The document discusses a study that found children with autism often have immune system reactivity to gluten similar to celiac disease, even if they test negative for celiac. The study suggests a previously unknown subset of celiac exists. Removing gluten from the diet can be important for those with this immune response. Casein may also be difficult to digest. The study provides insight into gastrointestinal issues in autism and a starting point for diagnosis.

1. Evaluation of a Gluten-Casein Free
Diet
By: Janice Michelle Key & Zahra
Qureshi

2. Autism
The Gluten-Casein Free Diet has been a somewhat controversial dietary intervention for
children with autism. Most parents who implement it report that the results are remarkable
while some doctors report that there is not enough science behind it to account for the
changes. That may soon change due to the remarkable findings of a recent study
involving children with Autism.
In June 2013, a new study was published in the Public Library of Science Database that
details the discovery that many children with autism, especially those that have symptoms
of gastrointestinal disturbances also show immune system reactivity to gluten similar to
the reaction that is found in Celiac Disease which is an autoimmune disease involving the
inability to digest gluten. The study also found that while the IgG reaction to the gluten
protein is similar to that of Celiac Disease, many of the children actually tested negative
for Celiac Disease. (Lau, et al., 2013) The researchers believe that they have discovered
a subset type of Celiac Disease previously unknown to exist.
The results of this study are very important to those with Autism and further illustrates why
removing gluten from the diet can be vitally important to those that have this IgG response
to the protein. While it has not been studied as much as gluten, casein is another protein
that many of those with Celiac Disease also have trouble digesting. It is plausible but not
proven that those with this newly discovered subset type of Celiac Disease also have
difficulty digesting the casein with their already damaged intestinal tract.
In summary, this study provides at least one possible answer to the intense GI distress
that many children with autism suffer from and gives doctors a starting point to diagnosis
JMK

3. Literary Review
Team Member Journal Citation
Information
Journal Summary
Statement
Janice Key Whitely, P., Shattock, P.,
Knivsberg, A.-M., Seim,
A., Reichelt, K. L., Todd,
L., et al. (2013, January
4). Gluten- and casein-
free dietary intervention
for autism spectrum
conditions. Frontiers In
Human NueroScience ,
344.
http://www.ncbi.nlm.ni
h.gov/pmc/articles/PM
C3540005/
Upon reviewing various
studies involving the
GFCF diet, it was
determined that statically
significant positive
changes are seen with
the GFCF diet used
when implemented with
kids with autism.
Improvements in
communication were
noted as well as a
decrease in hyperactivity
symptoms.

4. Breakfast:
Gluten Free Corn Chex with Soy Milk and Half a Banana
Lunch:
Tuna Salad on a Bed of Lettuce with Fresh Tomatoes
(Tuna packed in water, Mayo, Pickle Relish, Boiled Egg)
Tortilla Chips - Plain
Grapes
Bottle of Water
Snack:
All Natural Popcorn (no butter)
Bottle of Water
Dinner:
Rice Pasta with Ground Turkey Meatball (just meat)
Spaghetti Sauce
Garlic Toast
Broccoli
Jell-o with a slice of Pineapple
Tea
Bedtime Snack:
Puffed Rice Cereal with Soy Milk
JMK

5. Food Item Number of Servings Serving Size Total Grams
SOY MILK-FLUID 1.75 1 c 420 grams
BOILED CHICKEN
EGG
1 1 LRG EGG 50 grams
BANANA 0.5 1 W/O SKIN 57 grams
RICE BREAD TOAST 1 1 SLICE 25 grams
RICE PASTA 0.75 1 c 151.5 grams
TUNA IN WATER 2 1 oz 56.7 grams
RICE PARMESEAN 1 1 tsp 2.5 grams
WATER 32 1 floz 2730.56 grams
BREWED TEA 1.5 1 c 355.2 grams
PUFFED RICE
CEREAL
0.5 1 OZ 14.2 grams
PINEAPPLE-RAW 1 1 SLICE3-1/2 DIAM 84 grams
JELLO-ORANGE 0.5 1 CUP 140 grams
GARLIC POWDER 1 1 TSP 2.8 grams
SOY MARGARINE 2 1 tsp 9.46 grams
BROCCOLI - BOILED 1 1 c 156 grams
SPAGHETTI SAUCE 0.5 1 CUP 124.5 grams
GROUND TURKEY 2 1 oz 56.7 grams
POPCORN- POPPED 1 1 pt 14 grams
RAW TOMATO 0.5 1 CUP CHOPPED 90 grams
LETTUCE -BIBB 2 1 oz 56.7 grams
TORTILLA CHIPS 2 1 oz 56.7 grams
PICKLE RELISH-
SWEET
1 1 TBSP 15 grams
KRAFT
MAYONNAISE
1 1 TBSP 14 grams
JMK

6. Nutrient Total Rec. %Rec
Calories 1842.74 1900 96.99%
Pro (g) 77.35 26 297.5%
Fat (g) 74.53 63.33 117.69%
Carb (g) 235.42 --
Fiber (g) 26.2 25 104.8%
Cal (mg) 418.58 800 52.32%
Iron (mg) 24.98 10 249.8%
Na (mg) 3557.69 2400 148.24%
Pot (mg) 3218.2 --
Phos (mg) 1021.12 500 204.22%
Ash (g) 16.64 --
vitA (IU) 6118.56 3000 203.95%
vitC (mg) 180.32 25 721.28%
Thia (mg) 2.3 0.6 383.33%
Ribo (mg) 1.75 0.6 291.67%
Nia (mg) 26.3 8 328.75%
H2O % 53.12 Children 4-8 --
satF (g) 13.73 21.11 65.04%
monoF (g) 24.23 21.11 114.78%
polyF (g) 15.34 21.11 72.67%
Chol (mg) 300.16 300 100.05%
GFC
F
DIE
T
JMK

7. Literary Review
Team
Member
Journal Citation Information Journal Summary Statement
Zahra
Qureshi
Johnson, 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
The article evaluates the positive
results of the GFCF diet in
children. After switching to the
diet, the children showed
improvements in behavior and
language skills.
This article also focuses on the
positive effects of the GFCF diet.
The researchers constructed a
questionnaire from 387 parents of
autistic children regarding the diet.
The overall message from the
parents was that the diet was very
efficient with few errors. The
parents also said that they saw
improvements in their children.
* Article discussed
more in depth on next
slide.

