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Tarnowska K, Gruczyńska-Sękowska E, Kowalska D, Majewska E, Kozłowska M, Winkler R. The opioid excess theory in autism spectrum disorders - is it worth investigating further? Crit Rev Food Sci Nutr 2021:1-14. [PMID: 34702104 DOI: 10.1080/10408398.2021.1996329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Autism spectrum disorders (ASD) are defined as neurodevelopmental disorders, which are highly variable in nature and do not form a uniform picture, either in terms of symptomatology or depth of the disturbance. Diagnosis of ASD is made for children who show signs of impairment in social interaction, communication and cognitive skills. The exact cause of autism spectrum disorders has not been determined to date. Although there is no cure for ASD, a variety interventions have been proposed. The most commonly used restrictive dietary intervention is the gluten-free casein-free diet (GFCF), which is based on the opioid excess theory. This paper summarizes and discusses research on the core elements of the opioid excess theory in ASD: increased levels of opioid peptides in body fluids in ASD patients, increased intestinal permeability, altered peptidase activity and the effectiveness of GFCF diet in alleviating symptoms of ASD. Furthermore, we discuss the difficulties and their causes in conducting research with ASD patients. The assumptions of the opioid excess theory have neither been definitively confirmed nor disproved. Research in this area should continue, taking into account the highest possible quality standards and the specific needs and abilities of patients with ASD and their families.
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Affiliation(s)
- Katarzyna Tarnowska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Eliza Gruczyńska-Sękowska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Dorota Kowalska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Ewa Majewska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Mariola Kozłowska
- Department of Chemistry, Institute of Food Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Renata Winkler
- Department of Organizational Behaviors, Cracow University of Economics, Cracow, Poland
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Quan L, Xu X, Cui Y, Han H, Hendren RL, Zhao L, You X. A systematic review and meta-analysis of the benefits of a gluten-free diet and/or casein-free diet for children with autism spectrum disorder. Nutr Rev 2021; 80:1237-1246. [PMID: 34617108 PMCID: PMC8990762 DOI: 10.1093/nutrit/nuab073] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
CONTEXT It has been suggested that a gluten-free and casein-free (GFCF) diet may alleviate the symptoms of autism spectrum disorder (ASD) and facilitate neurodevelopment of children with ASD. Studies to date have been inconclusive. OBJECTIVE This study aimed to evaluate (through quantitative meta-analysis) the efficacy and safety of a GFCF diet for children with ASD. To our knowledge, this is the first time such an analysis has been carried out. DATA SOURCES Eight electronic databases were searched, from the establishment of each database up to March 27, 2020: PubMed, Web of Science, Embase (Ovid), PsycINFO (Ovid), Cochrane Library, CNKI, Wanfang, and VIP databases. DATA EXTRACTION Two authors independently performed the data extraction and risk-of-bias assessment. DATA ANALYSIS A quantitative meta-analysis was performed with standard procedures by using Stata SE 15 software. Within the total of 8 studies, with 297 participants, 5 studies reported significant reductions in stereotypical behaviors [standard mean difference (SMD) = -0.41, 95% confidence interval (CI): -0.68 to -0.15], and 3 studies reported improvements in cognition (SMD = -0.46, 95% CI: -0.91 to -0.01) following GFCF dietary intervention. No statistically significant changes were observed in other symptomatic categories (all P > 0.05). CONCLUSION The current meta-analysis showed that a GFCF diet can reduce stereotypical behaviors and improve the cognition of children with ASD. Though most of the included studies were single-blind, the benefits of a GFCF diet that have been indicated are promising. Additional studies on a larger scale are warranted. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42020177619.
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Affiliation(s)
- Liuliu Quan
- L. Quan, H. Han, L. Zhao, and X. You are with the Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. X. Xu is with the Medical Science Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Y. Cui is with the Department of Blood Immunity, General Hospital of Shanxi Datong Tongmei Group, Datong, China. R. L. Hendren is with the Department of Psychiatry, University of California, San Francisco, California, USA. L. Zhao and X. You are with the Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China. L. Zhao and X. You are with the National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China. X. You is with the Autism Special Fund, Peking Union Medical Foundation, Beijing, China
| | - Xinjie Xu
- L. Quan, H. Han, L. Zhao, and X. You are with the Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. X. Xu is with the Medical Science Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Y. Cui is with the Department of Blood Immunity, General Hospital of Shanxi Datong Tongmei Group, Datong, China. R. L. Hendren is with the Department of Psychiatry, University of California, San Francisco, California, USA. L. Zhao and X. You are with the Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China. L. Zhao and X. You are with the National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China. X. You is with the Autism Special Fund, Peking Union Medical Foundation, Beijing, China
| | - Yonghong Cui
- L. Quan, H. Han, L. Zhao, and X. You are with the Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. X. Xu is with the Medical Science Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Y. Cui is with the Department of Blood Immunity, General Hospital of Shanxi Datong Tongmei Group, Datong, China. R. L. Hendren is with the Department of Psychiatry, University of California, San Francisco, California, USA. L. Zhao and X. You are with the Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China. L. Zhao and X. You are with the National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China. X. You is with the Autism Special Fund, Peking Union Medical Foundation, Beijing, China
