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The GFCF (Gluten-Free, Casein-Free) Diet for Autism and PDD

Diet Basics

Cookbooks

Vitamins, Enzymes

Finding GFCF food

What on earth are gluten and casein? Can removing them from my child's diet really improve the symptoms of autism and Pervasive Developmental Disorder (PDD)?

Gluten and casein are getting a lot of attention in the autism community and from doctors in the "Defeat Autism Now!" biomedical movement. Some parents, doctors and researchers say that children have shown mild to dramatic improvements in speech and/or behavior after these substances were removed from their diet. Some also report that their children have experienced fewer bouts of diarrhea and loose stools since starting a gluten-free, casein-free (GFCF) diet. Author Donna Williams, who has autism, says she has been helped by "nutritional supplements together with a dairy/gluten-free and low Salicylate diet." (Salicylates are found in some fruits likes apples and other foods). Some people report no benefits from the GFCF diet.

Gluten and gluten-like proteins are found in wheat and other grains, including oats, rye, barley, bulgar, durum, kamut and spelt, and foods made from those grains. They are also found in food starches, semolina, couscous, malt, some vinegars, soy sauce, flavorings, artificial colors and hydrolyzed vegetable proteins.

Casein is a protein found in milk and foods containing milk, such as cheese, butter, yogurt, ice cream, whey and even some brands of margarine. It also may be added to non-milk products such as soy cheese and hot dogs in the form of caseinate.

There is growing interest in the link between autism and gastrointestinal (GI) ailments. A study by the University of California Davis Health System found that children with autism born in the 1990s were more likely to have gastrointestinal problems, including constipation, diarrhea and vomiting, than autistic children who were born in the early 1980s. Some people use the GFCF diet mainly to ease gastrointestinal problems and food allergies or sensitivities.

According to one theory, some people with autism and PDD cannot properly digest gluten and casein, which form peptides, or substances that act like opiates in their bodies. The peptides then alter the person's behavior, perceptions, and responses to his environment. Some scientists now believe that peptides trigger an unusual immune system response in certain people. Research in the U.S. and Europe has found peptides in the urine of a significant number of children with autism. A doctor can order a urinary peptide test to see if proteins are being digested properly.

Studies are underway to examine the effectiveness of the GFCF diet, which has not gained widespread acceptance in the medical community. One recent study found behavioral improvements in children on a GFCF diet, while another study found no significant effects from the diet.

Medical tests can determine if your child has a sensitivity or an allergy to gluten, casein and other foods such as eggs, nuts and soybeans. Any pediatrician or a physician from the DAN! (Defeat Autism Now!) list can order these tests before you begin the diet.

Before you change your child's diet, consult with a physician and nutritionist to make sure you are providing a healthy diet and, if necessary, nutritional supplements. Also, read any of the books and web sites about the diet (listed below).

Some advocates of dietary intervention suggest removing one food from the diet at a time, so you will know which food was causing a problem. It also is helpful to ask people who do not know about the dietary change if they see any improvement after a few weeks.

It's often suggested to remove milk first because the body will clear itself of milk/casein the quickest. Gluten may be removed a month after the elimination of milk. It may take up to six months on a gluten-free diet for the body to rid itself of all gluten. That is why most advocates suggest giving the diet a trial of six months.

The diet can seem like a lot of work, at first. You must carefully read the ingredients on food packages. Beware of "hidden" casein and gluten in ingredient lists, such as curds, caseinate, lactose, bran, spices or certain types of vinegar. It may be hard to locate a substitute for the milk your child loves, although many children do adapt to the gluten-free, casein-free (GFCF) soy, potato, almond and rice milk substitutes available. (Companies listed below). Look for varieties that are enriched with calcium and Vitamin D. In addition, many parents provide vitamin and calcium supplements to their children on the diet.

Many communities have health food stores or regular supermarkets that stock flour, bread, crackers, cookies, pretzels, waffles, cereal, and pasta made of rice, potato or other gluten-free flours. There also are online retailers that sell GFCF foods and vitamins. Also, some web sites list commercially-available foods that are gluten-free and casein-free, such as Heinz ketchup, Bush's Baked Beans and Ore-Ida Golden Fries. Some prepared foods originally developed for people with Celiac Disease, a form of gluten intolerance, now come in casein-free varieties, too. To save money, some families choose to make their own GFCF foods using some of the cookbooks below.

Foods that CAN be eaten on a gluten-free, casein-free diet include rice, quinoa, amaranth, potato, buckwheat flour, soy, corn, fruits, oil, vegetables, beans, tapioca, meat, poultry, fish, shellfish, teff, nuts, eggs, and sorghum, among others.

Author Karyn Seroussi says her son now has no traces of autism, due in large part to a strict GFCF diet. Some parents report improved eye contact, less constipation or diarrhea, and better behavior. However, other parents do not notice a difference in their children.

Besides gluten and casein, some parents report that removing corn or soy led to equal or greater improvements in their children. Because soy protein is similar to gluten and casein, some diet proponents recommend removing it if the child seems very sensitive.

