639 - ‘Gluten-Free Casein-Free Diet for Autism Spectrum Disorders: Can It Be Effective in Solving Behavioural and Gastrointestinal Problems?’. Eurasian Journal Of Medicine. 52(3): 292–297.

Reference Number: 639

Year: 2020

Authors: Busra Baspinar, Hulya Yardimci

Link: Link to original paper

Health: ASD | Gut Microbiome - Creating Healthier Bread to Support Optimal Gut Health | Inflammation

Nutrition: Gluten>Gluten Free | Proteins

Summary

Autism spectrum disorder [ASD] is characterized by deficits in communication and social interactions combined with repetitive and restricted patterns of behaviors. Bidirectional changes in brain-gut microbiota are known to be responsible for the pathophysiology of many brain-related disorders, such as autism, as well as well-known gastrointestinal diseases, including gut disorders. Imbalance in the composition of gut microbiota is frequently observed in individuals with ASD. It is therefore believed that this imbalance is significant in the frequent occurrence of gastrointestinal symptoms. The integrity of the intestinal barrier and the blood-brain barrier [BBB] in individuals with ASD is affected. Incompletely digested peptides, toxins, and proinflammatory cytokines cross the BBB by entering the bloodstream and reach the central nervous system. As a result of the accumulation of these elements, brain function is adversely affected. It is hypothesized that incompletely digested peptides acting as opioid agonists reduce pain sensitivity and increase the severity of autism-specific behaviors. However, it is not known exactly how opioid peptides trigger ASD symptoms after they reach the brain. Diet therapies, especially elimination diets, are considered to be an alternative treatment to prevent this condition. Gluten-free casein-free [GFCF] diet is an elimination diet that involves the removal of certain proteins from the normal diet, such as gluten and casein. However, studies that demonstrate the beneficial effects of the GFCF diet on ASD patients and explain its mechanism is limited, which supports the opioid theory. This review aims to investigate the gastrointestinal and behavioral problems that are frequently observed in ASD, the possible action mechanisms of GFCF diets, and the efficacy of these elimination diets.

Significance of the study to the baker:

• Nutritional and gastrointestinal problems are very common in individuals with autism.

• Families turn to alternative treatments to solve these problems, believing that they are harmless.

• There is insufficient evidence for the effectiveness of these frequently used alternative treatments. One of these alternative treatments is the GFCF diet, one of the elimination diets.

• This diet is based on the opioid theory. However, there is insufficient evidence to prove its effectiveness.

• The benefit of this diet is controversial and with long-term administration, it may cause micronutrient deficiencies.

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