8. Effects of Gluten Free / Casein Free
Diet in Young Children with Autism:
A Pilot Study
 This Journal article went into depth with the
analysis of the GFCF diet on Children with
Autism. The authors stated that once the child
switches to the GFCF diet, it does take some
time for the body to adjust to the diet change –
this is not an overnight change. Over time
though, the studies have shown that because of
the diet modifications and changes the children
who were put on the diet showed changes in
their behavior and language. Since the children
were monitored, the researchers stated that notZQ

9. Breakfast:
Omelet
Soy Milk and Half an Apple
Lunch:
Turkey Sandwich (Includes Fresh Lettuce and
Tomatoes)
Banana Chips
Almond Rice Bar and Peach Jell-O
Bottle of Water
Snack:
Celery with Peanut Butter (no salt added)
Bottle of Water
Dinner:
Rice with Lean Ground Beef Patties
Peas and Carrots
Dry Rice Pudding (Made Using Water)
Bottle of Water
Bedtime Snack:
ZQ
***Note this diet is
designed for a 4-8
year old child
whose intake is
between 1400-1600
calories.

10. Food Item
Number of
Servings
Serving Size
Total Grams
OMELET
(Chicken Egg)
1 1 LRG EGG 59 grams
SOY MILK-FLUID 2 1 CUP 480 grams
RAW APPLE 1 1 CUP SLICES 110 grams
RICE BREAD
TOAST
2 1 SLICE 50 grams
TURKEY BREAST 2 1 SLICE 42.5 grams
RAW LETTUCE 2 1 LEAF 20 grams
RAW TOMATO 0.5
1 CUP
CHOPPED
90 grams
ALMOND RICE
BAR
1 1 oz BAR 28.35 grams
BANANA CHIPS 1 1 oz 28.35 grams
PEACH JELLO 0.5 1 CUP 140 grams
WATER -
BOTTLED
19.5 1 fl oz BOTTLE 576 grams
RAW CELERY 0.5 1 CUP 60 grams
PEANUT BUTTER
(w/o salt)
2 1 TBSP 32 grams
GROUND BEEF 2 1 oz 56.7 grams
RICE 0.5 1 CUP 81 grams
PEAS - BOILED 0.5 1 CUP 80 grams
ZQ

11. Nutrient Total Rec. %Rec
Calories 1526.4 1900 80.34%
Pro (g) 69.81 26 268.5%
Fat (g) 62.87 63.33 99.27%
Carb (g) 183.89 --
Fiber (g) 26.08 25 104.32%
Cal (mg) 316.59 800 39.57%
Iron (mg) 13.78 10 137.8%
Na (mg) 1476.15 2400 61.51%
Pot (mg) 2599.15 --
Phos (mg) 987.64 500 197.53%
Ash (g) 11.1 --
vitA (IU) 15813.43 3000 527.11%
vitC (mg) 91.95 25 367.8%
Thia (mg) 2.06 0.6 343.33%
Ribo (mg) 1.66 0.6 276.67%
Nia (mg) 24.38 8 304.75%
H2O % 56.45
Children 4-
8
--
satF (g) 20.41 21.11 96.68%
monoF (g) 20.62 21.11 97.68%
polyF (g) 14.27 21.11 67.6%
GFC
F
DIE
T
ZQ

12. Group Consensus on the GFCF Diet
for 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 with
all diets it comes down to balancing the intake of nutrients and proteins needed for
the body.
• Calorically sound – Yes, it is easy to maintain proper calorie control. Both of the
daily diets were set for a 4-8 year old child and displayed that it is manageable to
maintain the calorie count.
• Nutrient Density – The diet is very nutritious but, calcium supplements might be
considered depending on the type of milk substitute that is used. Almond milk while
high in protein has more calcium than cow’s milk. Also, it would be a good idea to
make sure that a doctor routinely checks vitamin D levels for children that are not
getting 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

13. Group Consensus ctd.
• Expense – Ready made gluten free breads, pastas, crackers etc., are generally
more expensive than their non GF counterparts. But, with careful planning it is not
excessive.
• Time – Other than additional time needed to seek out GFCF foods and careful
reading of food labels, this diet does not require any additional time to prepare
foods than traditional diets would. As with all diets, it requires careful planning and
making conscious decisions.
•Based on scientific support – While some scientific studies have proven
benefits to implementing the GFCF diet with kids with autism, the majority of
information comes from antidotal evidence from parents.
• Other – I personally have witnessed drastic changes from my own child within
just a week of removing dairy, and within about 4 weeks of removing gluten. We
usually know within 30 minutes if he has accidentally ingested either protein. He
has been GFCF for almost 3 years. – JMK
• Other – Growing up I personally knew a child who had severe autism. His mom
used to tell us that she had difficulty getting him to eat specific foods (that are
exempt from the GFCF diet). I saw the child a few years ago and saw a remarkable
change in both his behavior and health. The little boy’s attitude changed and heJMK and ZQ

14. References
Johnson, 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 intervention
for 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). Markers
of 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

15. THE END
By: Janice Michelle Key & Zahra