Gluten- and Casein-free Diet Not Effective Autism Treatment

April 28, 2010

AUSTIN, Texas — The use of gluten-free and/or casein-free (GFCF) diets in the treatment of autism spectrum disorders (ASD) is not supported by current research, says a team of scientists with The University of Texas at Austin's Meadows Center Autism Spectrum Disorders Institute.

The conclusion was reached after critical analysis of 15 published, major scientific studies on GFCF as an effective treatment method for ASD.

"Many causes for ASD have been proposed," says Austin Mulloy, lead researcher on the study and doctoral student in the Department of Special Education at The University of Texas at Austin, "and even though the actual etiology remains unknown, potential causes have been translated into treatment methods and shared with the public well before there is sufficient evidence regarding treatment effectiveness or safety."

"Among the many proposed causes is the theory that people with autism have insufficient enzymatic activity in the gastrointestinal tract and increased gastrointestinal permeability. It's suggested that they tend to absorb toxic byproducts of the incompletely digested proteins casein and gluten.

"Casein is a naturally occurring protein found in milk and other dairy products and gluten is a protein in wheat, barley and other grains. Consequently, the number of parents who have elected to put their children with autism on gluten- and casein-free diets has increased significantly in the past several years."

The research team reported that a number of gross methodological flaws invalidate studies that show support for using the diet as an ASD treatment. According to Mulloy and his colleagues, a number of documented phenomena other than efficacy of the GFCF diet can explain the outcomes observed in the studies.

"Given that a variety of adverse consequences are known to be associated with a gluten- and casein-free diet," says Mulloy, "my fellow researchers and I recommend that the diet only be implemented with children whose doctors have identified them as having allergies or intolerances to gluten or casein."

Autism spectrum disorder refers to neurological and developmental disorders that include autism, Asperger syndrome and a range of other pervasive developmental disorders. Defining features of ASD include impairments in social interaction, communication and imagination along with restricted interests and, in some cases, intellectual disability. Current estimates suggest that about one in every 100 children is diagnosed with ASD.

Other researchers who contributed to the study include Russell Lang, University of California, Santa Barbara; Mark O'Reilly, The University of Texas at Austin; Jeff Sigafoos, Victoria University of Wellington, New Zealand; Guilio Lancioni, University of Bari, Italy; and Mandy Rispoli, Texas A&M University.

The study was published in the summer 2010 edition of the peer-reviewed journal Research in Autism Spectrum Disorders. Further details about the study are available from Austin Mulloy.

The Autism Spectrum Disorders Institute is part the Meadows Center for Preventing Educational Risk in the College of Education at The University of Texas at Austin.

For more information, contact: Kay Randall, College of Education, 512 471 6033.

15 Comments to "Gluten- and Casein-free Diet Not Effective Autism Treatment"

1.  Roxy Powers said on April 28, 2010

What a stupid story. A bunch of non-medical doctors commenting about medical treatment for autism. How about running the story ABA does not cure autism and costs $50,000 to $70,000 a year. What adverse consequences are there for not eating milk and dairy products? Our ancestors the cavemen who lived on the earth thousands of years never ate those, and were just fine. The departments of special educations are green with envy when parents find more success by removing the foods they are allergic to than doing ABA.

2.  Martin Matthews said on April 28, 2010

This "news" report and "conclusion" is 100 percent bunk. It's embarrassing to humanity that any part of the medical profession would aim to deter people (whose children are ill) from paying attention to FOOD INTAKE. Shame on them!

It's important to understand that Diet for Autism (including the GFCF diet) comprises omitting known problematic foods/substances and adding necessary nutrients. Multiple studies indicate that nutrient deficiencies are common with autism. Being attentive to diet (what children eat) is 100 percent common sense.

Gastrointestinal issues are but one reason to be strategic about food choices with autism. There are many others, and many dietary approaches known to be helpful. The avoidance of gluten and/or casein, or the GFCF diet, is but one dietary strategy for helping autism - there are several other diets that prove very effective.

To only restrict foods without conscious attention to the purpose and intent of what's meant to be a healing intervention is unsafe and NOT the onus of autism diets. Rather, autism diets are a nutritional intervention - focus on helping the body heal through food choices.

This is ancient wisdom and modern learning. A nutrition expert from California has synthesized the autism nutrition information in an award-winning book called "Nourishing Hope for Autism." If you read it you will realize the depth of the scientific (and practical) rationale for autism diets.

