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The GFCF (Gluten-Free, Casein-Free) Diet for Autism and PDD 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 and autism consultant Donna Williams 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 that can tell if proteins are not being digested properly. Studies are currently underway to examine the effectiveness of the GFCF diet, which has not gained widespread acceptance in the U.S. 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 several online and mail-order businesses 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, another 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 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 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.
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.
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.
Diet Intervention and Autism: Implementing a Gluten Free and Casein Free Diet
for Autistic Children and Adults by Marilyn Le Breton. This British book answers questions about what to cook, how to
avoid cross contamination, how much work the diet involves, and how strictly it
must be followed.
The Encyclopedia of Dietary Interventions for the Treatment of Autism and Related Disorders 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 "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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who has autism herself, says she has been helped by "nutritional
supplements together with a dairy/gluten-free and low Salicylate diet."
Some people report no benefits from the GFCF diet. (Salicylates are
found in some fruits likes apples and other foods).
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.
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.
are available. Chewables, liquids and powders
available. May be more expensive than other brands.