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Can Special Diets Treat Autism?

Review of Studies Shows Gluten-Free or Casein-Free Diets Aren't Effective as Autism Treatment

Reviewing the Evidence on Autism Diets

To test evidence about the diets, which Mulloy says can be expensive and time-consuming to follow, the researchers searched medical literature for scientific studies of the effectiveness of the autism diets.

From a total of 134 studies, they narrowed the number to 15 papers involving 14 studies. They used a number of criteria, such as whether the researchers evaluated how the diet helped symptoms and involved the dietary intervention of foods that are casein-free, gluten-free, or both.

Of the 14 studies that were reviewed, one looked at just gluten-free diets, another at just casein-free, and the others looked at both gluten-free and casein-free diets.

"None of the reviewed studies were capable of providing conclusive evidence," the researchers write.

Just as importantly, Mulloy tells WebMD, ''there are several known harms that should be taken into consideration." There is the possibility of nutritional deficiencies, especially calcium, he says.

Parents may also spend much time and money on the diets, he says, and those resources could be better spent on more proven treatments.

''The final negative effect is the diet can be stigmatizing," he says. For instance, ''the child may not be able to eat birthday cake at a birthday party.''

He does see a potential role for the diets, however. "If a child is experiencing acute behavioral changes associated with diet, or if the doctor has identified allergies or food intolerance associated with gluten or casein, then it is worthwhile to consider use of the diet," he says.

Second Opinion

''This study summarizes what a lot of the science has been saying for awhile, which is there is not a lot of good evidence to support using this diet as frequently as parents report using it," says Daniel Coury, MD, medical director of the Autism Treatment Network and chief of developmental and behavioral pediatrics at Nationwide Children's Hospital in Columbus, Ohio.

That said, Coury tells WebMD, "I think there is a role for it in some children." On that list, he says, would be children with autism who also have celiac disease, marked by problems digesting gluten. ''Children with autism could certainly have celiac disease, which responds well to the gluten-free diet," he says.

The take-away message for parents, in Coury's view, is: "If [parents] are spending a good deal of their income or time investing in this diet instead of investing in other treatments shown to be more effective, that would not be good."

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