Gluten Free, Casein Free Diet (GFCF)

Many families of children with autism spectrum disorders are interested in dietary and nutritional interventions that might help some of their children's symptoms. Removal of gluten (a protein found in barley, rye, oats, and wheat) and casein (a protein found in dairy products), in what is known as a Gluten Free, Casein Free diet, or GFCF, is a popular dietary treatment for symptoms of autism. It is based on the hypothesis that these proteins are absorbed differently in children with autism spectrum disorders and act like false opiate-like chemicals in the brain. The hypothesis is not based on an allergic response. Neither the hypothesis nor the effectiveness of this dietary intervention has been demonstrated in scientific studies to date. Studies are ongoing in a number of centers. However, many families report that dietary elimination of gluten and casein has helped regulate bowel habits, sleep, activity, habitual behaviors and enhance overall progress in their individual child. No specific laboratory tests can predict which children might be observed by their families to have a positive response to dietary intervention. For that reason, many families elect a trial of dietary restriction with careful observation by the family and their autism treatment team.

A trial of dietary restriction requires attention to basic nutritional guidelines. Dairy products are the most common source of calcium and vitamin D in young children in the U.S. Many young children depend on dairy products for a balanced protein intake. Alternative sources of these nutrients require substitution of other food and beverage products with attention to nutritional content rather than solely as a milk substitute beverage. Substitution of gluten free products requires attention to the overall fiber and vitamin content of a child's diet. Vitamin and supplement use may have both positive effects and side effects. Consultation with a dietitian or physician should be considered and can be helpful to families in the determination of healthy application of a GFCF diet. This may be especially true for children who are picky eaters.

I personally don’t think the theory behind the GFCF diet makes a lot of sense. My theory can explain abnormal levels of opiate like, endorphin molecules in the brain of autistic children – it is a result of constant stress response activation along probably with chronic inflammation. However, I suspect the GFCF diet does improve autistic behaviors, but through an unexpected mechanism. A GFCF diet is inherently one that removes many of the substances we call food that have become so awful for us, such as white brad (wheat), refined pasta (wheat), pizza (wheat), breading (wheat), ketchup (which contains gluten), and ice cream (gluten and dairy). It is also a diet in which the family is paying very close attention to the child getting the nutrition he needs, rather than letting food choices be dictated by which fast food restaurant is most convenient on the way home from school. A child who is receiving nourishing food is much more likely to behave well and be happy because the homeostatic balances that underlie resiliency to stress will be in better shape. So, I am all for a GFCF diet, as long as the family is paying close attention to making sure the child gets the nutrients their doctor recommends.

Supplementation

There are many people who believe that deficiencies in various substances such as vitamins and minerals are responsible for some of the symptoms of autism. I agree that the modern human diet is a part of the causation of autism, but likely not due to any particular deficiency, such as the lack of a specific mineral, with the possible exception of omega 3 fatty acids. It is the totallity of the deficiencies, the vast quantities of simple sugars we consume, the general lack of good nutrients in the foods we eat, the toxic fats we overdose on, and so on, all together that alter normal human homeostatic balances and result in bodies that lose their resiliency to deal with the world. My recommendations on how to deal with this toxic diet are contained at the beginning of Matt's Daily Health Guide, which is downloadable from the Coping with Autism page of this website.

Some substances that have specific applicability to autism research are discussed below.

     Vitamin B6

A supplement that some parents feel is beneficial for an autistic child is Vitamin B6, taken with magnesium (which makes the vitamin effective). The result of research studies is mixed; some children respond positively, some negatively, some not at all or very little.

     Carnitine

Researchers have recently duplicated the results of a previous study showed that L-acetyl carnitine (LAC), a form of the amino acid carnitine, significantly reduced hyperactive behavior in Fragile X Syndrome boys with ADHD who were treated with it for one year without causing adverse side effects. This new study involved 51 boys between 6 and 12 years old with FXS and ADHD. Each patient followed the treatment for 12 months, which involved 500 milligrams of LAC or a placebo given twice daily. Those treated with LAC demonstrated reduced hyperactive behavior and increased attention. No side effects were exhibited, confirming that LAC is a safe alternative to stimulants. The patients treated with LAC also had significantly improved social ability compared to the placebo-treated group. The researchers also suggest that these results may be applicable to children with autism, who also do not easily tolerate stimulants.

     Secretin

In the search for treatment for autism, there has been much discussion in the last few years about the use of secretin, a substance approved by the Food and Drug Administration (FDA) for a single dose normally given to aid in diagnosis of a gastrointestinal problem. Anecdotal reports have shown improvement in autism symptoms, including sleep patterns, eye contact, language skills, and alertness. Several clinical trials conducted in the last few years have found no significant improvements in symptoms between patients who received secretin and those who received a placebo.