Gluten-free Casein-free Diets For Autism Spectrum Disorder (ASD)

As we know, people with autism spectrum disorder (ASD) are prone to having gastrointestinal discomfort such as bloating, diarrhoea, constipation, and gastroesophageal reflux. 

Therefore, many studies investigate whether the intervention of a specific diet can help relieve their gastrointestinal symptoms and even address their core symptoms such as restrictive and repetitive behaviour or social withdrawal. Among so many types of diets, the gluten-free and casein diets are two of the most popular diets that are always used for people with autism spectrum disorder (ASD), although their mechanisms are not fully understood.

So, what is a gluten-free and casein-free diet?

Let’s introduce you to the content and examples of substitutes for a gluten-free and casein-free diet.

Gluten is a protein that cannot be digested in the gastrointestinal tract but is easily found in daily foods such as bread and cereals, while casein is a phosphoprotein found in mammalian milk. 

Therefore, a gluten-free and casein-free diet is a diet with the elimination of those foods that contain gluten and casein. The consumer can buy gluten-free and casein-free food sources as substitutes in their recipes.

Below are examples of food substitutes used in recipes:

Substitute for bread

  • Rye bread
  • Corn Tortillas
  • Cauliflower Bread

Substitutes for pasta

  • Brown rice pasta
  • Chickpea pasta
  • Soba noodles
  • Konjac noodles

Substitutes for milk

  • A2 milk
  • Soya milk
  • Almond milk
  • Rice milk
  • Coconut milk
  • Oat milk

Why might it be suitable for children with ASD?

Possible mechanism of gluten-free and casein free in autism spectrum disorder:

  • Children with autism develop higher IgG and IgA antibodies to gluten or casein.
  • Gluten or casein may bind to lymphocytes and tissue enzymes (CD26), triggering inflammatory and immune reactions in children with autism.
  • Following a GCFC diet may lead to higher vitamin D, E, and magnesium levels. 
  • They will have a better intake of fibre, legumes, vegetables, and fat.

Some evidence shows it might help in these aspects:

  • Communication and use of language
  • Attention and concentration
  • Social integration and interaction 
  • Self-injurious behaviour and altered pain perception 
  • Repetitive or stereotyped patterns of behaviour
  • Motor co-ordination 
  • Hyperactivity

Why might it be bad for children with ASD?

Some nutritional deficiencies may happen:

  • Calcium
  • Phosphorus
  • Pantothenic acid
  • Tryptophan

Conclusion

The effects of gluten-free and casein-free diets on children with ASD are still controversial. It is always necessary to ask for a medical expert’s opinion whenever parents want to make a change in their children’s diet. Furthermore, it is also advisable for parents to have a more detailed and comprehensive lab test for their children before starting any new diet in order to prevent nutritional defects in their meals. Observe the children’s core symptoms and behaviour after beginning a further dietary intervention and see whether there are improvements.

References:

1.Elder JH, Shankar M, Shuster J, Theriaque D, Burns S, Sherrill L. The gluten-free, casein-free diet in autism: results of a preliminary double blind clinical trial. J Autism Dev Disord. 2006 Apr;36(3):413-20. doi: 10.1007/s10803-006-0079-0. PMID: 16555138.

2.Marcason W. What is the current status of research concerning use of a gluten-free, casein-free diet for children diagnosed with autism? J Am Diet Assoc. 2009 Mar;109(3):572. doi: 10.1016/j.jada.2009.01.013. PMID: 19248872.

3.https://www.special-learning.com/article/gluten-free-casein-free-diets-for-special-kids/

4.https://tacanow.org/family-resources/top-reasons-to-implement-a-gluten-free-casein-free-diet

5.https://www.childrensmn.org/educationmaterials/childrensmn/article/15864/gluten-free-casein-free-diet-for-autism-spectrum-disorder/

6.A.M. Knivsberg, K.L. Reichelt, T. HØien & M. NØdland (2002) A Randomised, Controlled Study of Dietary Intervention in Autistic Syndromes, Nutritional Neuroscience, 5:4, 251-261, DOI: 10.1080/10284150290028945

7.Croall ID, Hoggard N, Hadjivassiliou M. Gluten and Autism Spectrum Disorder. Nutrients. 2021 Feb 9;13(2):572. doi: 10.3390/nu13020572. PMID: 33572226; PMCID: PMC7915454.