Gluten Free / Casein Free (GF/CF Diet)
This diet insists on an entire avoidance of all gluten products and all dairy products. Researchers and parents
say after using this diet for three months large improvements are observed in social isolation, eye contact,
mutism, learning skills, hyperactivity, stereotypic activity, and panic attacks. The protein found in gluten and
casein may cause disruption in normal brain activity as well as an inflammatory response resulting in the
symptoms seen in autism. Many foods have a trace of contamination with gluten, such as coating on French
fries and raisins with wheat powder to keep them from sticking, so it can be very difficult to avoid all foods
and contaminated foods.        

To see full benefits from this diet parents must devote consistency.  This kind of commitment is often
difficult because of the complexity of the diet, and even minimal amounts of gluten or casein will affect the
outcome and you may not see any benefit. The diet has to be followed at home, school, and wherever the
child eats. Even eating a small graham cracker (which contains gluten) could hinder the effectiveness of the
diet.

Food restriction is a difficult task as there are many hidden sources of gluten found in the ingredients of
many processed foods. For example, gravy made with wheat flour would be forbidden on a gluten-free diet.
Gluten is found (in wheat, rye, barley, and possibly oats) and casein (in all dairy products, including milk,
yogurt, cheese, ice cream, calcium or salt of casein) can cause two problems:

•        They are common food allergens especially in children and adults with autism. The basic theory is that
a subgroup of children with autism may not be able to fully metabolize gluten and casein (casein is a protein
found in milk). Peptides, part of the gluten and casein proteins, can be detected in abnormally high amounts
in the urine of this subgroup of children. This fact has been scientifically documented. However, whether
these peptides cross the bloodstream barrier into the brain and influence the behavior of children with autism
is a theory that needs further investigation.

•        Certain peptides from gluten and casein can attach to opioid-receptors in the brain, and can have a
potent effect on behavior (like heroin or morphine), causing problems including sleepiness, giddiness,
inattention/”zoning out”, and aggressive and self-inflicted behavior. In some individuals the proteins also
known as peptides cannot be completely digested by enzymes in the digestive system.

These problems appear to be due to:

•        A failure of the digestive tract to fully digest the gluten and casein peptides into single amino acids.

•        Inflammation of the gut, allowing the gluten and casein peptides to enter the bloodstream and reach
opioid receptors in the brain.


Benefits from the Gluten and Casein Free Diet

Children who most crave dairy and/or wheat, and who eat a lot of it, are most likely to benefit from this
particular diet. Casein-free diets usually achieve results within a month, and sometimes within a week.
Gluten free diets usually take 1-3 months to produce benefits. In some children there is a worsening of
symptoms for a few days (similar to a drug withdrawal) followed by improvement in behavior.

Outcomes from the diet usually fall into three categories:

•        Neurological improvements, such as reduced head banging, improved eye contact, or calmer, less
agitated behavior.

•        Gastrointestinal improvements, such as more regular, solid stools which make toilet training easier.

•        No improvement at all, indicating the child is not sensitive to gluten or casein.

Parents should continue the diet at least until gastrointestinal problems are addressed, and in that case
duration is possibly everlasting. It is important that a calcium supplement be taken while on a dairy-free diet
unless a child has an exceptionally nutritious diet rich in calcium. There are tests available for allergies to
wheat and dairy. However, a negative allergy test does not mean that dairy and wheat are ok, as they can
also cause problems due to opioid reaction. A trial of avoiding the foods is the best test.

When any child is on a restricted diet, the family should be working with a registered dietitian to assess the
need for vitamin and mineral supplements and to discuss alternative sources of calcium, fiber and protein.

Acceptable Milk Replacements:

Soy milk, Rice milk, Almond milk, Potato milk, Coconut milk

Many children with autism also benefit by removing corn and/or soy products.
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