"Gluten-Free, Casein-Free Diets
for Autism Put to the Test" The so-called opioid-excess
theory of autism is that when certain wheat and
dairy proteins are ingested, morphine-like protein fragments
are created, that then leak into the bloodstream,
cross into the brain, and cause neurological damage
that can manifest as autism. The whole theory started
with the apparent discovery of these opioid peptides in the
urine of children with autism, but missing from the urine of
children who develop normally.
But a decade later a more
specific test failed to find urinary opioid peptides
in children with autism. The spectral analysis of urine from
autistic children, the pink line here, is practically identical with
that of those without autism, and so the whole theory
was called into question until a more sensitive
test was developed. "Elevated concentrations
of circulating casomorphins, the exogenous opioid peptides
from bovine milk casein, may contribute to the development
of autism in children," but because several studies
failed to detect casomorphins in autistic children, this
was called into question. Here, however, they demonstrated
that autistic children do indeed have evidence of significantly higher levels of urine bovine casomorphins
than normal children. Furthermore, the severity
of autistic symptoms correlated with casomorphin
concentrations.
The more casomorphins they
had flowing through their body, the worse their autism
symptoms tended to be. "Because casomorphins
interact with opioid and serotonin receptors, the known
modulators of synaptogenesis"— the creation of nerve-to-nerve
connections within the brain— maybe "chronic exposure
to elevated levels of bovine casomorphins may impair
early child development, setting the stage for
autistic disorders." But you don't know
until you put it to the test. If increasing exposure to
casomorphin opioids from cow's milk is correlated
with increasing severity of autism symptoms, why not just
try giving kids opioid blocking drugs? That's such the medical mentality. Instead, why not try to treat the
cause with a dietary intervention? Not only to see if, indeed,
it even is a cause, but if it is, to see if we can
actually help these children.
It started with case reports like
this, where a seven-year-old girl with autistic behavior was
described as benefiting from a gluten-free, casein-free diet,
a quite remarkable case in which, "over the period of two years, the girl
changed from being severely withdrawn to a normally communicating child
who enjoyed the company of others." And her dramatic improvements
seemed to correlate with decreasing urine peptide levels
after one year, then two years. OK, but maybe this one
case was just a fluke? Some docs figured it was
worth a try and published spectacular results like
this, claiming 80% of their autistic children improved after three months of
a gluten-free, casein-free diet. Even just specifically cutting out
the cow's milk protein, the casein, appeared to lead to marked
improvement in behavioral symptoms, but none of these studies
had a control group. It wasn't until 2002 when the
first randomized controlled study of a dietary intervention in
autistic syndromes was published. Twenty children with autism, half randomized to a gluten-
and casein-free diet for a year, tested before and after, and
those on the diet did better. Did better how? Here's where the "resistance to
communication and interaction" scores of all 20 kids started out in the diet group and
the control group.
This is the before. If there was no change after
a year for any of the kids, the bars would end up looking like
this, the same before and after. The gray is the before;
the black is the after. But the control group actually ended
up like this; so two got better. Remember this is resistance
to communication and interaction, so the lower the better. Two got worse, and the
rest were just as bad off as they were when they started. But in the diet group,
they all got better. Social isolation scores. Again, the lower the better. In the control group, half got better,
half got worse or stayed the same. In the diet intervention
group, they all got better. Overall, in terms of
total impairment, half got better and half got
worse in the control group, but in the diet group
they all got better. What does that mean in terms of real
life terms instead of just numbers? All the kids started out sharing
the most common autistic trait: lack of relationships with their peers, ignoring other children or not
knowing how to interact. Some had abnormal temper tantrums
or strange emotional reactions, like laughing when other people cried.
Extreme anxiety was noted
in some of the children in response to common situations. "These unusual emotions
were drastically reduced in the diet group, but not
in the control group. Inability to take other people's
perspective and lack of empathy, also other common autistic traits." Some of the children could
suddenly hit or bite others or make negative comments. Progress was made regarding
development of empathy in the diet group, but not
in the control group. "Some children also disliked
and rejected physical contact, even from their parents." This was no longer a problem
after a year on the diet. "While none of the changes were
significant in the control group, significant positive changes were
registered in the diet group, regarding peer relationship, anxiety,
empathy, and physical contact."
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