Friday, January 9, 2009

Celiac Disease and Autism

Americans spend about $2 billion per year on gluten-free products that assist not only individuals that have an allergic reaction to the protein that is in wheat, barley, oats, and rye, but also those individuals that have been diagnosis with such mental health diseases as autism and ADHD (attention deficient hyperactivity disorder). Over the past year or so, manufacturers in the US have sold over $2 billion worth of products with "gluten-free" claims according to Nielson Co.

As posted previously, gluten is found in everything from commercial baked goods to pastas, to medications and lipsticks, to kids toys such as Play Doh. Celiac Disease is an autoimmune disease of the small intestines caused by the body's reaction to the gluten protein gliadin. The only treatment is a diet free of gluten based ingredients.

We will shift gears a little today and look at how a gluten-free diet assist those with autism.

Proponents of the gluten-free diet say that many children with autism have gastrointestinal difficulties that make it hard for them to digest certain grains properly. There are different possibilities for ways in which this could affect children with autism. The most studied theory is that eating gluten leads to high levels of protein by-products, called gluteomorphines, in some children with autism. These by-products may then affect behavior like a drug would. Specifically, in these children, gluteomorphines could reduce their desire for social interaction, block pain messages, and increase confusion. If gluten is taken out of the diet, the idea is that this will reduce the level of gluteomorphines, and behavior will improve as a result.

What is the theory behind it?

Gluten is broken down in the intestines into several by-products, including one called gluteomorphine. These by-products are much more common in the urine of children with autism than in children without autism. Some scientists have concluded that they are leaking from the intestines into the blood of these children. Many research studies report that children with autism often have gastrointestinal problems, including intestinal leakage. The argument is that, if gluteomorphine is being absorbed into the general circulation in children with autism, then it could affect behavior. In support of this theory, there is evidence that blocking at least some of the action of gluteomorphine improves the behavior of children with autism. Moreover, recent evidence of a genetic mutation common among children with autism has been traced to a gene involved in gastrointestinal function

Does it work?

The effectiveness of elimination diets in improving the behavior of children with autism has only recently been scientifically researched. This research has almost always examined diets that are both casein- and gluten-free.
One well-controlled study focused on children with autism who had abnormally high protein by-products in their urine, and therefore were more likely to be sensitive to casein and gluten (see What is the theory behind it?). One group of these children was fed a strict casein- and gluten-free diet for 12 months. This group had significantly fewer autistic symptoms than the remaining children, who were not fed this diet. Another well-controlled study of casein- and gluten-free diets focused on children with autism regardless of the level of protein by-products in their urine. Overall, the study found no significant differences in behavior between children on the elimination diet and children on regular diets, although individual parents reported behavioral improvements. This overall lack of effect in the second study could be because the elimination diet only lasted 6 weeks, or because the children were not pre-selected according to the level of protein by-products in their urine.

Regardless, in both cases, the tested diets were casein- and gluten-free, so it is not clear whether it was the elimination of casein, gluten, or both that resulted in any improvements. A third study that did examine the effect of a gluten-free diet on the behavior of children with autism did not compare children on the elimination diet with children not on the diet. Therefore, even though there were improvements seen in the behavior of children on the diet, these may also have occurred over the 5 months of the study without the elimination diet.

The current thinking is that there is at least some evidence showing that a gluten-free diet, when combined with a casein-free diet, can help improve the behavior of some children with autism. Although the casein-free diet combined with a gluten-free diet is popular, there is little evidence to support or refute this intervention and reviewers have determined that meaningful conclusions cannot be drawn from the existing literature.

Is it harmful?

The major health concern for a child on a gluten-free diet is whether the child receives adequate nutrition. A recent report showed that the protein and nutrient intakes of children with autism on casein- and gluten-free diets were not different from those of children with autism on standard diets, but there was a trend towards lower calcium and copper intake in children on elimination diets (11). As a result, some researchers suggest that all children on elimination diets should be under the care of a nutritionist or physician (1).

Resources

Cookbooks as well as casein- and gluten-free diet starter kits for children with autism can be found at: http://www.gfcfdiet.com/.

The Food Allergy and Anaphylaxis Network provides many resources to help children live with a gluten-free diet: http://www.foodallergy.org/.

Several books that might be helpful in understanding the casein-free diet approach are:
Diet Intervention and Autism: Implementing a Gluten Free and Casein Free Diet for Autistic Children and Adults: A Guide for Parents by Marilyn Le Breton and Rosemary Kessick. 2001. Jessica Kingsley Publishers.

How to Eat Well Again on a Wheat, Gluten and Dairy-Free Diet by F. Crosthwaite. 2006. Merton Books.

Special Diets for Special People: Understanding and Implementing a Gluten-Free and Casein-Free Diet to Aid in the Treatment of Autism and Related Developmental Disorders by Lisa S Lewis 2005. Future Horizons.

The Kid-Friendly ADHD and Autism Cookbook: The Ultimate Guide to the Gluten-Free, Casein-Free Diet by P. Compart and D. Laake. 2006. Fair Winds Press.

article taken from this website http://autism.healingthresholds.com/therapy/gluten-free-diet

Personal Trainer in Charlotte, NC

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