Research into the GFCF diet continues. "Although the hypothesis may appear 'off the wall' in many respects, there are a number of pieces of evidence, which seem to support them. The ideas are compatible with virtually all the accepted biological data on autism and are therefore worthy of consideration. The dietary method must still be considered as experimental and no positive results can be promised or are claimed for every person," according to Paul Shattock and Dr. Paul Whiteley of the British Autism Research Unit at the University of Sunderland, which provides scientific information on the diet.


The Details: Books, Recipes and Web Sites (return to top)

A useful free web site is GFCFdiet.com, which publishes a list of commercially available GFCF foods, acceptable ingredients, manufacturers' phone numbers and more.

The Kid-Friendly ADHD and Autism Cookbook: The Ultimate Guide to the Gluten-Free, Casein-Free Diet. The popular book by two Defeat Autism Now practitioners, developmental pediatrician Pamela Compart M.D. and nutritionist Dana Laake. Advice for feeding picky eaters, and a good explanation of how and why the diet can work. Recipes include information on calories, protein, fiber, etc., per serving. Updated 2009 edition has 100 new recipes plus advice for packing school lunches.

The Autism & ADHD Diet: A Step-by-Step Guide to Hope and Healing by Living Gluten Free and Casein Free (GFCF) and Other Interventions by Barrie Silberberg, mother of a boy with Asperger's Syndrome. Her son's behavioral symptoms improved dramatically after starting a diet free of gluten, casein, artificial dyes and preservatives. New
 

Unraveling the Mystery of Autism and Pervasive Developmental Disorder: A Mother's Story of Research and Recovery by Karyn Seroussi. An excellent book for parents considering a gluten-free, casein-free diet for a child with autism or PDD. Seroussi's son recovered from autism by strictly adhering to this diet. She discusses food intolerances, yeast and vaccines and includes a FAQ section.

Special Diets for Special Kids: Understanding and Implementing Special Diets to Aid in the Treatment of Autism and Related Developmental Disorders by Lisa Lewis, Ph.D. One of the first books to explain the gluten-free, casein-free diet and how it can help treat autism. Her explanation of the science behind the diet is not as easy to follow as Seroussi's. However, this book has more than 150 recipes for breads, cakes, candy, chili, macaroni and cheese, etc.

1885477813.01.TZZZZZZZ (3850 bytes) Special Diets for Special Kids, Two by Lisa Lewis, Ph.D. A sequel to her first book (above) with more than 175 new gluten-free, casein-free recipes and cooking tips. Recipes for peanut butter bread, bananaberry shake, oven fries, barbequed chicken pie and other foods that kids will eat. 

The Gluten-Free Gourmet Cooks Fast and Healthy: Wheat-Free Recipes with Less Fuss and Less Fat by Bette Hagman and Joseph A. Murray. Hagman is the author of several excellent, gluten-free cookbooks.

feastyeast.jpg (3645 bytes) Feast Without Yeast: 4 Stages to Better Health: A Complete Guide to Implementing Yeast Free, Wheat (Gluten) Free and Milk (Casein) Free Living by Bruce Semon M.D., Ph.D., and Lori Kornblum. Contains more than 200 original recipes. Good for those concerned about yeast overgrowth, a problem in some people with autism.

The Encyclopedia of Dietary Interventions for the Treatment of Autism and Related Disorders by diet gurus Karyn Seroussi and Lisa Lewis Ph.D. For the experienced diet follower, or for anyone who wants a reference guide to explain the research, terms, and principles behind different diets that are used for ASD.
 

Enzymes.jpg (2409 bytes)

Enzymes for Autism and other Neurological Conditions. Author and parent Karen L. DeFelice discusses the role of enzymes in helping people with autism digest foods that create problems for them. Some parents use enzymes alone, or in addition to a gluten-free, milk-free diet, or to handle diet infractions.

Other autism diet resources:


Enzymes and Vitamin / Mineral Supplements (return to top)

Many doctors and nutritionists in the Defeat Autism Now! (DAN) biomedical movement recommend enzyme supplements to help some patients digest foods that cause problems for them.

Also, a number of DAN! practitioners recommend specific vitamins, such as B-6 and methyl B-12; minerals such as calcium, magnesium and zinc; amino acids such as taurine, carnitine and glutamine; probiotics (the healthy bacteria found in yogurt); and essential fatty acids, such as purified fish oil. Calcium, magnesium and Vitamin D are especially important for children on a casein-free diet to replace nutrients found in cow's milk.

"There are several reasons to suspect that children on the autism spectrum may not be getting sufficient nutrients, including chronic diarrhea or constipation, gastrointestinal inflammation, and a tendency to restrict food choices," according to an article at the Interactive Autism Network.

According to NICHCY, "Some anecdotal evidence has shown that Vitamin B6 and magnesium help children with autism and PDD-NOS. The rationale for this is that Vitamin B6 helps the formation of neurotransmitters, which are thought to malfunction in such children."

Parents should consult their child's health care provider about dietary changes and nutritional supplements.

GFCF vitamins and dietary supplements:


Mail Order and Online Retailers of GFCF Foods

Retailers of multiple brands of baking mixes, flours, pretzels, cereals, breads, cookies and more:

Ready-to-cook or prepared GFCF meals

Makers of single brands:

Manufacturers of milk substitutes (often sold in supermarkets, look for calcium-enriched varieties):

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