 |
This article is in need of attention from an expert on the subject. WikiProject Alternative medicine may be able to help recruit one. (February 2009) |
A gluten-free casein-free diet (or GFCF diet) eliminates intake of the naturally-occurring proteins gluten (found naturally in wheat, barley, spelt, triticale, kamut, rye and possibly oats) and casein (found in milk). The Autism Research Institute and other advocacy groups recommend the diet as a treatment for autism and related disorders. Studies supporting these claims have had significant flaws, and the data are inadequate to guide treatment recommendations.[1][2] A 2008 study found reduced bone thickness in 4-8 year old autistic boys on a casein-free diet.[3]
Contents |
Background
In the 1960s, Curtis Dohan[4] speculated that the low incidence of schizophrenia in certain South Pacific Island societies was a result of a diet low in wheat and milk-based foods.[5] Dohan proposed a genetic defect wherein individuals are incapable of completely metabolizing gluten and casein as a possible etiology for schizophrenia. Dohan hypothesized that elevated peptide levels from this incomplete metabolism could be responsible for schizophrenic behaviors.
The possibility of a relationship between autism and the consumption of gluten and casein was first articulated by Kalle Reichelt in 1991.[6] Based on studies showing correlation between autism and increased urinary peptide levels,[citation needed] Reichelt hypothesized that some of these peptides may have an opiate effect. This led to the development of the Opioid Excess Theory, expounded by Paul Shattock and others,[7] which speculates that peptides with opioid activity cross into the bloodstream from the lumen of the intestine, and then into the brain. These peptides were speculated to arise from incomplete digestion of certain foods, in particular gluten from wheat and certain other cereals and from casein from milk and dairy produce. Further work confirmed opioid peptides such as casomorphines[8] (from casein) and gluten exorphines and gliadorphin (from gluten) as possible suspects, due to their chemical similarity to opiates. Reichelt hypothesized that long term exposure to these opiate peptides may have effects on brain maturation and contribute to social awkwardness and isolation. On this basis, Reichelt and others have proposed a gluten-free casein-free (GFCF) diet for sufferers of autism to minimize the buildup of opiate peptides. Scientific evidence from randomized controlled trials shows a lack of efficacy.[2]
Effectiveness
A 2008 systematic review from the Cochrane Library indicates that a gluten-free and/or casein-free diet has not been shown to have any effect on the behavior or functioning of individuals with autism. Likewise, research on adverse outcomes and disbenefits is lacking. Two randomized trials were included in the review. The first included ten individuals, was single blind (with parents aware of allocation), and reported reduced autistic traits; the second included fifteen individuals, was double blind, and found no significant differences in outcomes.[2] The first study has been criticized for its small sample size and single-blinding; both factors are associated with positive outcomes bias.[1]
Testimonials of individual parents and teachers range from no discernible effect to claims of complete recovery.[9]
Safety
A 2008 study found that boys with autism had significantly thinner bones than neurotypical boys, starting around age 5–6 years, and that boys using casein-free diets had nearly twice the deviation in bone thickness as other boys in the study. [3]
Practical implementation
 |
Wikibooks Cookbook has a recipe/module on |
The implementation of a GFCF diet involves removing all sources of gluten and casein from a person's diet. Gluten is found in all products containing wheat, rye, and barley. Many gluten-free breads, pastas, and snacks are available commercially. Gluten-free cookbooks have been available for decades. Casein is found in dairy products such as milk or cheese, but is also present in smaller amounts in many substitute dairy products such as vegetarian cheese substitutes, which use casein to provide texture. Advocates of the GFCF diet often recommend total elimination of dairy from the diet; however, whey is a different milk protein from casein and can be included in this diet according to others.
See also
- Gluten sensitivity
- Autism therapies
- List of diets
- List of alternative therapies for developmental and learning disabilities
References
- ^ a b Christison GW, Ivany K (2006). "Elimination diets in autism spectrum disorders: any wheat amidst the chaff?". J Dev Behav Pediatr 27 (2 Suppl 2): S162–71. doi:. PMID 16685183.
- ^ a b c Millward C, Ferriter M, Calver S, Connell-Jones G (2008). "Gluten- and casein-free diets for autistic spectrum disorder". Cochrane Database Syst Rev (2): CD003498. doi:. PMID 18425890.
- ^ a b Hediger ML, England LJ, Molloy CA, Yu KF, Manning-Courtney P, Mills JL (2008). "Reduced bone cortical thickness in boys with autism or autism spectrum disorder". J Autism Dev Disord 38 (5): 848–56. doi:. PMID 17879151. Lay summary – NIH News (2008-01-29).
- ^ http://www.utmem.edu/pathology/Faculty%20pages/dohan.htm
- ^ Dohan, F.C. (1966) Cereals and Schizophrenia, data and hypothesis Acta Physiologica Scandinavica, 42, 125-132.
- ^ Reichelt KL, Knivsberg A-M, Lind G, Nødland M. Probable etiology and possible treatment of childhood autism. Brain Dysfunct 1991; 4: 308-19
- ^ Shattock P, Whiteley P. (2002) "Biochemical aspects in autism spectrum disorders: updating the opioid-excess theory and presenting new opportunities for biomedical intervention" "Autism Research Unit, University of Sunderland, UK.
- ^ Sun Z, Cade JR (1999). "A Peptide Found in Schizophrenia and Autism Causes Behavioral Changes in Rats". Autism 3 (1): 85–95. doi:.
- ^ Elder JH, Shankar M, Shuster J, Theriaque D, Burns S, Sherrill L (2006). "The gluten-free, casein-free diet in autism: results of a preliminary double blind clinical trial". J Autism Dev Disord 36 (3): 413–20. doi:. PMID 16555138.
External links
This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)
