Gluten-free, casein-free diet

From Wikipedia, the free encyclopedia

Jump to: navigation, search
 This article is in need of attention from an expert on the subject. Please help recruit one or improve this article yourself. See the talk page for details. Please consider using {{Expert-subject}} to associate this request with a WikiProject. (February 2009)
The neutrality of this article is disputed. Please see the discussion on the talk page. Please do not remove this message until the dispute is resolved. (May 2009)

A gluten-free casein-free diet (or GFCF diet) eliminates intake of the naturally-occurring proteins gluten (found naturally in wheat, barley, spelt, triticale, kamut, rye and possibly oats) and casein (found in milk). The Autism Research Institute and other advocacy groups recommend the diet as a treatment for autism and related disorders. Studies supporting these claims have had significant flaws, and the data are inadequate to guide treatment recommendations.[1][2] Moreover, studies have found that such diets can lead to nutrient deficiencies that weaken bone structure, increasing the risk of broken bones.[3]

Contents

[edit] Background

In the 1960s, Curtis Dohan[4] speculated that the low incidence of schizophrenia in certain South Pacific Island societies was a result of a diet low in wheat and milk-based foods.[5] Dohan proposed a genetic defect wherein individuals are incapable of completely metabolizing gluten and casein as a possible etiology for schizophrenia. Dohan hypothesized that elevated peptide levels from this incomplete metabolism could be responsible for schizophrenic behaviors.

The possibility of a relationship between autism and the consumption of gluten and casein was first articulated by Kalle Reichelt in 1991.[6] Based on studies showing correlation between autism and increased urinary peptide levels,[citation needed] Reichelt hypothesized that some of these peptides may have an opiate effect. This led to the development of the Opioid Excess Theory, expounded by Paul Shattock and others,[7] which speculates that peptides with opioid activity cross into the bloodstream from the lumen of the intestine, and then into the brain. These peptides were speculated to arise from incomplete digestion of certain foods, in particular gluten from wheat and certain other cereals and from casein from milk and dairy produce. Further work confirmed opioid peptides such as casomorphines[8] (from casein) and gluten exorphines and gliadorphin (from gluten) as possible suspects, due to their chemical similarity to opiates. Reichelt hypothesized that long term exposure to these opiate peptides may have effects on brain maturation and contribute to social awkwardness and isolation. On this basis, Reichelt and others have proposed a gluten-free casein-free (GFCF) diet for sufferers of autism to minimize the buildup of opiate peptides. Scientific evidence from randomized controlled trials shows a lack of efficacy.[2]

[edit] Effectiveness

Reports on the effectiveness of the GFCF diet for autism come almost entirely from testimonials of individual parents or teachers. Reported results range from no discernible effect to claims of complete recovery following implementation of a gluten-free casein-free regimen.[9] Adequately designed, controlled studies and clinical trials show the GFCF diet is ineffective.[2] A small single blind study has documented fewer autistic behaviors in children fed a gluten-free, casein-free diet, but noted no change in cognitive skills, linguistic ability or motor ability.[10] This study has been criticized for its small sample size, single-blind design which may have skewed the results as effectiveness was determined in part by interviewing the parents, who knew whether their child was receiving the GFCF diet.[1] The study adds nothing to the scientific literature, being smaller, and more poorly designed than previous experiments.

A 2006 double-blind short-term study found no significant differences in behavior between children with autism on a gluten-free, casein-free diet and those on regular diets.[9]

[edit] Safety

A 2008 study found that boys with autism had significantly thinner bones than neurotypical boys, starting around age 5–6 years, and that boys using casein-free diets had nearly twice the deviation in bone thickness as other boys in the study. [3] Meaning that it is a risk to bone-health to go on this diet.

[edit] Practical implementation

Main article: gluten-free diet
Sister project Wikibooks Cookbook has a recipe/module on

The implementation of a GFCF diet involves removing all sources of gluten and casein from a person's diet. Gluten is found in all products containing wheat, rye, and barley. Many gluten-free breads, pastas, and snacks are available commercially. Gluten-free cookbooks have been available for decades. Casein is found in dairy products such as milk or cheese, but is also present in smaller amounts in many substitute dairy products such as vegetarian cheese substitutes, which use casein to provide texture. Advocates of the GFCF diet often recommend total elimination of dairy from the diet; however, whey is a different milk protein from casein and can be included in this diet according to others.

[edit] See also

[edit] References

  1. ^ a b Christison GW, Ivany K (2006). "Elimination diets in autism spectrum disorders: any wheat amidst the chaff?". J Dev Behav Pediatr 27 (2 Suppl 2): S162–71. doi:10.1097/00004703-200604002-00015. PMID 16685183. 
  2. ^ a b c Millward C, Ferriter M, Calver S, Connell-Jones G (2008). "Gluten- and casein-free diets for autistic spectrum disorder". Cochrane Database Syst Rev (2): CD003498. doi:10.1002/14651858.CD003498.pub3. PMID 18425890. 
  3. ^ a b Hediger ML, England LJ, Molloy CA, Yu KF, Manning-Courtney P, Mills JL (2008). "Reduced bone cortical thickness in boys with autism or autism spectrum disorder". J Autism Dev Disord 38 (5): 848–56. doi:10.1007/s10803-007-0453-6. PMID 17879151. Lay summary – NIH News (2008-01-29). 
  4. ^ http://www.utmem.edu/pathology/Faculty%20pages/dohan.htm
  5. ^ Dohan, F.C. (1966) Cereals and Schizophrenia, data and hypothesis Acta Physiologica Scandinavica, 42, 125-132.
  6. ^ Reichelt KL, Knivsberg A-M, Lind G, Nødland M. Probable etiology and possible treatment of childhood autism. Brain Dysfunct 1991; 4: 308-19
  7. ^ Shattock P, Whiteley P. (2002) "Biochemical aspects in autism spectrum disorders: updating the opioid-excess theory and presenting new opportunities for biomedical intervention" "Autism Research Unit, University of Sunderland, UK.
  8. ^ Sun, Z. and Cade, J.R. (1999) A peptide found in schizophrenia and autism causes behavioral changes in rats. Autism, 3(1), 85-95.
  9. ^ a b Elder JH, Shankar M, Shuster J, Theriaque D, Burns S, Sherrill L (2006). "The gluten-free, casein-free diet in autism: results of a preliminary double blind clinical trial". J Autism Dev Disord 36 (3): 413–20. doi:10.1007/s10803-006-0079-0. PMID 16555138. 
  10. ^ Knivsberg, A.M.; et al. (2002). "A randomised, controlled study of dietary intervention in autistic syndromes". Nutritional Neuroscience 5 (4): 251–261. doi:10.1080/10284150290028945. PMID 12168688. 

[edit] External links

Retrieved from "http://en.wikipedia.org/wiki/Gluten-free,_casein-free_diet"
Personal tools
Languages