Complementary, Holistic, and Integrative Medicine: Autism Spectrum Disorder and Gluten- and Casein-Free Diet

1. Cara Dosman, MD* 2. Denise Adams, PhD† 3. Bev Wudel, MD‡ 4. Laura Vogels, BSc† 5. Justine Turner, MD, PhD§ 6. Sunita Vohra, MD, MSc† 1. *Division of Developmental Pediatrics, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Alberta, Canada. 2. †CARE Program, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Alberta, Canada. 3. ‡Internal Medicine Resident, College of, Medicine, University of Saskatchewan, Saskatchewan, Canada. 4. §Department of Pediatric Gastroenterology and Nutrition, Faculty of Medicine and Dentistry, University of Alberta, Alberta, Canada. * Abbreviations: ASD: : autism spectrum disorder BMD: : bone mineral density gfcf-d: : gluten-free and casein-free diet RCT: : randomized controlled trial After completing this article, readers should be able to: 1. Understand current evidence for using a gluten- and casein-free diet for children with autism spectrum disorder. 2. Understand potential harms of the gluten- and casein-free diet. 3. Be aware of what nutritional monitoring should be considered while children are on the gluten- and casein-free diet. Many parents of children with autism want to try a gluten-free and casein-free diet (gfcf-d) for their child to see if it will help. Some studies have found positive results, but questions remain unanswered. Parents should consider potential benefits and potential harms of trying the diet. Potential benefits to the affected child include improved communication, social interaction, and behavioral flexibility and decreased inattention and hyperactivity. Potential harms of the diet include nutritional deficiencies and the effort and costs associated with maintaining it. Caution should be used when trying to decide whether to try a gfcf-d for a child who already has nutritional deficiency, growth problems, or restricted diet due to difficulty accepting new foods. Before starting a gluten-free diet, the child should be screened for celiac disease, especially if the child has had gastrointestinal symptoms, such as diarrhea, constipation, anorexia, vomiting, abdominal pain, or weight loss. If parents want to try a gfcf-d, they should consider seeking guidance from a therapist to help introduce the diet in a gradual way and a dietitian to monitor their child’s nutritional intake while on the diet and to recommend supplementation if necessary. Weight also needs to be monitored. Parents and health …