Evaluation of a Gluten-Casein FreeDietBy: Janice Michelle Key & ZahraQureshi
AutismThe Gluten-Casein Free Diet has been a somewhat controversial dietary intervention forchildren with autism. Most parents who implement it report that the results are remarkablewhile some doctors report that there is not enough science behind it to account for thechanges. That may soon change due to the remarkable findings of a recent studyinvolving children with Autism.In June 2013, a new study was published in the Public Library of Science Database thatdetails the discovery that many children with autism, especially those that have symptomsof gastrointestinal disturbances also show immune system reactivity to gluten similar tothe reaction that is found in Celiac Disease which is an autoimmune disease involving theinability to digest gluten. The study also found that while the IgG reaction to the glutenprotein is similar to that of Celiac Disease, many of the children actually tested negativefor Celiac Disease. (Lau, et al., 2013) The researchers believe that they have discovereda subset type of Celiac Disease previously unknown to exist.The results of this study are very important to those with Autism and further illustrates whyremoving gluten from the diet can be vitally important to those that have this IgG responseto the protein. While it has not been studied as much as gluten, casein is another proteinthat many of those with Celiac Disease also have trouble digesting. It is plausible but notproven that those with this newly discovered subset type of Celiac Disease also havedifficulty digesting the casein with their already damaged intestinal tract.In summary, this study provides at least one possible answer to the intense GI distressthat many children with autism suffer from and gives doctors a starting point to diagnosisJMK
Literary ReviewTeam Member Journal CitationInformationJournal SummaryStatementJanice Key Whitely, P., Shattock, P.,Knivsberg, A.-M., Seim,A., Reichelt, K. L., Todd,L., et al. (2013, January4). Gluten- and casein-free dietary interventionfor autism spectrumconditions. Frontiers InHuman NueroScience ,344.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540005/Upon reviewing variousstudies involving theGFCF diet, it wasdetermined that staticallysignificant positivechanges are seen withthe GFCF diet usedwhen implemented withkids with autism.Improvements incommunication werenoted as well as adecrease in hyperactivitysymptoms.
Breakfast:Gluten Free Corn Chex with Soy Milk and Half a BananaLunch:Tuna Salad on a Bed of Lettuce with Fresh Tomatoes(Tuna packed in water, Mayo, Pickle Relish, Boiled Egg)Tortilla Chips - PlainGrapesBottle of WaterSnack:All Natural Popcorn (no butter)Bottle of WaterDinner:Rice Pasta with Ground Turkey Meatball (just meat)Spaghetti SauceGarlic ToastBroccoliJell-o with a slice of PineappleTeaBedtime Snack:Puffed Rice Cereal with Soy MilkJMK
Food Item Number of Servings Serving Size Total GramsSOY MILK-FLUID 1.75 1 c 420 gramsBOILED CHICKENEGG1 1 LRG EGG 50 gramsBANANA 0.5 1 W/O SKIN 57 gramsRICE BREAD TOAST 1 1 SLICE 25 gramsRICE PASTA 0.75 1 c 151.5 gramsTUNA IN WATER 2 1 oz 56.7 gramsRICE PARMESEAN 1 1 tsp 2.5 gramsWATER 32 1 floz 2730.56 gramsBREWED TEA 1.5 1 c 355.2 gramsPUFFED RICECEREAL0.5 1 OZ 14.2 gramsPINEAPPLE-RAW 1 1 SLICE3-1/2 DIAM 84 gramsJELLO-ORANGE 0.5 1 CUP 140 gramsGARLIC POWDER 1 1 TSP 2.8 gramsSOY MARGARINE 2 1 tsp 9.46 gramsBROCCOLI - BOILED 1 1 c 156 gramsSPAGHETTI SAUCE 0.5 1 CUP 124.5 gramsGROUND TURKEY 2 1 oz 56.7 gramsPOPCORN- POPPED 1 1 pt 14 gramsRAW TOMATO 0.5 1 CUP CHOPPED 90 gramsLETTUCE -BIBB 2 1 oz 56.7 gramsTORTILLA CHIPS 2 1 oz 56.7 gramsPICKLE RELISH-SWEET1 1 TBSP 15 gramsKRAFTMAYONNAISE1 1 TBSP 14 gramsJMK
Literary ReviewTeamMemberJournal Citation Information Journal Summary StatementZahraQureshiJohnson, C., Handen, B., Zimmer,M.,Sacco, K., & Turner, K. (2003).Effects ofGluten Free/Casein Free Diet inYoung Children with Autism: A PilotStudy.Journal of Developmental andPhysical Disabilities, 23(3), 213-225.Pennesi, C., & Klein. L. (2012).Effectiveness of the Gluten-Free,Casein-Free Diet for Children DiagnosedwithAutism Spectrum Disorder: BasedonThe article evaluates the positiveresults of the GFCF diet inchildren. After switching to thediet, the children showedimprovements in behavior andlanguage skills.This article also focuses on thepositive effects of the GFCF diet.The researchers constructed aquestionnaire from 387 parents ofautistic children regarding the diet.The overall message from theparents was that the diet was veryefficient with few errors. Theparents also said that they sawimprovements in their children.* Article discussedmore in depth on nextslide.
