Influence of a Combined Gluten-Free and Casein-Free Diet on Behavior Disorders in Children and Adolescents Diagnosed with Autism Spectrum Disorder: A 12-Month Follow-Up Clinical Trial

J Autism Dev Disord. 2020 Mar;50(3):935-948. doi: 10.1007/s10803-019-04333-1.

Abstract

The use of alternative interventions, such as gluten-free and casein-free (GFCF) diets, is frequent due to limited therapies for Autism Spectrum Disorder (ASD). Our aims were to determine the influence of a GFCF diet on behavior disorders in children and adolescents diagnosed with ASD and the potential association with urinary beta-casomorphin concentrations. Thirty-seven patients were recruited for this crossover trial. Each patient consumed a normal diet (including gluten and casein) for 6 months and a GFCF diet for another 6 months. The order of the intervention (beginning with normal diet or with GFCF diet) was assigned randomly. Patients were evaluated at three time-points (at the beginning of the study, after normal diet and after GFCF diet). Questionnaires regarding behavior and autism and dietary adherence were completed and urinary beta-casomorphin concentrations were determined at each time-point. No significant behavioral changes and no association with urinary beta-casomorphin concentrations were found after GFCF diet. A 6-month GFCF diet do not induce significant changes in behavioral symptoms of autism and urinary beta-casomorphin concentrations. Further studies with a long follow-up period similar to ours and including placebo and blinding elements are needed to identify better those respondents to GFCF diets.

Keywords: Autism spectrum disorder; Beta-casomorphin; Casein; Diet; Gluten.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Autism Spectrum Disorder / diet therapy*
  • Caseins / administration & dosage*
  • Child
  • Child, Preschool
  • Diet, Gluten-Free*
  • Endorphins / urine
  • Female
  • Glutens / administration & dosage
  • Humans
  • Male

Substances

  • Caseins
  • Endorphins
  • beta-casomorphins
  • Glutens