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Autism, PDD, and Diet

Some autistic children and teens show improvement when placed on a gluten-free, casein-free diet (GF-CF diet). The kids who respond best are the ones who self-limit their diets primarily to dairy foods and/or processed and baked foods made with wheat, barley and rye flours. Some children with pervasive development disorder (PDD) and attention deficit hyperactivity disorder (ADHD) also respond well to the diet.

Research shows growing evidence of the possible reason; some autistic people may lack an enzyme necessary to properly break down casein proteins (in dairy foods), and gluten proteins (in wheat and other commonly used flours). Instead their bodies break down these proteins into peptides that are chemically similar to opiates. One theory currently under study is that these peptides attach to the opiate receptors in the brain, contributing to the behaviors and learning problems seen in many autistic people.

Since autistic kids lacking the enzyme get opiate-like chemicals from the gluten and casein proteins, they literally become "addicted" to those foods, craving them and refusing to eat anything else. Many parents of autistic children have noted that their child self-limits his diet almost exclusively to foods like bread and crackers, and/or he drinks excessive amounts of milk.

Before going further I would like to emphasize several key points. First, not all autistic children respond to the gluten-free, casein-free diet; there seems to be a subset of autistic kids who respond favorably. Of those who do respond, the range of improvement can vary from mild to dramatic.

Also, time is of the essence; the length of time between the autism diagnosis and starting the diet seems to be a significant factor in the amount of improvement. Having said that, even some autistic teens who are being put on the diet for the first time have shown some mild improvement.

Be aware that if an autistic child is "addicted" to the opiate-like peptides his body makes from the gluten and casein proteins, he will go through withdrawal when first put on a gluten- and casein-free diet. His behavior problems will be worse for a few days and then he will get better, after going through the withdrawal phase.

It is never too late to try the diet, and it is generally a very safe intervention, especially when bolstered with nutritional supplements such as vitamins. If an autistic child is self-limiting to bread and milk, the GF-CF diet will probably be more nutritious than the child's current diet. Parents should work closely with their doctor and a nutritionist when putting their autistic child on any kind of dietary intervention.

One note of caution; some autistic kids have additional food allergies and sensitivities along with the gluten and casein problems, so new foods should be introduced cautiously. Foods to which some people have severe allergies such as peanuts and eggs should only be tested at a doctor's office. Also, soy protein is somewhat similar in structure to milk protein, so watch for sensitivity reactions when adding soy products to the diet.

An excellent book on this subject, written by a mother who helped her son recover from autism by putting him on a gluten-free, casein-free diet is "Unraveling the Mystery of Autism and Pervasive Development Disorder: A Mother's Story of Research and Recovery", by Karyn Seroussi (ISBN 0767907981).

Karyn and her scientist husband did a great deal of research as soon as their son Miles was diagnosed with autism. About four months after the diagnosis they put him on a gluten-free, casein-free diet and he showed dramatic improvement. The diet, plus therapy, helped Miles recover to the point where his learning and behaviors are normal in every way for his age. Miles still has "autism"; he remains on the diet because if he eats anything with gluten or casein the autistic symptoms come back.

See Karen Seroussi's book and the special cookbooks listed on the "Autism Resources" page for comprehensive information about gluten- and casein-free foods and diets.


My "Autism Website Links" page has links to many websites with information on autism, diet and more.

Another gastro-intestinal problem frequently seen in autistic people is an overgrowth of yeast in the intestines. A small amount of yeast in the gut is normal, and is kept in check by the "good" bacteria in the intestines. Antibiotics given for an infection can destroy the "good" bacteria along with the bad bacteria. If a child has chronic ear infections and is repeatedly given antibiotics, an overgrowth of yeast can occur.

Left untreated, excessive yeast can cause a problem referred to as "leaky gut" because the yeast turns into a fungus that attacks the walls of the intestines. Tiny holes are poked in the intestine wall, and these holes allow particles to pass from the intestines into the bloodstream that normally would not pass through; this may be one mechanism by which the peptides from improperly digested gluten and casein proteins reach the brain.

Intestinal yeast can be controlled through diet, for example eating soy yogurt with active cultures, and also by giving a probiotic supplement such as acidopholus (look for a brand that is specifies it is safe for kids). Another option is a non-systemic (administered orally) medication called nystatin; your pediatrician must write a prescription.

Note: children should not be put on the gluten-free, casein-free diet "cold turkey", rather the diet should be introduced gradually, for a trial period of several months.

New foods introduced into the diet should be given on a rotated basis to avoid development of new food sensitivities. See Karen Seroussi's book for a good example of diet rotation.

If a child is doing well on the diet and suddenly regresses to previously observed autistic behaviors, do some detective work and find out what he ate that day, perhaps at school or a friend's house.

Karen's son Miles was doing well on the diet and suddenly regressed one day; a couple of days later his teacher sent a note home with Miles saying that he had eaten a piece of cheese and swallowed it before she could get to him. That one little piece of cheese caused several days of autistic behaviors before the peptides were dissipated from Miles' body.

Another important aspect of autism that people need to be aware of is the effect on family members. Parents can find their relationship and marriage strained, and siblings can feel left out as parents spend more time with the autistic child and less time with them. Several books listed on the "Autism Resources" page have chapters on these issues, helping individuals and families cope with the sadness, anger, grief, frustration, and stress that can come with raising an autistic child. And the authors show that there can be moments of joy and happiness, too, on the difficult journey with an autistic family member.

As a side note, I have put myself on a gluten-free diet to see if it would help me feel better. I'm a light eater, but for years I have felt some extra "bloating" after most meals, out of proportion to the amount of food eaten. It occured to me that a gluten-free diet might help make me feel less bloated after meals, and it actually does make a difference. So I speak from experience when I say a gluten-free diet doesn't have to be boring, and it really isn't difficult to maintain.

There are many gluten-free foods on the market, see the information on the "Autism Resources" page. Karyn Seroussi's book and all the cookbooks listed on the Autism Resources page have comprehensive information about gluten-free foods, and several of the website links lead to sites with information and recipes.

I have also posted a printer-friendly page with the autism information on my website (includes the information on the homepage, this page, the Autism Resources page and the Autism Website Links page).

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