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When processed by a transglutaminase enzyme, it can interact with immunological cells and produce cytotoxic inflammation. In autism, it is believed that peptides from gluten and casein cross the intestinal microvillus barrier and enter the blood stream. They also cross the blood-brain barrier. In the brain, certain amino acid sequences of these peptides compete with natural peptides, which bind to opioid receptors. These receptors are G-protein receptors in cell membrane surfaces of neurons. Binding to these receptors disturbs the neuronal function and ultimately leads to or contributes to autism (Department of Pediatrics Staff).
Limited Reliable Scientific Evidence
UK researchers investigated more than 30 scientific articles on the effectiveness of the gluten-free, casein-free diet on autistic children (Bastian, 2004). They found one, which provided reliable scientific evidence that the diet works. The particular study, however, was conducted on only 20 children aged 5-10 who had high levels of protein in their urine. When the diet was given to them, they exhibited reduced autistic traits. Nonetheless, the prevailing opinion was the need for more and larger randomized trials to support the result (Bastian).
Autistic traits include verbal and non-verbal communication, speaking when spoken to, lack of eye contact, repetitive talk and movement and non-sharing of emotions (Bastian, 2004). The researchers remarked about the difficulty of removing gluten and casein proteins from children's diet. These substances are included in wheat, most cereals and dairy products. The researchers also said that children could suffer withdrawal symptoms if the substances are removed from their diet. Parents are advised to first obtain stronger evidence on the diet's effectiveness before they make a decision to use it and make the difficult change in their lifestyle. They can get appropriate information from the Health Research and Education Foundation through its information arm, Informed Health Online, for free (Bastian).
These researchers performed the 2002 Cochrane Review, using the Danish Instrument for Measuring Autistic Traits ratings (Geraghty & Marschner, 2008). The instrument also covered social contact and ritualized behaviors. A review was conducted in 2006 and found no significant benefit derived from the diet in the treatment of ASD. A recent study showed that boys aged 5-6 with ASD had much thinner bones than those without the ailment. Boys on casein-free diets were found to have thinner bones twice than those with minimally restricted diets. Parents were advised to consider important matters before starting their children on the diet. They should first determine how many times a day their children eat foods with gluten and casein and what they will miss if they start on the gluten-and-casein-free diet. If these food products are a large part of their current intake, many nutrients will be missed. These are protein, mainly from dairy; calcium, Vitamin D, B Vitamins, and, quite importantly, iron. Parents who are decided to adopt the diet plan should also give their children a multivitamin-mineral supplement and additional calcium-Vitamin D supplement. They should also consult a registered dietitian if they will implement the diet plan (Geraghty & Marschner).
The gluten-free-casein-free diet first became popular when used to treat celiac disease (Sodergen, 2008). Celiac disease is a condition in which the body is unable to digest gluten properly, leading to intestinal injury. It became more popular with the emergence of lactose intolerance, food allergy and acid reflux. But it has not maintained the same level of popularity with its use to treat autism, attention deficit hyperactivity disorder or ADHD and other developmental learning disability or respiratory problems like asthma. Not only are these conditions unrelated to digestion. The diet treatment is also given to children. Parents who adhere to the diet even give to their toddlers. In removing gluten and casein, parents only eliminate corn, soy, sugar, food dyes and artificial additives. The issue and question has been how food can affect autism, which is a neuro-biological problem in the brain. Researchers at the Autism Center at Children's Hospital of Pittsburgh explained that gluten and casein break down into morphine-line products when consumed. Autistic people have inflamed intestines and cannot expel these substances (Sodergren).
Director Cynthia Johnson of the Center said that the diet helps a subgroup of children with autism, although it does not work on all of them (Sodergren, 2008). She and her team studied 36 autistic children's skills and behaviors while on the diet or Omega 3 supplements. It is not too easy putting a child on the diet. It eliminates chicken nuggets, macaroni and cheese, chocolate milk, and desserts. For this, a number of families usually stop using it. Dr. Johnson formed parent support groups for these families, which back out of the diet. But families, which saw quick changes in their children when placed on the diet, say it works. All the difficulties they put up with are worth the trouble. One child could go to the amusement park and talk only a few days off milk. Another child could speak three-word sentences from fewer words within a month's use of the diet. Within a single day, another child, who used to be quite silent, began to make noises and his eyes glowed (Sodergren).
But it does not seem to work for all families (Sodergren, 2008). Some families are not able to remove every trace of gluten and casein from their autistic children's foods. Other families simply say the diet does not work, even those who saw dramatic changes in the beginning. Those who travel a lot find it difficult to remain on the diet. Two weeks before their autistic child entered kindergarten, they put him out of it. A few families, which tried it and got good results, noticed that their child's behavior had gone back. In the meantime, most of them felt it was still the right thing to try. One mother says there is no harm in trying it. Diet, for her, has a huge impact on anybody's health, so the controversial diet is worth exploring (Sodergren).
Different Approaches to a Mysterious Condition
Autism remains a mystery, although a combination of genetic and environmental causes are believed to be behind it (Shukla, 2010). Current approaches include educational programs, drugs and special diets. Parents will try anything to get a cure but studies on the effectiveness of the diet free of gluten and casein have yielded mixed results. Not only is the diet difficult and expensive to prepare. There is also no guarantee that a child will get all the needed nutrients if placed on the diet (Shukla).
The Effects of Gluten on Autistic Children
Gluten is a problem only to those who are gluten- sensitive, like autistic people (Woeller, 2010). The substance is commonly found in wheat, which is the most frequent choice for making bread, pasta and other baked products. Hybridization has raised the amount of gluten in wheat today to a much higher amount than a century ago. There has also been a preference for the doughy texture of high gluten wheat (Woeller).
Gluten has already been known to cause skin disorders, autoimmune disease, digestive disorders, and neurological disorders (Woeller, 2010). Gluten promotes inflammation in the gut and other body systems. These are common problems occurring in autistic children. It can also predispose to food allergies because it damages the lining of the intestines. The finger-like projections, called villi, in a gluten-sensitive child are flat from the lack of ability to produce enzymes needed for digestion. The condition results in mal-absorption, a deficiency of nutrients and food allergies. Inadequate breakdown and poor absorption of food particles increase food allergies. Autism doctors believe that this is behind cognitive symptoms in autistic people. Language problems, poor attention, and self-stimulatory behavior are among these. Gluten proteins interfere with the action of brain chemicals. At the same time, behavioral problems, such as these, are associated with gluten sensitivity and autism, such as aggression, self-injury and tantrums (Woeller).
Autism doctors suggest to parents who suspect that their child is gluten sensitive or has unexplainable and chronic symptoms to conduct a test (Woeller, 2010). They should eliminate gluten from his meals for 3-4 months and observe. If his condition improves, parents have discovered the precise cure for gluten sensitivity. Gluten-free grains are available for them, such as rice, millet, buckwheat and corn (Woeller).
Double Blind Study at the University of Texas
Researchers at the Health Science Center are currently conducting the study to obtain serious evidence in response to increasing numbers of parents who believe in the diet (UPI, 2008). It will also deal with proliferating mis-information about the diet. The study involves 38 autistic children, aged 3-9, who will be given gluten-free and casein-free foods before a four-week study. Gluten and milk powder will be given to half of them and placebo to the other half. Autism doctors say casomorphin peptide in milk and gliaomorphic peptide in gluten affect the behavior of autistic children. Investigator Katherine Loveland said that many autistic children have gastrointestinal problems, such as constipation and diarrhea. She pointed to…[continue]
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