| | - Heze Han
- L. Quan, H. Han, L. Zhao, and X. You are with the Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. X. Xu is with the Medical Science Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Y. Cui is with the Department of Blood Immunity, General Hospital of Shanxi Datong Tongmei Group, Datong, China. R. L. Hendren is with the Department of Psychiatry, University of California, San Francisco, California, USA. L. Zhao and X. You are with the Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China. L. Zhao and X. You are with the National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China. X. You is with the Autism Special Fund, Peking Union Medical Foundation, Beijing, China
| | - Robert L Hendren
- L. Quan, H. Han, L. Zhao, and X. You are with the Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. X. Xu is with the Medical Science Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Y. Cui is with the Department of Blood Immunity, General Hospital of Shanxi Datong Tongmei Group, Datong, China. R. L. Hendren is with the Department of Psychiatry, University of California, San Francisco, California, USA. L. Zhao and X. You are with the Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China. L. Zhao and X. You are with the National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China. X. You is with the Autism Special Fund, Peking Union Medical Foundation, Beijing, China
| | - Lidan Zhao
- L. Quan, H. Han, L. Zhao, and X. You are with the Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. X. Xu is with the Medical Science Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Y. Cui is with the Department of Blood Immunity, General Hospital of Shanxi Datong Tongmei Group, Datong, China. R. L. Hendren is with the Department of Psychiatry, University of California, San Francisco, California, USA. L. Zhao and X. You are with the Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China. L. Zhao and X. You are with the National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China. X. You is with the Autism Special Fund, Peking Union Medical Foundation, Beijing, China
| | - Xin You
- L. Quan, H. Han, L. Zhao, and X. You are with the Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. X. Xu is with the Medical Science Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Y. Cui is with the Department of Blood Immunity, General Hospital of Shanxi Datong Tongmei Group, Datong, China. R. L. Hendren is with the Department of Psychiatry, University of California, San Francisco, California, USA. L. Zhao and X. You are with the Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China. L. Zhao and X. You are with the National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China. X. You is with the Autism Special Fund, Peking Union Medical Foundation, Beijing, China
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Ketogenic Dietary Therapies in Patients with Autism Spectrum Disorder: Facts or Fads? A Scoping Review and a Proposal for a Shared Protocol. Nutrients 2021; 13:nu13062057. [PMID: 34208488 PMCID: PMC8234312 DOI: 10.3390/nu13062057] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/03/2021] [Accepted: 06/14/2021] [Indexed: 02/06/2023] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with increasing incidence. An expanding body of literature is examining connections between ASD and dietary interventions. Existing reports suggest a beneficial effect of ketogenic dietary therapies (KDTs) in improving behavioral symptoms in ASD. In this context, the purpose of this scoping review was to identify and map available evidence in the literature about the feasibility and potential efficacy of KDTs in pediatric patients with ASD and to inform clinical practice in the field. Moreover, based on the resulting data from the literature review, we aimed to provide a shared protocol to develop a personalized KDT intervention in patients with ASD. A comprehensive and structured web-based literature search was performed using PubMed and Scopus and it yielded 203 records. Seven papers were finally selected and included in the review. Data were abstracted by independent coders. High variability was identified in study designs and dietary aspects emerged among selected studies. Results supported the effectiveness of KDTs in promoting behavioral improvements. Clinical recommendations on which patients may benefit most from KDTs implementation and difficulties in dietary adherence were discussed.
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Rawat K, Singh N, Kumari P, Saha L. A review on preventive role of ketogenic diet (KD) in CNS disorders from the gut microbiota perspective. Rev Neurosci 2020; 32:143-157. [PMID: 33070123 DOI: 10.1515/revneuro-2020-0078] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/30/2020] [Indexed: 12/11/2022]
Abstract
The gut microbiota plays an important role in neurological diseases via the gut-brain axis. Many factors such as diet, antibiotic therapy, stress, metabolism, age, geography and genetics are known to play a critical role in regulating the colonization pattern of the microbiota. Recent studies have shown the role of the low carbohydrate, adequate protein, and high fat "ketogenic diet" in remodeling the composition of the gut microbiome and thereby facilitating protective effects in various central nervous system (CNS) disorders. Gut microbes are found to be involved in the pathogenesis of various CNS disorders like epilepsy, Parkinson's disease (PD), Alzheimer's disease (AD), autism spectrum disorders (ASDs), multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS) and stress, anxiety and depression. In vivo studies have shown an intricate link between gut microbes and KD and specific microbes/probiotics proved useful in in vivo CNS disease models. In the present review, we discuss the gut-brain bidirectional axis and the underlying mechanism of KD-based therapy targeting gut microbiome in in vivo animal models and clinical studies in neurological diseases. Also, we tried to infer how KD by altering the microbiota composition contributes towards the protective role in various CNS disorders. This review helps to uncover the mechanisms that are utilized by the KD and gut microbiota to modulate gut-brain axis functions and may provide novel opportunities to target therapies to the gut to treat neurologic disorders.
