No link between popular autism diet, behavioral improvement

Eliminating gluten and casein from the diets of children with autism did not improve their behavior, sleep or bowel patterns, data from a tightly controlled University of Rochester study indicated.

“It would have been wonderful for children with autism and their families if we found that the gluten-free, casein-free diet could really help, but this small study didn’t show significant benefits,” Susan Hyman, MD, associate professor of pediatrics at Golisano Children’s Hospital, said in a press release. She will present these data at the International Meeting for Autism Research in Philadelphia this weekend.

Hyman and colleagues enrolled 22 children aged 2.5 to 5.5 years, 14 of whom completed the 18-week intensive dietary and behavioral intervention. All children were screened for iron and vitamin D deficiency, milk and wheat allergies as well as celiac disease.

One child with a positive test for celiac disease and one child with an iron deficiency were excluded; others were excluded due to nonadherence to the study requirements. The researchers monitored vitamin D, iron, calcium, protein and other nutrients throughout the study to ensure that no child was deficient.

After four weeks of monitored dietary intake, the researchers randomly assigned children to a food challenge with milk, wheat, both or neither and obtained data before and after administering challenge snacks.

The researchers observed no differences in length of sleep, waking, number of stools or activity by actigraph between children assigned to a gluten and casein challenge and those assigned to casein and placebo.

Small but statistically insignificant increases as measured by the Ritvo Freeman Real Life Rating Scale were observed in interaction during standard play sessions after a child was challenged with gluten or casein and in language after gluten challenge.

The researchers emphasized that due to the small differences in behavior between the groups and the small numbers of participants, the noted behavioral changes may be attributable to chance.

Despite a lack of evidence, up to one-third of children with autism are subjected to restrictive gluten- and casein-free diets. “This is really just the tip of the iceberg,” Hyman said. “There are many possible effects of diet including over- and under-nutrition on behavior in children with autism spectrum disorders that need to be scientifically investigated so families can make informed decisions about the therapies they choose for their children.”

Hyman noted that children with significant gastrointestinal disease were excluded from this study and that these subpopulations may benefit from such dietary interventions, thus accounting for positive anecdotal reports.

Funding was provided by the National Institutes of Mental Health Studies to Advance Autism Treatment Research and the National Center for Research Resources.

Read the article online at http://www.pediatricsupersite.com/view.aspx?rid=64643