The National Institute of Mental Health (NIMH) is sponsoring a clinical trial investigating potential therapeutic benefits of a gluten-free diet in children with autism. The trial is titled “Diet and Behavior in Young Children with Autism”. The multi-year trial (ID NCT00090428) launched in 204 and was scheduled to conclude in February 2009. No publications have been released as yet.
Trial participants will follow a gluten-free and casein-free diet for 18 weeks. Participants will be evaluated using standard autism testing methods, scheduled laboratory tests, and weekly diet and sleep diaries. Ages eligible for the study range from 2.5 years to 4.5 years.
Autism is a serious brain disorder. The condition affects brain development and often causes educational and social problems. Studies suggest a gluten-free and casein-free diet may have a therapeutic effect on children with autism.
The current research cycle investigating potential benefits of a gluten- and casein-free diet for children with autism began in 2004 with a review article published in the Cochrane Database of Systematic Reviews.1 Various research articles have suggested that excessive opioid activity linked to peptides derived from gluten and casein may be related to the origins of autism. Literature reviews have underscored the need for quality randomized controlled clinical trials.2
Gluten is found in wheat, rye, and barley - the majority of the grains we consume every day. Why is gluten such a problem? Humans cannot completely digest gluten in their gastrointestinal (GI) tracts. The undigested large protein fragments may cause a chronic inflammatory response in the lining of the GI tract. This chronic inflammation sets the stage for development of many other serious conditions, including
- Malabsorption syndrome
- Rheumatoid arthritis
- Celiac disease
- Osteoporosis
- Fibromyalgia
- Behavioral disorders
The good news is that gluten intolerance can be addressed directly, by managing one’s diet, correcting nutritional deficiencies, and restoring the normal intestinal microorganisms that have been compromised by the ongoing gluten-provoked GI inflammation.
The key step is dietary control - maintaining a gluten- and casein-free diet. This step in itself frequently provides significant benefits for affected individuals.
For example, there have been many anecdotal reports describing the benefits of gluten- and casein-free diets for children with autism. A family with an autistic child could weigh the challenges involved in maintaining a three-month gluten- and casein-free diet against the potential benefits.
Many nutritional supplements are available to help address the consequences of gluten intolerance. These products may be of benefit in gluten-sensitive children with autism.
- Gluten-Breaking Enzymes – Gluten-breaking enzymes breakdown gluten, casein, and soy proteins after exposure to these food contaminants. For children who are especially sensitive, gluten-breaking enzymes may help prevent inflammatory reactions after exposure to small quantities of these antigenin proteins.
- Prebiotics – Prebiotics stimulate growth of normal intestinal microorganisms which enhance gastrointestinal and immune system functions.
- Probiotics – Probiotics are living “friendly” microorganisms that help restore normal microorganism balance to the GI tract and assist in supporting immune system function.
- Vitamin D3 and Calcium-Citrate – Vitamin D and calcium work synergistically to help build strong bones. Vitamin D helps strengthen the immune system, promotes neuromuscular function, and helps normalize glucose metabolism. Vitamin D3 is the biologically active form of vitamin D.
1Millward C, et al: Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev 2(CD003498), 2004
2Millward C, et al: Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database Syst Rev Apr 16(2):CD003498, 2008 [update]
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