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Affiliation(s)
- Kajal Rawat
- Department of Pharmacology, Post Graduate Institute of Medical Education & Research (PGIMER), Research Block B, Chandigarh, India
| | - Neha Singh
- Department of Pharmacology, Post Graduate Institute of Medical Education & Research (PGIMER), Research Block B, Chandigarh, India
| | - Puja Kumari
- Department of Pharmacology, Post Graduate Institute of Medical Education & Research (PGIMER), Research Block B, Chandigarh, India
| | - Lekha Saha
- Department of Pharmacology, Post Graduate Institute of Medical Education & Research (PGIMER), Research Block B, Chandigarh, India
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5
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Vartanian C. Overview of Nutritional Therapy for Autism Spectrum Disorder. ADVANCES IN NEUROBIOLOGY 2020; 24:527-534. [PMID: 32006371 DOI: 10.1007/978-3-030-30402-7_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
The objective of this chapter is to evaluate the latest research pertinent to nutritional management in the treatment of autism spectrum disorder (ASD) and discuss the effectiveness of dietary interventions, nutritional approaches, and supplementation in ASD. To date, the best conventional treatments for autism have been based on a combination of pharmacotherapy, behavioral treatments, and nutritional/dietary therapy, leading many parents and caregivers to opt for specific dietary interventions in the hope of alleviating the symptoms of their children and helping them cope with this disorder. Thus, the role of a registered dietitian and a nutrition specialist is crucial in planning specific nutritional and dietary interventions tailored to individual needs, to make sure the child's nutritional needs for growth and development are being met. In addition, a careful monitoring of the nutritional status and the positive or negative outcomes pertinent to the planned intervention is a must. Furthermore, numerous studies have also discussed how the maternal diet and specific dietary supplements might affect the behavioral development of children in the first few years of life. A review of the abovementioned nutrition-related key points is discussed in this chapter.
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Affiliation(s)
- Carla Vartanian
- Royal Society of Medicine, General Practice with Primary Healthcare Section, London, UK.
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6
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Siddiqi S, Urooj A, D'Souza MJ. Dietary Patterns and Anthropometric Measures of Indian Children with Autism Spectrum Disorder. J Autism Dev Disord 2019; 49:1586-1598. [PMID: 30554336 DOI: 10.1007/s10803-018-3850-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Research literature on dietary patterns & eating habits of children with Autism Spectrum Disorder (ASD) in India is limited. To explore this, a pilot study (n = 53) which included 45 boys and 8 girls (age group of 2-13 years) was conducted. Three day food records, Food Frequency Questionnaire and Children Eating Behavior Inventory were used to assess the dietary intakes and mealtime behavior problems respectively. Findings revealed lower intake of fruits and vegetables which reflected on their micronutrient status which was significantly (p ≤ 0.05) in lower amounts predominantly B-Complex, Calcium and Iron. The study has suggested a strong need for future implementation of nutritional intervention programs at the earliest to expand food variety among children with ASD of this region.
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Affiliation(s)
- Seema Siddiqi
- Department of Studies in Food Science and Nutrition, University of Mysore, Mysuru, India
| | - Asna Urooj
- Department of Studies in Food Science and Nutrition, University of Mysore, Mysuru, India.
| | - Melwin James D'Souza
- Department of Studies in Food Science and Nutrition, University of Mysore, Mysuru, India
- Department of Food Nutrition and Dietetics, Milagres College, Mangaluru, India
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Madzhidova S, Sedrakyan L. The Use of Dietary Interventions in Pediatric Patients. PHARMACY 2019; 7:E10. [PMID: 30650554 PMCID: PMC6473714 DOI: 10.3390/pharmacy7010010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/08/2019] [Accepted: 01/08/2019] [Indexed: 12/16/2022] Open
Abstract
Complementary and alternative treatment approaches are becoming more common among children with chronic conditions. The prevalence of CAM use among US adults was estimated to be around 42% in 2015 and around 44% to 50% among adults with neurologic disorders. Studies demonstrate that children with certain chronic illnesses such as asthma, cancer, genetic disorders, attention-deficit/hyperactivity disorder (ADHD), and other neurodevelopmental disorders are treated with complementary and alternative treatments at higher rates. Dietary therapies are gaining increasing popularity in the mainstream population. Although the majority of "fad" diets do not have enough supporting evidence, some dietary therapies have been utilized for decades and have numerous published studies. The objective of this review is to describe the dietary interventions used in children with the specific chronic conditions, to evaluate their efficacy based on published data and to encourage pharmacist involvement in the management and care of such patients.
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Affiliation(s)
- Shirin Madzhidova
- Department of Pharmacy Practice, Philadelphia College of Osteopathic Medicine, Georgia Campus, Suwanee, GA 30024, USA.
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8
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Dietary interventions for autism spectrum disorder: New perspectives from the gut-brain axis. Physiol Behav 2018; 194:577-582. [PMID: 30036560 DOI: 10.1016/j.physbeh.2018.07.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 06/12/2018] [Accepted: 07/18/2018] [Indexed: 02/06/2023]
Abstract
There is still controversy surrounding the effectiveness of dietary interventions for autism spectrum disorder (ASD), namely the gluten-free/casein free diet and the ketogenic diet. Additionally, as studies mainly investigated their impact on ASD symptoms and behaviors, much remains unknown about their mechanisms of action and physiological effects. Given the recent surge of global interest in the gut-brain axis and its involvement in ASD, we underline the importance of understanding the physiological effects of such restrictive diets that remove certain nutritional items from one's diet. Some evidence has emerged with findings of the gut-microbial, inflammatory, and neuronal effects of these diets. We propose probiotics as a potential alternative that can serve similar biological purposes as these elimination diets and outline different physiological routes whereby probiotics can lead to improvements for individuals with ASD. We hope that future research can delineate the complete physiological effects of these diets. Such knowledge can guide the creation of more informed interventions, which conserve the components resulting in positive behavioral change while being less restrictive and devoid of the harmful effects of limiting certain nutrients.
