Going Gluten-Free

Help for Autism

bowl of apples

A gluten-free diet has been embraced by many parents in the autism community, who say eliminating gluten (along with casein, the protein in dairy) improved their child's symptoms significantly -- in some cases even "curing" their child of autism. In fact, the gluten-free, casein- free diet (GFCF) is the number-one alternative treatment parents are trying for autism, with about one out of five families following it, according to a survey by Autism Speaks. "This isn't a diet that we actively promote, but we want to be supportive of families without giving them false hope," says Daniel Coury, M.D., medical director of the Autism Speaks Autism Treatment Network.

There is reason for skepticism: A large controlled study on the effectiveness of the GFCF diet has never been done. However, there have been some recent, hopeful findings. Researchers at Penn State found that a GFCF diet improved symptoms such as tantrums, poor eye contact, impaired speech, and skin rashes for certain groups of kids with autism: those who followed the diet most closely, those who stayed on it for at least 6 months, and those who also had food allergies or digestive issues such as chronic constipation and diarrhea (nearly half of kids with autism have GI problems).

When Denise Fulton's son Grant was diagnosed with autism at age 2, he had chronic diarrhea and rashes that frequently became infected, and he was waking every hour during the night. After removing gluten, dairy, and soy, his GI issues stopped, he began sleeping soundly, and his skin cleared over a few weeks. "His speech improved and his behavioral therapies became much more effective," says Fulton, of Bellingham, Washington.

However, when Alison Singer tried a GFCF diet after her then- 3-year-old daughter Jodie was diagnosed with autism, she stopped the diet after a few months. "I saw no changes, except that I was exhausted from buying and cooking new foods and worrying that Jodie wasn't eating enough," says Singer, from Scarsdale, New York. "I felt like it only added to her difference because she couldn't have the same things as other kids." Singer, who is now the president of the Autism Science Foundation, advises parents to focus instead on the interventions that are proven to help, such as applied behavior analysis and occupational, physical, and speech therapies.

Why the GFCF diet seems to help certain children but not others isn't fully understood. One theory is that some kids with autism are unable to fully break down gluten and casein; they may have a "leaky gut" that allows the partially digested proteins to seep through the intestinal walls and into the bloodstream, where they collide with immune cells. The activated immune cells then slip into the brain and cause inflammation. "Brain inflammation produces a cascade of chemicals that can increase sensory hypersensitivity, sleep disturbances, and problems paying attention," says Martha Herbert, M.D., Ph.D., assistant professor of neurology at Harvard Medical School and coauthor of The Autism Revolution Whole-Body Strategies for Making Life All It Can Be. "There's also evidence that the proteins cross into the brain and act like opiate drugs." This would not only cause behavior changes but also explain why some children with autism eat a "beige diet" consisting of mostly gluten- and casein-containing foods like crackers, grilled-cheese sandwiches, and milk: They are literally addicted to them.

ADHD Advances

Some parents are also getting rid of gluten with the hope of improving their child's ADHD -- and there does seem to be a connection between gluten intolerance and attention. People with celiac disease often report brain "fogginess" and agitation when they eat gluten. A small Italian study found that 15 percent of kids and adults with ADHD tested positive for celiac. After they ate a gluten-free diet for six months, they had a decrease in distractibility and impulsiveness.

Though her son Oliver doesn't have celiac, New York City mom Katherine Pennington says cutting out gluten three years ago made a difference in his ADHD and eventually enabled him to stop taking meds. "He became calmer, kinder, and easier to connect with," she remembers. When Oliver, now 12, occasionally splurges on a bagel, he immediately becomes restless.

Kids with undiagnosed celiac or gluten sensitivity may simply be showing ADHD-like symptoms. "With primary ADHD, however, diet changes don't make a dramatic difference," says Jay Salpekar, M.D., director of the Neurobehavior Program at Children's National Medical Center, in Washington, D.C. "A healthy diet will improve a child's energy level and feeling of well-being, but it probably won't make him less hyperactive or more attentive if he truly has ADHD."

 

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