Effects of Gluten Free / Casein FreeDiet in Young Children with Autism:A Pilot Study This Journal article went into depth with theanalysis of the GFCF diet on Children withAutism. The authors stated that once the childswitches to the GFCF diet, it does take sometime for the body to adjust to the diet change –this is not an overnight change. Over timethough, the studies have shown that because ofthe diet modifications and changes the childrenwho were put on the diet showed changes intheir behavior and language. Since the childrenwere monitored, the researchers stated that notZQ
Breakfast:OmeletSoy Milk and Half an AppleLunch:Turkey Sandwich (Includes Fresh Lettuce andTomatoes)Banana ChipsAlmond Rice Bar and Peach Jell-OBottle of WaterSnack:Celery with Peanut Butter (no salt added)Bottle of WaterDinner:Rice with Lean Ground Beef PattiesPeas and CarrotsDry Rice Pudding (Made Using Water)Bottle of WaterBedtime Snack:ZQ***Note this diet isdesigned for a 4-8year old childwhose intake isbetween 1400-1600calories.
Food ItemNumber ofServingsServing SizeTotal GramsOMELET(Chicken Egg)1 1 LRG EGG 59 gramsSOY MILK-FLUID 2 1 CUP 480 gramsRAW APPLE 1 1 CUP SLICES 110 gramsRICE BREADTOAST2 1 SLICE 50 gramsTURKEY BREAST 2 1 SLICE 42.5 gramsRAW LETTUCE 2 1 LEAF 20 gramsRAW TOMATO 0.51 CUPCHOPPED90 gramsALMOND RICEBAR1 1 oz BAR 28.35 gramsBANANA CHIPS 1 1 oz 28.35 gramsPEACH JELLO 0.5 1 CUP 140 gramsWATER -BOTTLED19.5 1 fl oz BOTTLE 576 gramsRAW CELERY 0.5 1 CUP 60 gramsPEANUT BUTTER(w/o salt)2 1 TBSP 32 gramsGROUND BEEF 2 1 oz 56.7 gramsRICE 0.5 1 CUP 81 gramsPEAS - BOILED 0.5 1 CUP 80 gramsZQ
Group Consensus on the GFCF Dietfor Autism• Adequacy – Yes, the diet can provide the adequate nutrition needed for example,for a child with Autism as shown in the daily diet plans.• Balance – Yes, the diet can involved a balanced diet of protein, vegetables, fruits,starches and fats. If SOY milk is used instead of other choices such as rice milk,then it can sometimes provide more protein than is recommended though. As withall diets it comes down to balancing the intake of nutrients and proteins needed forthe body.• Calorically sound – Yes, it is easy to maintain proper calorie control. Both of thedaily diets were set for a 4-8 year old child and displayed that it is manageable tomaintain the calorie count.• Nutrient Density – The diet is very nutritious but, calcium supplements might beconsidered depending on the type of milk substitute that is used. Almond milk whilehigh in protein has more calcium than cow’s milk. Also, it would be a good idea tomake sure that a doctor routinely checks vitamin D levels for children that are notgetting fortified foods such as regular breads, cereal or milk.• Variety – Yes, it is easy to have a varied diet while GFCF. Different restaurants,for example, have adapted some of their meals to the GFCF diet. Also a variety ofJMK and ZQ
Group Consensus ctd.• Expense – Ready made gluten free breads, pastas, crackers etc., are generallymore expensive than their non GF counterparts. But, with careful planning it is notexcessive.• Time – Other than additional time needed to seek out GFCF foods and carefulreading of food labels, this diet does not require any additional time to preparefoods than traditional diets would. As with all diets, it requires careful planning andmaking conscious decisions.•Based on scientific support – While some scientific studies have provenbenefits to implementing the GFCF diet with kids with autism, the majority ofinformation comes from antidotal evidence from parents.• Other – I personally have witnessed drastic changes from my own child withinjust a week of removing dairy, and within about 4 weeks of removing gluten. Weusually know within 30 minutes if he has accidentally ingested either protein. Hehas been GFCF for almost 3 years. – JMK• Other – Growing up I personally knew a child who had severe autism. His momused to tell us that she had difficulty getting him to eat specific foods (that areexempt from the GFCF diet). I saw the child a few years ago and saw a remarkablechange in both his behavior and health. The little boy’s attitude changed and heJMK and ZQ
ReferencesJohnson, C., Handen, B., Zimmer, M., Sacco, K., & Turner, K. (2003).Effects of Gluten Free/Casein Free Diet in Young Children with Autism:A Pilot Study. Journal of Developmental and Physical Disabilities,23(3), 213-225.Pennesi, C., & Klein. L. (2012). Effectiveness of the Gluten-Free, Casein-Free Diet for Children Diagnosed with Autism Spectrum Disorder:Based on Parental Report. Nutritional Neuroscience, 15(2), 85-91.Whitely, P., Shattock, P., Knivsberg, A.-M., Seim, A., Reichelt, K. L., Todd,L., et al. (2013, January 4). Gluten- and casein-free dietary interventionfor autism spectrum conditions. Frontiers In Human NueroScience ,344. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540005/Lau, Green, Taylor, Hellberg, Ajamian, Tan, et al. (2013, June 18). Markersof Celiac Disease and Gluten Sensitivity in Children with Autism.Retrieved June 21, 2013, from Public Library of Science Journal:http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0066155