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Gogou M, Kolios G. Are therapeutic diets an emerging additional choice in autism spectrum disorder management? World J Pediatr 2018; 14:215-223. [PMID: 29846886 DOI: 10.1007/s12519-018-0164-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 05/14/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND A nutritional background has been recognized in the pathophysiology of autism and a series of nutritional interventions have been considered as complementary therapeutic options. As available treatments and interventions are not effective in all individuals, new therapies could broaden management options for these patients. Our aim is to provide current literature data about the effect of therapeutic diets on autism spectrum disorder. DATA SOURCE A systematic review was conducted by two reviewers independently. Prospective clinical and preclinical studies were considered. RESULT Therapeutic diets that have been used in children with autism include ketogenic and gluten/casein-free diet. We were able to identify 8 studies conducted in animal models of autism demonstrating a beneficial effect on neurophysiological and clinical parameters. Only 1 clinical study was found showing improvement in childhood autism rating scale after implementation of ketogenic diet. With regard to gluten/casein-free diet, 4 clinical studies were totally found with 2 of them showing a favorable outcome in children with autism. Furthermore, a combination of gluten-free and modified ketogenic diet in a study had a positive effect on social affect scores. No serious adverse events have been reported. CONCLUSION Despite encouraging laboratory data, there is controversy about the real clinical effect of therapeutic diets in patients with autism. More research is needed to provide sounder scientific evidence.
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Affiliation(s)
- M Gogou
- 2nd Department of Pediatrics, School of Medicine, University General Hospital AHEPA, Aristotle University of Thessaloniki, Thessaloníki, Greece.
| | - G Kolios
- Laboratory of Pharmacology, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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James Onaolapo O, Yetunde Onaolapo A. Nutrition in autism spectrum disorders: A review of evidences for an emerging central role in aetiology, expression, and management. AIMS MEDICAL SCIENCE 2018. [DOI: 10.3934/medsci.2018.2.122] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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11
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Bora S, Rindfleisch JA. The Elimination Diet. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00086-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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12
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Wilson J, Wright B, Jost S, Smith R, Pearce H, Richardson S. Can urinary indolylacroylglycine levels be used to determine whether children with autism will benefit from dietary intervention? Pediatr Res 2017; 81:672-679. [PMID: 27879968 DOI: 10.1038/pr.2016.256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 10/09/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND An increase in urinary indolyl-3-acryloylglycine (IAG) has been reported in children with autism spectrum disorders (ASD) who suffer with bowel problems in comparison to ASD children without gastrointestinal (GI) problems. The case for dietary intervention for ASD children with GI symptoms might be strengthened were such a difference to be autism-specific. METHODS Quantitative analysis of urinary IAG levels was performed for 53 children on the autism spectrum and 146 age-matched controls. The parents of each child were asked to provide information on bowel symptoms experienced by the child and their eating habits over a period of 2 wk. RESULTS We find no significant difference in urinary IAG levels between the ASD children with GI problems and ASD children without GI problems. Although we see some difference between ASD children with GI problems and controls in mainstream schools with GI problems, the difference between non-autistic children with other developmental disorders and controls in mainstream schools is more significant so that any difference is not autism-specific. We find a strong correlation between bowel symptoms and diet problems in ASD children, especially idiosyncratic feeding behavior and we show that ASD children suffering from multiple bowel symptoms tend to be those who also have dietary problems. CONCLUSION We found no evidence to support the hypothesis that children with ASD who suffer with bowel problems have increased levels of urinary IAG in comparison to children with ASD who do not have gastrointestinal problems.
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Affiliation(s)
- Julie Wilson
- Department of Mathematics, University of York, York, UK.,Department of Chemistry, University of York, York, UK
| | - Barry Wright
- Hull York Medical School, University of York, York, UK.,Leeds and York Partnership NHS Foundation Trust, Leeds, UK
| | - Sandra Jost
- Leeds and York Partnership NHS Foundation Trust, Leeds, UK.,Department of Health Science, University of York, York, UK
| | - Robert Smith
- York Teaching Hospital NHS Foundation Trust, York, UK
| | - Helen Pearce
- Tees, Esk and Wear Valleys NHS Foundation Trust, Middlesbrough, UK
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Severance EG, Yolken RH, Eaton WW. Autoimmune diseases, gastrointestinal disorders and the microbiome in schizophrenia: more than a gut feeling. Schizophr Res 2016; 176:23-35. [PMID: 25034760 PMCID: PMC4294997 DOI: 10.1016/j.schres.2014.06.027] [Citation(s) in RCA: 159] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 06/17/2014] [Accepted: 06/19/2014] [Indexed: 12/12/2022]
Abstract
Autoimmunity, gastrointestinal (GI) disorders and schizophrenia have been associated with one another for a long time. This paper reviews these connections and provides a context by which multiple risk factors for schizophrenia may be related. Epidemiological studies strongly link schizophrenia with autoimmune disorders including enteropathic celiac disease. Exposure to wheat gluten and bovine milk casein also contribute to non-celiac food sensitivities in susceptible individuals. Co-morbid GI inflammation accompanies humoral immunity to food antigens, occurs early during the course of schizophrenia and appears to be independent from antipsychotic-generated motility effects. This inflammation impacts endothelial barrier permeability and can precipitate translocation of gut bacteria into systemic circulation. Infection by the neurotropic gut pathogen, Toxoplasma gondii, will elicit an inflammatory GI environment. Such processes trigger innate immunity, including activation of complement C1q, which also functions at synapses in the brain. The emerging field of microbiome research lies at the center of these interactions with evidence that the abundance and diversity of resident gut microbiota contribute to digestion, inflammation, gut permeability and behavior. Dietary modifications of core bacterial compositions may explain inefficient gluten digestion and how immigrant status in certain situations is a risk factor for schizophrenia. Gut microbiome research in schizophrenia is in its infancy, but data in related fields suggest disease-associated altered phylogenetic compositions. In summary, this review surveys associative and experimental data linking autoimmunity, GI activity and schizophrenia, and proposes that understanding of disrupted biological pathways outside of the brain can lend valuable information regarding pathogeneses of complex, polygenic brain disorders.
