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Diet and Autism

An interview with Brian Udell, MD.
Reviewed by Louise Chang, MD

Autism affects nearly one out of every 110 children, according to the CDC. That's more children diagnosed with autism than with diabetes, cancer, and AIDS combined.  Yet a cure has yet to be found, and formal autism treatments are limited. So many parents are trying autism diets and supplements they've heard about from other parents or the media.

But can a child's diet really have an effect on autism or other autism spectrum disorders (ASD)? And which nutrients or foods offer promise to improve behavior, encourage children to be more communicative, or relieve the gastrointestinal conditions that often accompany autism?

 

WebMD turned to autism and learning disorder specialist Brian Udell, MD, director of the Child Development Center of America, for answers.

What are common medical and nutritional challenges for kids with ASDs?

The most common GI symptoms include chronic diarrhea, abdominal distention, discomfort and bloating, gastroesophogeal reflux disease (GERD), excessive gas, constipation, fecal impaction, food regurgitation, and a leaky gut syndrome. Children with autism are also at risk for many other nutritional problems such as nutrient deficiencies, food allergies, food intolerances, and feeding problems.

What are the treatments for autism?

First, there are no cures for the disorder and there is no one single best treatment for all children with ASDs. Every child must be evaluated individually. This can be tricky because the diagnosis usually occurs in 1- to 3-year-olds who are not great communicators. Doctors base their treatment protocols on lab results, parent reports, and physical exams. Even though there are no lab tests to diagnose autism, there are tests that can help us manage underlying symptoms.

Most children show improvement with early-intervention treatment services, where they learn important skills like walking, talking, and interacting with other children. 

Depending on the symptoms, [many] kids are treated with some form of diet. Medication is common, as are physical, occupational, social, educational, and communication therapy. And because the research lags behind, some physicians try complementary and alternative medicine approaches that are safe.

What are some common dietary changes that may offer symptom relief?

According to the Autism Network, nearly one in five children with autism are on a special diet. There is no specific ASD diet, but removing certain proteins may relieve symptoms. The gluten-free, casein-free (GFCF) diet has the most research and is one of the most common dietary interventions. About 25% of my patients find relief and improvement with this diet. It excludes gluten, the protein in wheat, and casein, the protein in milk. In theory, kids improve on the diet because incomplete breakdown of these proteins create a ... substance that can inflame the gut. Studies have shown improvement and parents anecdotally report success when these two proteins are removed from the diet. 

Parents can also have their children tested for celiac disease, which responds to a gluten-free diet. 

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