rate of autism among children born to mothers with celiac disease.

When researchers eliminate from their study the very children who are most likely to demonstrate the link being studied, that certainly calls into question the conclusions of that study.

 
Jefferson
Rating: ratingfullratingfullratingfullratingfullratingfull Unrated ( Author)
said this on
29 Oct 2015 11:51:26 AM PST
"One child was excluded because of a positive test for celiac disease and one was excluded for iron deficiency." Clearly, a child with celiac disease must avoid gluten, and should not be subjected to a gluten challenge.

Also, the point about the percentage of celiacs in the general population simply proves the researchers' point in excluding the child with celiac disease: Including a 10% celiac disease presence in a small group, when just 1% of the general population has the disease would skew the results, while excluding the child would have little or no impact on the results.

 
dappy
Rating: ratingfullratingemptyratingemptyratingemptyratingempty Unrated
said this on
28 Sep 2015 7:35:20 AM PST
Well, I have talked to two such parents of autistic children who would heartily disagree. Both have seen marked improvement in their child's behavior since putting them on a GF diet. They would never abandon this approach because of research to the contrary. Dealing with it and publishing perhaps erroneous research are on far different planes.

 
Michael
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said this on
28 Sep 2015 4:39:00 PM PST
Giving a snack weekly, which may contain gluten or casein, is a design failure because it will take months to years and a lot of other additional steps and therapies to heal damage from gluten. Follow the money. Who funded this study?

 
Gene Ann
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said this on
05 Oct 2015 7:05:46 PM PST
My thoughts exactly--poor design and show me the money. You can't switch food challenges after a few days because there are delayed reactions to consuming gluten plus it takes several weeks to get it out of your system. Trial design will determine your outcome. Figures don't lie, but liars can figure.

 
Gillian
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said this on
12 Oct 2015 6:26:08 AM PST
So True!

 
Jefferson
Rating: ratingfullratingfullratingfullratingfullratingfull Unrated ( Author)
said this on
29 Oct 2015 11:37:58 AM PST
Who funded the study? National Institutes for Mental Health (Studies to Advance Autism Research in Treatment) NIMH U54 MH077397 and the National Center for Research Resources (NCRR) NIH UL1RR024160.




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