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Affiliation(s)
- Emily G. Severance
- Stanley Division of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 1105, Baltimore, MD 21287-4933 U.S.A
| | - Robert H. Yolken
- Stanley Division of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 1105, Baltimore, MD 21287-4933 U.S.A
| | - William W. Eaton
- Department of Mental Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, U.S.A
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Elder JH, Kreider CM, Schaefer NM, de Laosa MB. A review of gluten- and casein-free diets for treatment of autism: 2005-2015. NUTRITION AND DIETARY SUPPLEMENTS 2015; 7:87-101. [PMID: 28111520 PMCID: PMC5242335 DOI: 10.2147/nds.s74718] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The gluten free, casein free (GFCF) diet is heralded by strong anecdotal parental reports to greatly improve and even "cure" symptoms of Autism Spectrum Disorders (ASD). Yet to date, little conclusive empirical evidence exists supporting its use. OBJECTIVE The purpose of this paper is to provide an overview of the state of the recent evidence regarding use of GFCF diet for treatment of individuals with ASD. METHODS Five database providers (PubMed, Web of Knowledge, EBSCO, ProQuest, and WorldCat) were used to search 19 databases yielding a total of 491 articles that were published through February 2015. Peer reviewed articles published between 2005 and February 2015 were included for review if study participants were identified as having ASD and investigated the effects of the GFCF diet on ASD behaviors or the relationship between the diet and these behaviors. RESULTS Evaluation of search results yielded 11 reviews, 7 group experimental studies including 5 randomized controlled trials, 5 case reports, and 4 group observational studies published during the last 10 years. These studies represent a marked increase in number of reported studies as well as increased scientific rigor in investigation of GFCF diets in ASD. CONCLUSIONS While strong empirical support for the GFCF diet in ASD is currently lacking, studies point to the need for identifying subsets of individuals (e.g., those with documented gastrointestinal abnormalities) who may be the best responders to the GFCF diet. Identifying these subsets is critically needed to enhance rigor in this research area. Until rigorous research supporting use of GFCF diet is reported, clinicians should continue use caution and consider several factors when advising regarding implementation of the GFCF diet for individuals with ASD.
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Affiliation(s)
- Jennifer Harrison Elder
- Department of Family and Community Health Nursing Science, University of Florida, Gainesville, FL USA
| | | | - Nancy M Schaefer
- Health Science Center Library, University of Florida, Gainesville, FL USA
| | - Mary B de Laosa
- Department of Psychology, University of Florida, Gainesville, FL USA
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Pusponegoro HD, Ismael S, Firmansyah A, Sastroasmoro S, Vandenplas Y. Gluten and casein supplementation does not increase symptoms in children with autism spectrum disorder. Acta Paediatr 2015; 104:e500-5. [PMID: 26148018 DOI: 10.1111/apa.13108] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 06/02/2015] [Accepted: 06/30/2015] [Indexed: 11/26/2022]
Abstract
AIM A gluten- and casein-free diet is often given to children with autism spectrum disorder (ASD). We aimed to determine the effect of gluten and casein supplementation on maladaptive behaviour, gastrointestinal symptom severity and intestinal fatty acids binding protein (I-FABP) excretion in children with ASD. METHODS A randomised, controlled, double-blind trial was performed on 74 children with ASD with severe maladaptive behaviour and increased urinary I-FABP. Subjects were randomised to receive gluten-casein or a placebo for seven days. We evaluated maladaptive behaviour before and after supplementation, using I-FABP excretion, the approach withdrawal problem composite subtest of the Pervasive Developmental Disorder Behavior Inventory and the Gastrointestinal Symptom Severity Index. RESULTS The mean approach withdrawal problem composite score was significantly higher before supplementation than after, both in the placebo and in the gluten-casein group. However, the mean difference was not significant and may have been caused by additional therapy. There was no significant difference in gastrointestinal symptoms and urinary I-FABP excretion. CONCLUSION Administrating gluten-casein to children with ASD for one week did not increase maladaptive behaviour, gastrointestinal symptom severity or urinary I-FABP excretion. The effect of prolonged administration or other mechanisms of enterocyte damage in ASD should be explored.
