Special Diets &
Autism: Is there a benefit? By Vicki Kobliner, MS, RD O
n a recent episode of the popular “Dr Oz Show,” which was devoted to autism, Mehmet Oz asked his
panel of physicians if a gluten and casein free diet really helped. Before the panel- ists could respond, there was a resounding chorus of yeses from the parents in the audi- ence. Following that reaction, a number of the guest physicians also confirmed that they have seen benefits in patients with autism when they adopt a gluten and casein free (GFCF) diet. However, if you try to research GFCF diet, you will find multiple parent testimonials lauding the effects of the diet, and a comparable number of research and newspaper articles quoting healthcare pro- fessionals who believe it is little more than snake oil. As for other diets that are gaining popularity for children with autism, there is little research at all, and even less support from the medical community. This is a sad and confusing state of affairs for parents trying to navigate the over- whelming myriad of treatment choices for a child with autism to choose the best course of action. When it comes to diets, it helps to understand why they help, and which child may be the best candidate.
While autism is certainly a spectrum,
with each child exhibiting a mix of char- acteristics, there are some symptoms and behaviors that are consistent. A large number of Autism Spectrum Disorder (ASD) kids suffer from chronic diarrhea or constipation. Parents will report that their child has almost never had a normal bowel movement. Many children exhibit bowel distress in non-verbal ways such as leaning their belly over the arm of a sofa, or otherwise placing pressure on the abdomen. They are frequently picky eat- ers with very limited diets, often consisting of mostly “white” foods such as processed grains, starchy vegetables and dairy prod- ucts. What this indicates is a child with a digestive disorder. If a typical child experi- enced these symptoms, it would never be considered acceptable, and no child on the
36 Natural Nutmeg
spectrum should have to suffer because poor digestion is just “a part of autism.” A special diet should be primarily used to address the digestive problem, but in many cases will lead to functional improvements as well. Some of the common digestive issues
seen in children on the spectrum are food sensitivities, inadequate digestive enzyme production, and an imbalance of good bacteria and pathogens in the intestinal tract. Beneficial bacteria are necessary for digestion, immune function and neurotrans- mitter production, and a deficiency can lead to dysfunction in any of those areas. It can cause intestinal permeability or “leaky gut,” which allows toxins and pathogens to pass into the bloodstream that should have been filtered out. Any diet intervention that resolves some of these issues can be healing to the child. The gluten and casein free diet is most
well known and frequently implemented. This diet completely removes any foods con- taining the proteins gluten (found in wheat, barley and rye) and casein (found in milk and milk products). There are a number of reasons why this diet is believed to improve not only bowel irregularities, but improve function in ASD. One concept called the “opioid theory” notes that the molecular structure of the proteins gluten and casein are quite similar to that of morphine, which can cross the protective blood-brain barrier, and may in fact be “drugging” the develop- ing brain. The presence of a leaky gut allows these proteins to pass into the bloodstream, while a well functioning digestive tract
would prevent it. It is interesting to note that autism used to be called “childhood schizo- phrenia,” and many research studies have implicated gluten in the onset or increase in schizophrenic symptoms. To get the best results from this diet, it is important to find alternate sources of calcium and Vitamin D, which usually come from dairy products. In addition, most gluten containing grains are fortified with B vitamins and iron, so these nutrients must be provided elsewhere. A common mistake when adopting this diet is to replace all the gluten containing crackers, cereals, cookies, and cakes with gluten free versions. A better plan is to slowly incorporate more fruits, vegetables and other nutritious foods to re- place some of the gluten. Bean-based flours, dried fruits and veggie chips are a few ways to do that. In addition, with any special diet, the quality of the food matters. Food that is organic, toxin-free, and without artificial ad- ditives will reduce the overall toxic burden on the body.
Another diet used for autism is the Specific Carbohydrate Diet (SCD). This diet was originally designed for people suffering from Crohn’s and Colitis, and completely removes all sources of starches. While the diet is restrictive, it can also be tremendously effective in normalizing digestion. When implemented correctly it is quite nourishing, but can be deficient in multiple nutrients if not done carefully. Other diets such as low phenol, low oxalate and food sensitivity diets are also used. Each one requires careful planning for
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