Autism and GFCF Diet, and Effects on GI System

1. Autism and GFCF Diet, and Effects on GI System By: Erin Smith

2. Outline • Background information • Studies • Conclusion • Future Research

3. Background information • Autism Spectrum Disorder - developmental disorders marked by impairments in the ability to communicate and interact socially and by the presence of repetitive behaviors or restricted interests • Asperger’s Syndrome

4. Statistics • 1 in 150 children born today have or will eventually have autism • 10% of cases = genetic background • No known etiology

6. History…….. • 1943- Leo Kanner published his first paper identifying autistic children /1938 • 1967-Book published by Professor Bruno Bettelem, who claimed that a traumatized unloved child retreated into autism. • Not looking for “medical” answers

7. Today….. • Children usually not undergoing any medical therapies to try and treat their disorder • Researchers- Etiological disorders related to autistic children

8. Related disorders • Gastrointestinal disorders (most prominent) • Gluten or Casein • Antimicrobial use? • Disrupt microflora and produce neurotoxins

9. Gastrointestinal micro-flora studies in late-onset autism. Clinical Infectious Diseases. • microbiological study of the intestinal contents • Autistic and control group • Autistic group- late onset, GI symptoms, many on GFCF diet Finegold SM, Molitoris D, Song Y, et al.

10. Gastrointestinal micro-flora studies in late-onset autism. Clinical Infectious Diseases. • All- no antibacterial agents for at least 1 mo. • Stool specimens • Gastric/duodenal juices obtained • Specimens homogenized • Culture primarily for clostridia.

11. 13 with autism and 8 w/o had clostridia and ruminococci 23 species of Clostridium and 5 of Ruminococcus found in the autistic group 15clostridial species and 5 ruminococcal species in the controlgroup Mean counts of the clostridia and ruminococci

12. Conclusion • microorganisms may be involved in late-onset autism. • A double-blind, placebo-controlled trial should be performed with an agent effective in patients with autism

13. GFCF Diet • Improvement in symptoms by as much as 80% when placed on a strict gluten and casein free diet. • Do this first to set the way for further treatments.

14. Gluten and casein free diets in autism: A study of the effects on food choice and nutrition. • study looks at the effects on nutrition/food choice when practicing a GFCF Diet • Results: Not substantially different Cornish E

15. Gluten and casein free diets in autism: A study of the effects on food choice and nutrition. • GFCF Problems: • Lack of conventional foods • Time • Money

16. Development of double blind gluten and casein free test foods for use in an autism dietary trial. • Developed GF, CF, and GFCF products • Muffin, porridge and batter mix, lemon and almond cookies, and chocolate crispy bars • Double blind study • 60 children with autism from 3 to 6 yoa Adams SJ, Burton N, Cutress A, et al

17. Development of double blind gluten and casein free test foods for use in an autism dietary trial. • Families received: test foods, detailed cooking instructions and behavior and food preference questionnaires for self-completion • Offer foods 28 days- record acceptability • Studied acceptability

18. Development of double blind gluten and casein free test foods for use in an autism dietary trial. • Results: • 38 parents responding 63% stated children were willing to try new food • 95% of children tried at least some of food • Muffins, chocolate crispies liked best • Porridge, batter liked the least

19. Development of double blind gluten and casein free test foods for use in an autism dietary trial. • Parents suggested alternative savory foods be an option (ex. Bread) 2008 • Now there are a lot of products

20. What is the current status of research concerning use of a gluten-free, casein-free diet for children diagnosed with autism? • Between April 2006 and October 2008 • two-staged randomized control study • Subjects fulfilled requirements for PDD (pervasive developmental disorder) and ASD • Parents filled out questionnaire Marcason W.

21. What is the current status of research concerning use of a gluten-free, casein-free diet for children diagnosed with autism? • Duplicate urine samples sent to two labs • IAG compounds have been associated with a more efficient diet plan • 38 participants following gluten and casein free diet and 34 that weren’t following a diet plan

22. What is the current status of research concerning use of a gluten-free, casein-free diet for children diagnosed with autism?

23. What is the current status of research concerning use of a gluten-free, casein-free diet for children diagnosed with autism? • Testing for results: • ADOS ( Autism Diagnostic Observational Schedule ) • VABS (Vineland Adaptive Behavior Scoring) • ADHD scoring

24. ADOS: Decreased shows improvement

25. ADHD: Decrease shows improvement

26. What is the current status of research concerning use of a gluten-free, casein-free diet for children diagnosed with autism? • Results: • GFCF diet at 8,12, and 24 mo. Showed benefits • Less impressive change between 8-24 mo. • Conclusion: • Would have been better if could have been a double-blind or some placebo element added • Hard to measure accurately

27. The gluten- and casein-free diet in children with autism • 1st double blind trial done to control carefully for other interventions • 22 children with ASD between the ages of 2.5 and 5.5 years of age • 10 hours a week of early intensive behavioral intervention (EIBI) with no other interventions Brown Univ Child Adolesc Behav Lett

28. The gluten- and casein-free diet in children with autism • 4 weeks of the GFCF diet, the participants were screened for iron and Vitamin D deficiency • 12wks only 14 children were left

29. The gluten- and casein-free diet in children with autism • parent/teacher/ researcher scores of attention or activity: • frequency or quality of stools • sleep behavior • activity levels on either the baseline/diet comparison • pre-/postsnack comparisons.

30. The gluten- and casein-free diet in children with autism • Results: • Conclusion • very sm. research group, increase numbers • Did not recruit children with ASD that had GI distress • Did not see positive results

31. Conclusion • Treatments should be specialized for each child’s individual needs. • GFCF diet does not work for everyone but has been shown to work for some

32. Future Research….. • Research of supplementing with probiotics and prebiotics • Double blinded studies with more participants need to be done • Cases of ASD are increasing every year so research needs to be done to find a solution!

33. Any Questions ?