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Affiliation(s)
| | - Sofyan Ismael
- Department of Child Health, Medical School, University of Indonesia, Jakarta, Indonesia
| | - Agus Firmansyah
- Department of Child Health, Medical School, University of Indonesia, Jakarta, Indonesia
| | - Sudigdo Sastroasmoro
- Department of Child Health, Medical School, University of Indonesia, Jakarta, Indonesia
| | - Yvan Vandenplas
- Department of Paediatrics, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
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16
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Darnai G, Plózer E, Perlaki G, Orsi G, Nagy SA, Horváth R, Schwarcz A, Kovács N, Altbäcker A, Janszky J, Clemens Z. Milk and dairy consumption correlates with cerebral cortical as well as cerebral white matter volume in healthy young adults. Int J Food Sci Nutr 2015; 66:826-9. [DOI: 10.3109/09637486.2015.1093609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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17
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Levy SE, Hyman SL. Complementary and alternative medicine treatments for children with autism spectrum disorders. Child Adolesc Psychiatr Clin N Am 2015; 24:117-43. [PMID: 25455579 DOI: 10.1016/j.chc.2014.09.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
There are many treatments in current use for core and associated symptoms of autism spectrum disorders (ASD). This review discusses the complementary and alternative medical (CAM) treatments commonly added to conventional interventions for children with ASD, including natural products, mind and body practices, and other biomedical treatments. The article focuses on factors associated with use of CAM, the empirical evidence for the most frequently used treatments, and how clinicians work with families who choose CAM treatments. Some treatments have been ineffective, some have unacceptable potential side effects, and others require more study in depth.
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Affiliation(s)
- Susan E Levy
- Division of Developmental & Behavioral Pediatrics, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3550 Market Street, 3rd Floor, Philadelphia, PA 19104, USA.
| | - Susan L Hyman
- Neurodevelopmental and Behavioral Pediatrics, Golisano Children's Hospital, School of Medicine and Dentistry, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA
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18
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Winburn E, Charlton J, McConachie H, McColl E, Parr J, O'Hare A, Baird G, Gringras P, Wilson DC, Adamson A, Adams S, Le Couteur A. Parents' and child health professionals' attitudes towards dietary interventions for children with autism spectrum disorders. J Autism Dev Disord 2014; 44:747-57. [PMID: 23996225 DOI: 10.1007/s10803-013-1922-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Parents of children with autism spectrum disorders (ASD) use a wide range of interventions including poorly evidenced dietary interventions. To investigate parents' and professionals' experience of dietary interventions and attitudes towards a proposed trial to evaluate the gluten free casein free diet (GFCFD). Survey of U.K. parents of children with ASD, and professionals. 258 parents and 244 professionals participated. 83 of children had received a range of dietary manipulations; three quarters of professionals have been asked for advice about GFCFD. Respondents identified an inadequate evidence base for dietary interventions in ASD and suggested modifications to a proposed trial design. Both parents and professionals supported the need for further evaluation of dietary interventions in ASD.
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19
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Szachta P, Frank M, Gałecka M, Ignyś I. Zaburzenia przewodu pokarmowego i terapia żywieniowa dzieci z zaburzeniami ze spektrum autyzmu – aktualny stan wiedzy. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.pepo.2014.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Diolordi L, del Balzo V, Bernabei P, Vitiello V, Donini LM. Eating habits and dietary patterns in children with autism. Eat Weight Disord 2014; 19:295-301. [PMID: 24981567 DOI: 10.1007/s40519-014-0137-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 04/10/2014] [Indexed: 01/15/2023] Open
Abstract
The children with autism have feeding problems such as chewing, preference for the same food that often are responsible for the nutrient imbalance. In this study, we have analyzed the differences in food consumption (food frequency) and eating behavior (CEBI test) between children with autism and their typically developing peers. A statistically significant difference was observed between the two groups for the consumption of milk, yogurt, pulses, rice, and fruit juices (p ≤ 0,005). We observed a significant difference in the analysis of CEBI results when considering the 6- to 9.5-year-aged subgroup with autism vs control subgroup (103.50 and 110.14, respectively). The advices given by nutritionists have proved crucial to improve eating habits in children with autism, in the follow-up.
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Affiliation(s)
- Laura Diolordi
- Department of Experimental Medicine, Research Unit of Food Science and Human Nutrition, "Sapienza" University of Rome, p.le Aldo Moro, 5, 00185, Roma, Italy
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Dosman C, Adams D, Wudel B, Vogels L, Turner J, Vohra S. Complementary, holistic, and integrative medicine: autism spectrum disorder and gluten- and casein-free diet. Pediatr Rev 2013; 34:e36-41. [PMID: 24085796 DOI: 10.1542/pir.34-10-e36] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
On the basis of review of the published literature,limitations in current data do not support the use ofa gluten-free and casein-free diet (gfcf-d) asa primary autism spectrum disorder (ASD) treatment.(13)(25)(26)(36) On the basis of clinical opinion, given the popularity of parents seeking a gfcf-d for their children with ASD, clinicians should acknowledge family’s concerns and provide appropriate information about a gfcf-d toguide them and prevent possible harm.
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Affiliation(s)
- Cara Dosman
- Division of Developmental Pediatrics, Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Alberta, Canada
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22
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Pasha I, Saeed F, Sultan MT, Batool R, Aziz M, Ahmed W. Wheat Allergy and Intolerence; Recent Updates and Perspectives. Crit Rev Food Sci Nutr 2013; 56:13-24. [DOI: 10.1080/10408398.2012.659818] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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23
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Whitehouse AJO. Complementary and alternative medicine for autism spectrum disorders: rationale, safety and efficacy. J Paediatr Child Health 2013; 49:E438-42:quiz E442. [PMID: 23682728 DOI: 10.1111/jpc.12242] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2012] [Indexed: 11/28/2022]
Abstract
Complementary and alternative medicine is widely used for children with autism spectrum disorder, despite uncertainty regarding efficacy. This review describes complementary and alternative practices commonly used among this population, the rationale for the use of each practice, as well as the side-effect profile and evidence for efficacy. The existing evidence base indicates that melatonin can be recommended as a treatment for sleeping disturbances associated with autism spectrum disorder, while secretin can be rejected as an efficacious treatment for broader autistic symptoms. There is insufficient evidence to draw conclusions on the efficacy of modified diets, hyperbaric oxygen therapy, immune therapy, and vitamin and fatty acid supplementation. There is a clear need for methodologically rigorous studies to provide evidence-based guidance to families and clinicians regarding complementary and alternative practices for individuals with autism spectrum disorders.