THOUSANDS of parents across the world ARE and HAVE effectively applied nutrition-focused healing diets for their children with autism, and thousands of children are happier and healthier because of it.


3.  Bob Sears said on May 4, 2010

Allow me to mention several key issues here involving this study:

1. This isn't an actual research study. It's a review of 15 studies done by other researchers. So, there was no new testing done to determine the effectiveness of the GFCF diet in this study.

2. The results of THIS study don't actually find that the diet is ineffective, as the news story generated by this study has implied. Notice the title of the news story: "Gluten and casein free diet not effective for autism treatment." BUT, here is the abstract: Gluten and Casein free diets in the treatment of autism spectrum disorders: a systematic review (PDF).

Please note: to view any linked PDF files in this comment, you must first download the Acrobat Reader plug-in for your browser.

4.  Kim Peters said on May 5, 2010

I am so thankful for this research! Finally an objective review that I can share with parents who are searching for the best "treatment" for their child. With a disability like autism, challenging behavior can be very common; in my experience these diets only cause more challenging behavior! Thanks to all involved, as this provides parents with some vital information!

5.  Laurin Flowers said on May 12, 2010

Within three days of removing Gluten and Casein from my daughters diet. . . she started responding to questions with yes or no answers. . started sleeping through the entire night. . and she seemed to come out of a fog and was able to focus on us. . . . just sayin

6.  Jay Howard said on May 16, 2010

My 7-year-old HFA son has been following the DAN! protocol, including GFCF for four years, and GFCF + SCD for the last two and a half. My son has progressed, but his GI problems keep getting worse. My spouse swears by DAN!, and that there have been major improvements from this diet, but all of his peers that we know from school and ABA that do not follow this diet have progressed as well or better than my son. We are fortunate in that our children WILL improve, as ASD are delays, not static conditions. While I drank the DAN!/GFCF "Kool-Aid" and defended it for years, I choose to see what the other approaches exist. What I found out led me to be convinced that GFCF and other DAN! protocols are not only ineffective, but potentially dangerous. Very few consider the psychological and emotional impact of this process as well. We stopped weekly chelation after we saw little improvement and my son began having nightmares (often accompanied by severe reflux) and looking at the window all day for the nurses car. Four months after we stopped, he still asks if the nurse is coming.

If you are sold on GFCF, DAN!, etc. you owe it to yourself, and even more to your child, to at least do some serious research into alternative points of view. You may not change your mind, but at least you will be informed.

7.  Angela said on May 25, 2010

Well, regardless of this "study," my son made dramatic improvement within one month of being on the GFCF diet. Nothing else changed during that time. I don't think it is a cure-all or that every kid benefits, but my son did. Jay, how is GFCF dangerous? That's ridiculous.

8.  Amy said on June 3, 2010

My 4 year old son has been on the diet for 4 weeks with no cheating. We haven't seen any changes in him yet. I see lots of stories about kids that it has helped. I am going to keep with it so that I don't have any regrets later. But we certainly haven't seen any miracles so far.

9.  dAVE ROST said on June 4, 2010

I have a 13-year-old son. Have noticed when I do not give him gluten food (pizza, bread, cakes), he acts much better. Also, it helps a lot not giving him sweet stuff like ice cream, etc.

10.  sam said on June 9, 2010

What a load of rubbish study. How can you call this study scientifically sound when it appears the researchers themselves are biased negatively -- so what about the placebo effect of that? You discredit all the positive response studies, but what about the negative studies? I'm amazed at the quality of your study coming from scientific background.

11.  Roni said on Oct. 16, 2011

Our son is 4 years old, not yet diagnosed but displays some behavious typical of an autistic child (and some definitely not tipical). His current diagnosis is 'quirky and complex'. We started our son on a GFCF as well as Soya, citrus and sweetcorn free diet. We have noticed improvement in his digestive system now that we have removed these ingredients but he had a bout of dioarrea when he ate a few tomatoes the other day. He loves tomatoes and can eat many at a time. Before this diet we had never thought that this could be one of the triggers. We have seen positive changes in his development but he also started school full time (in special needs education) in September, around the time we started with the diet and we don't know if the positive changes are due to school and diet or both together. This has been useful for us to identify the foods which are not good for him and we now know that tomato is definitely one of them. We have decided to go back to a normal diet in December, putting one ingredient back a time to see whether we identify any changes in his behaviour or digestive system... We have also noticed that all these foods are free from preservatives, additives, sweetners and artificial flavours. This part of our family diet we will keep. I will definitely be very careful when buying food for our family in the future.

