Diet Changes and Autism

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By Dr. Vladimir Barayev

There are some very vocal people who have claimed that the symptoms of autism can be alleviated or even cured through a change in the types of food children eat specifically by removing gluten (wheat) and casein (dairy) from their diets. The reason for this assumption is that these foods supposedly cause a level of inflammation in the intestines that makes them “leaky” and toxins can enter into the blood and then brain to cause damage. As a Pediatrician, I am often asked if these specific dietary changes can lead to changes in behavior with my patients and I am cautious in giving a scientific answer because many families are understandably looking for safe and effective ways to help their child. 

Based on interventional research trials neither gluten-free or dairy-free diets have definitive proven beneficial effects on children with Autism in the short term (6 months). There is insufficient data to say if these diets are beneficial when consumed over the long term over 1-2 years. The problem, however, is that these diets can be very restrictive and difficult to sustain and lead children to social isolation due to food avoidance. As more research comes out these recommendations can become clearer but in the meantime, we should all be vigilant and wary of poorly proven treatments. 


You may be surprised to learn that this question has been addressed by medical research from 5 interventional research trials and here is what they found:
In 2010 a study in Denmark followed 72 children aged 4-10 with autism for 2 years. The study found after 8-12 months on the diet that there were improvements in social functioning and communication. There was a big issue with this study as 30% of the children on gluten and casein-free diets dropped out of the study by 12 months. So the families that felt that the diet didn’t help left the experiment leaving the experiment to demonstrate the experiences of the remaining participants making the results less impressive. 


In 2002 a study from Norway of 20 children with autism was followed for 7 years. Parental report data showed improvement is the symptoms of autism, however, there is a very large caveat in this study in that it has been demonstrated that relying on parental reports of child symptoms to be highly inaccurate. This is the reason that research studies are preferably double-blinded meaning neither researchers nor families know which diet the children are on and cannot bias their opinions. 


A study in 2006 from the University Of Florida Department of Psychiatry followed 15 children with autism for 12 weeks. They spent 6 weeks eating wheat and dairy-free diets and then 6 weeks eating their regular diets. The result after the intervention showed no change/no benefits in the symptoms of autism compared with a regular diet. The parents were not told which diets they were given by researchers but six of the families on diets containing gluten and casein said their children had improved language skills (the opposite of what they thought would happen).


A 2016 double-blinded randomized control trial at the University of Rochester followed 14 children with ASD for 3 months and compared their behaviors and development once exposed to dairy and wheat vs no exposure to dairy and wheat. The study showed no significant differences in behaviors over the 3-month trial. The study was limited as they needed to enroll at least 30 children to see a statistical difference however they were only able to have 14 participants. 


Another more recent study in 2019 from Poland followed 66 children aged 3-5 for 6 months half on gluten-free diet and the other half on regular diet. There was no significant difference of ADOS (autism testing) scores in the children on the gluten-free diet.