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Affiliation(s)
- Andrew J O Whitehouse
- Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia; Neurocognitive Development Unit, School of Psychology, University of Western Australia, Perth, Western Australia, Australia
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24
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Lau NM, Green PHR, Taylor AK, Hellberg D, Ajamian M, Tan CZ, Kosofsky BE, Higgins JJ, Rajadhyaksha AM, Alaedini A. Markers of Celiac Disease and Gluten Sensitivity in Children with Autism. PLoS One 2013; 8:e66155. [PMID: 23823064 PMCID: PMC3688832 DOI: 10.1371/journal.pone.0066155] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Accepted: 05/01/2013] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Gastrointestinal symptoms are a common feature in children with autism, drawing attention to a potential association with celiac disease or gluten sensitivity. However, studies to date regarding the immune response to gluten in autism and its association with celiac disease have been inconsistent. The aim of this study was to assess immune reactivity to gluten in pediatric patients diagnosed with autism according to strict criteria and to evaluate the potential link between autism and celiac disease. METHODS Study participants included children (with or without gastrointestinal symptoms) diagnosed with autism according to both the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview, Revised (ADI-R) (n = 37), their unaffected siblings (n = 27), and age-matched healthy controls (n = 76). Serum specimens were tested for antibodies to native gliadin, deamidated gliadin, and transglutaminase 2 (TG2). Affected children were genotyped for celiac disease associated HLA-DQ2 and -DQ8 alleles. RESULTS Children with autism had significantly higher levels of IgG antibody to gliadin compared with unrelated healthy controls (p<0.01). The IgG levels were also higher compared to the unaffected siblings, but did not reach statistical significance. The IgG anti-gliadin antibody response was significantly greater in the autistic children with gastrointestinal symptoms in comparison to those without them (p<0.01). There was no difference in IgA response to gliadin across groups. The levels of celiac disease-specific serologic markers, i.e., antibodies to deamidated gliadin and TG2, did not differ between patients and controls. An association between increased anti-gliadin antibody and presence of HLA-DQ2 and/or -DQ8 was not observed. CONCLUSIONS A subset of children with autism displays increased immune reactivity to gluten, the mechanism of which appears to be distinct from that in celiac disease. The increased anti-gliadin antibody response and its association with GI symptoms points to a potential mechanism involving immunologic and/or intestinal permeability abnormalities in affected children.
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Affiliation(s)
- Nga M. Lau
- Department of Medicine, Columbia University, New York, New York, United States of America
- Celiac Disease Center, Columbia University, New York, New York, United States of America
| | - Peter H. R. Green
- Department of Medicine, Columbia University, New York, New York, United States of America
- Celiac Disease Center, Columbia University, New York, New York, United States of America
| | - Annette K. Taylor
- Kimball Genetics, a Division of LabCorp, Denver, Colorado, United States of America
| | - Dan Hellberg
- Center for Clinical Research, Uppsala Univeristy, Falun, Sweden
| | - Mary Ajamian
- Department of Medicine, Columbia University, New York, New York, United States of America
- Celiac Disease Center, Columbia University, New York, New York, United States of America
| | - Caroline Z. Tan
- Department of Medicine, Columbia University, New York, New York, United States of America
- Celiac Disease Center, Columbia University, New York, New York, United States of America
| | - Barry E. Kosofsky
- Department of Neurology & Neuroscience, Weill Cornell Medical College, New York, New York, United States of America
- Department of Pediatrics, Weill Cornell Medical College, New York, New York, United States of America
| | - Joseph J. Higgins
- Department of Pediatrics, Weill Cornell Medical College, New York, New York, United States of America
| | - Anjali M. Rajadhyaksha
- Department of Neurology & Neuroscience, Weill Cornell Medical College, New York, New York, United States of America
- Department of Pediatrics, Weill Cornell Medical College, New York, New York, United States of America
| | - Armin Alaedini
- Department of Medicine, Columbia University, New York, New York, United States of America
- Celiac Disease Center, Columbia University, New York, New York, United States of America
- Institute of Human Nutrition, Columbia University, New York, New York, United States of America
- * E-mail:
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25
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Feeding Problems and Nutrient Intake in Children with Autism Spectrum Disorders: A Meta-analysis and Comprehensive Review of the Literature. J Autism Dev Disord 2013; 43:2159-73. [DOI: 10.1007/s10803-013-1771-5] [Citation(s) in RCA: 311] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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A review of complementary and alternative treatments for autism spectrum disorders. AUTISM RESEARCH AND TREATMENT 2012; 2012:870391. [PMID: 23243505 PMCID: PMC3515887 DOI: 10.1155/2012/870391] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Revised: 08/08/2012] [Accepted: 09/07/2012] [Indexed: 12/30/2022]
Abstract
Given the severe and chronic problems associated with Autism Spectrum Disorders (ASD) and the limitations of available treatments, there exists a large public health need for additional interventions. As more parents are inquiring about complementary and alternative treatments (CATs), both parents and practitioners require up-to-date information about them and whether and how to integrate them into treatment. After presenting data on CAT usage patterns for ASD, we review 13 ingestible (i.e., orally administered) and 6 noningestible (i.e., externally administered) CATs for ASD. For each CAT we briefly describe its definition; rationale for use; current research support, limitations, and future directions; safety issues; and whether we currently recommend, not recommend, or find it acceptable for the treatment of ASD. We conclude this paper with recommendations for future research and ten clinical recommendations for practitioners.