12.  Matt said on Jan. 8, 2012

Its unfortunate such misinformation was published anywhere.
I have yet to work with an autistic child who has not shown significant improvements when placed on a sugar free, cassein free, gluten free diet that emphasizes animal proteins and cooked vegetables. Diet is an important piece of the puzzle, but hyper/hypo sensitivity to sensory inputs (ex: an overreaction to tactile stimulus) must also be addressed. If you have an autistic child and need help the highest success rate is from the Family Hope Center (Philadelphia). And, yes, they require a cassein/gluten free diet.

13.  David said on Jan. 9, 2012

The more I read and research the GFCG diet studies The more doubtful I become of it's effectiveness on my sons behavior. One positive thing about the GFCF diet is it reduces the amount of additives and preservitives he eats, and I tend to believe that reducing/removing these toxic chemicals from his diet has been the bigger benefit.

14.  Janice said on Feb. 16, 2012

I have long considered this diet a load of bunk, in terms of Autism relief. I am a parent in a multiplex Autism family, who tried it tirelessly and exactingly for years when my children were young, and who saw no improvement in any of them (nor did my spouse) -- just more daily, grinding effort for a family that was already overloaded. It was with great relief that we all, finally, ditched it.

15.  Tara J. Marshall said on March 27, 2012

Okay, I've read the papers, and I've read parents' concerns on this issue.
There is no such thing as a "gluten deficiency", which seems to be a concern of some misinformed parents. Gluten is not necessary in a healthy diet, and reducing and removing gluten from the diet has a beneficial effect upon many different disease processes, especially those involving inflammation, such as autoimmune disorders and autism. In fact, gluten is a recent addition to the human diet, only in the past 10,000 years... and gluten content in wheat, rye, barley, and oats has increased signficantly in recent centuries.

What is true is that autistic children tend to have multiple vitamin and mineral deficiencies. These will not be corrected just by being on a gluten-free diet. In fact, if the new diet is high in gluten-free carbohydrates such as white rice, potato chips, and popcorn, nutritional deficiency status may even get WORSE. The problem with these children is NOT that they are on a gluten-free diet. It is that they are eating far too many processed carbohydrates to begin with. Many parents switch their autistic children from a diet of pizza, macaroni & cheese, ice cream, chicken nuggets, and french fries to a diet of these same things that are gluten & casein free. This is okay to do on a temporary basis while you are changing over from one diet to another, but it is VITAL to introduce actual vegetables and fruits into the diet as soon as you can. That is the only way to get vital nutrients into a person through the diet, although you can also increase these through supplementation (and I generally recommend you do both).

For people with celiac disease and other forms of gluten-intolerance, a gluten-free diet is ESSENTIAL to absorbing vitamins and minerals from both foods and supplements. The very first symptom of celiac disease is frequently anemia, even in people with an adequate iron intake in their diets. Other symptoms can include bone deformities, such as stunted growth and osteomalacia, linked to malabsorption of calcium, magnesium, and Vitamin D. Research is inconclusive about how many children labelled as "failure to thrive" are actually celiac, but I suspect the number is very high. There have been several case-reports of children diagnosed as autistic experiencing a "spontanous recovery" from their autism symptoms within several months of starting a gluten-free diet.

I haven't seen any cases of "full recovery", as it were, but I've seen several children who made significant advances in MANY regions of development, including language, once they began the diet. And if even a few children are able to advance from being stereotypically "low-functioning autistic" to Asperger's, ADHD, or Learning Disabled in appearance, then I think it's worth a try with the kids.

I should note that I've been doing the Feingold, Gluten-Casein-Soy free diets, and others for several years. I even did the full Specific Carbohydrate Diet for a year due to a yeast infection in my intestines, and I tend to eat a fairly low-carbohydrate, low-grain (cheating on gluten-free grains a couple times per week max). During this time, I have stopped seizing, my ability to tolerate and participate in social settings has increased drastically, my sensory integration disorder has decreased in how it affects my life, and I've been able to work full-time and continue my education. I've also lost 50 pounds of weight, although I've seen the opposite result in some kids who were underweight when they began the diet.