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Abstract
Gluten sensitivity has been best recognized and understood in the context of two conditions, celiac disease and wheat allergy. However, some individuals complain of symptoms in response to ingestion of "gluten," without histologic or serologic evidence of celiac disease or wheat allergy. The term non-celiac gluten sensitivity (NCGS) has been suggested for this condition, although a role for gluten proteins as the sole trigger of the associated symptoms remains to be established. This article reviews the available information regarding symptomatology, epidemiology and genetics, serology and histology, and in vitro and in vivo experimental data on the pathophysiology of NCGS.
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Affiliation(s)
- Knut E A Lundin
- Department of Gastroenterology, Oslo University Hospital Rikshospitalet, Center for Immune Regulation, University of Oslo, Oslo, Norway.
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28
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Adam Rindfleisch J. Food Intolerance and Elimination Diet. Integr Med (Encinitas) 2012. [DOI: 10.1016/b978-1-4377-1793-8.00068-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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32
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Geraghty ME, Bates-Wall J, Ratliff-Schaub K, Lane AE. Nutritional Interventions and Therapies in Autism. ACTA ACUST UNITED AC 2010. [DOI: 10.1177/1941406410366848] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Part 1 in this series (“Nutritional Intake and Therapies in Autism”) addressed the nutrient intake of children with autism and the myriad factors likely to affect dietary intake and nutritional status. These included medical/nutritional factors (gastrointestinal symptoms/ issues, food allergies, metabolic abnormalities and/or preexisting nutrient deficiencies, and nutrition-related medication side effects) and behavioral/contextual factor subcategories (problem eating behaviors, sensory processing difficulties, and family factors). Part 2 of this 2-part series covers nutrition interventions used in autism, with emphasis on safety and efficacy as delineated by an evidence-based approach. Nutrition intervention topics will be introduced as to the scientific rationale or purported mechanism of the intervention, safety, efficacy, untoward effects, and interactions with nutrients, medications, or other dietary supplements. Broad topics of discussion include nutrition assessment of the child with autism, dietary supplements/herbs used in autism (multivitamins, probiotics, omega-3 fatty acids, vitamin B6—maganesium, melatonin, methylator pathway nutrients), and special diets, including a gluten-free, casein-free diet and the specific carbohydrate diet. Finally, behavioral/contextual interventions are discussed, and suggestions for future research to support clinical practice are proposed.
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Affiliation(s)
- Maureen E. Geraghty
- Division of Medical Dietetics, School of Allied Medical Professions, College of Medicine, The Ohio State University, Columbus, Ohio,
| | - Jody Bates-Wall
- Division of Medical Dietetics, School of Allied Medical Professions, College of Medicine, The Ohio State University, Columbus, Ohio, Nisonger Center for Developmental Disabilities, The Ohio State University, Columbus, Ohio
| | - Karen Ratliff-Schaub
- Nisonger Center for Developmental Disabilities, The Ohio State University, Columbus, Ohio, Diagnostic Center for Child Development Program, Nationwide Children's Hospital, Columbus, Ohio
| | - Alison E. Lane
- Division of Medical Dietetics, School of Allied Medical Professions, College of Medicine, The Ohio State University, Columbus, Ohio, Nisonger Center for Developmental Disabilities, The Ohio State University, Columbus, Ohio
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33
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Marcason W. What is the current status of research concerning use of a gluten-free, casein-free diet for children diagnosed with autism? ACTA ACUST UNITED AC 2009; 109:572. [PMID: 19248872 DOI: 10.1016/j.jada.2009.01.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Wendy Marcason
- American Dietetic Association's Knowledge Center Team, Chicago, IL, USA
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Abstract
Wheat is the dominant crop in temperate countries being used for human food and livestock feed. Its success depends partly on its adaptability and high yield potential but also on the gluten protein fraction which confers the viscoelastic properties that allow dough to be processed into bread, pasta, noodles, and other food products. Wheat also contributes essential amino acids, minerals, and vitamins, and beneficial phytochemicals and dietary fibre components to the human diet, and these are particularly enriched in whole-grain products. However, wheat products are also known or suggested to be responsible for a number of adverse reactions in humans, including intolerances (notably coeliac disease) and allergies (respiratory and food). Current and future concerns include sustaining wheat production and quality with reduced inputs of agrochemicals and developing lines with enhanced quality for specific end-uses, notably for biofuels and human nutrition.
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Affiliation(s)
- P R Shewry
- Department of Plant Sciences, Rothamsted Research, Harpenden, Hertfordshire, UK.
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35
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Goday P. Whey Watchers and Wheat Watchers: The Case Against Gluten and Casein in Autism. Nutr Clin Pract 2008; 23:581-2. [DOI: 10.1177/0884533608326277] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Praveen Goday
- From Pediatric Gastroenterology and Nutrition, Medical College of
Wisconsin, Milwaukee, Wisconsin
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