Written by Smita Srivastava
Food sensitivity, food rejection, and inadequate food intake are frequently seen in children with autism. This makes it a hindrance for them to develop physically and socially as they start developing nutritional problems. The Gluten-free Casein-free Diet, also known as GFCF is one such therapy used by healthcare teams that involves the elimination of proteins (casein and gluten) from the diet. The GFCF diet for managing autism has beneficial effects on the brain and social development.
While many parents wonder how the GFCF diet works, others may swear by its effectiveness. Together with health practitioners, they have and still report positive outcomes, thereby contributing to a healthy gut and brain in autistic kids. It is essential that autistic kids receive optimum fiber, vitamins, and minerals. Let’s delve deep into the gluten-free casein-free diet and understand why this diet therapy is important for children with autism.
In This Article
Gluten-free Casein-free diet is the most frequent alternative diet therapy administered for autistic children. This diet avoids gluten (found in rye, barley, and wheat) and casein (dairy) in order to improve gut health and brain. Most parents of children with autism stated positive changes in behavior, sleep and speech (1).
The underlying concept of the GFCF diet in autism is eliminating gluten and casein which are known to cause leaky gut in them. When the proteins, gluten, and casein, are compromised, small fragments of these enter the bloodstream and affect the brain. This contributes to typical symptoms of autism.
Some parents even hold the belief that their children have certain allergies or intolerances to the food ingredients (2). As a result, they opt for tests to confirm their assumptions. Many parents still opt for GFCF dietary choices as they claim to bring positive behavior and better speech even without allergies.
GFCF diet helps alleviate a variety of symptoms, right from social regulation to emotional development in autistic children. It is a kind of diet therapy that eliminates casein and gluten. These proteins are difficult to digest and result in gut damage in autistic children. With damage, fragments of these proteins enter the bloodstream and impact the brain in an adverse manner.
In short, these proteins affect the gut-brain axis negatively leading to typical symptoms of autism (3). Not only this, these proteins affect the metabolism of essential nutrients such as vitamin B12, folate (4), calcium, iron (5), and zinc, making kids nutritionally deficient.
The rationale behind this diet therapy is the idea that autistic children have either an allergy or heightened sensitivity to gluten and casein containing foods. Children with autism tend to metabolize peptides and proteins present in gluten and casein food sources in a different manner. As a result, the brain interprets them as artificial opiate-like compounds which then damages the GI tract.
Symptoms of typical autism arise and turn worst and if not managed immediately. The goal behind this diet is to reduce symptoms, enhance social interactions, improve speech and cognition.
Gluten is a protein found in grains such as wheat and its varieties, rye, barley, and oats. Foods that contain gluten are chapatis, seviyan/vermicelli, semolina, bulgur wheat, brewer’s yeast, wheat starch, couscous and products such as bread, breadcrumbs, cakes, muffins, pastas, malted beverages, donuts, naan, pita breads, cornbread, rolls (sweet and savory) (6).
There are certain foods served in restaurants or available in markets where gluten is served in a hidden manner. These include-
Casein is abundant in milk, curd, yogurt, cream (half and full), cheese, and butter. Non-dairy foods such as protein powders, soup bases, puddings, and custards, milk chocolate and white chocolate also contain casein. Many soy products and fortified products claiming to be lactose-free or dairy-free also contain casein.
Many times children with autism exhibit sensitivities to soy and corn apart from casein and gluten. Due to similar protein resemblances, it is advisable to eliminate these ingredients for at least 3 weeks and then give a trial. If it still persists, then better stop including further.
Excluding the easy-to-go snacks and favorite foods from the child’s diet is a tough challenge for parents when initiating a GFCF diet. While some autistic children have food aversions, sensory and behavioral issues, some instantly accept the GFCF diet.
Start with fresh vegetables, lean meat, eggs, fruits, dals, and rice. These are not just gluten-free and casein-free but also provide essential nutrients like amino acids, B-complex vitamins and fiber. Look for seasonally available ones.
There are grains declared gluten-free such as amaranth and quinoa. Being high in protein and fiber, it also provides phytochemicals and micronutrients like zinc, phosphorus, magnesium, iron, and folate.
Commercially prepared foods contain preservatives with gluten to increase the shelf life. Seasonings, condiments like soy sauce, flavorings and premixes of soups, and pancakes have a potential amount of gluten. Hence, it is essential to know about the added ingredients before symptoms aggravate. As per Indian Food Standards, foods containing less than 20 mg/kg of gluten can be considered as gluten-free in packaged food.
To implement the GFCF diet successfully, the first thing is to enlist all those foods consumed by autistic children and identify whether they contain gluten or casein. Once done, make sure it is eliminated gradually and then completely. The child shows progress once all these foods are completely eradicated rather than mere reduction. Positive changes in children with autism are seen typically after 2-3 weeks. Family members should maintain a journal to observe the changing behavior pattern post meal consumption.
Though certain foods are restricted in autism, there are more options available which can be incorporated daily. Some of them are-
Avoid | Include | |
Milk and milk products |
Cow milk Goat milk Sheep milk Other mammal milks Yogurt Dairy Cheese Sour cream Butter Milk chocolate Creams Most pastries |
Almond milk Non-dairy sour cream Coconut milk Non-dairy yogurt Cashew milk Rice milk Non-dairy cheese Pea milk Non-dairy ice cream |
Grains and pulses |
Wheat (wheat germ, wheat bran, wheat starch, dalia, durum wheat) Semolina (Suji) Barley (barley malt, barley extract) Vermicelli (Seviyaan) Oats (Oats bran and Oats Germ) Triticale (a cross between wheat and rye) Couscous (a derivative of wheat) Rye (a variety of wheat) |
Rice Sorghum (Jowar) Chestnut flour (singhara) Quinoa Pearl Millet (Bajra) Finger millet (Ragi) Amaranth Buckwheat Tapioca/ Sago (sabudana) All pulses
|
Nowadays pasta and pancake mixes made from rice flour and chickpea flour are available. Also include vegetables and fruits to improve fiber intake (7). Even fish and eggs can be consumed. Read the labels on food packets carefully before including them in your child’s diet.
The GFCF diet has numerous benefits for autistic children. Many parents even reported improvement in their children after following the GFCF diet (8). It is considered safe and effective diet therapy which greatly improves learning skills, social behaviors, cognitive functions, and communication skills. This effectiveness is possible with reduced ASD symptoms through diet via opioid theory.
Generally, the diet is considered safe but if this elimination diet goes on like this, the child might be prone to nutritional deficiencies. It would be better to sit with experts like dietitian and pediatrician, to understand and make the diet carefully with other options. It is important to ensure intake of high-fiber grains and vegetables to fulfill the requirements adequately (9).
This is quite challenging as many times information is not properly disclosed but this can be sorted by keeping certain points in mind like-
Parents feel bad when they find little or no options available. But today thanks to technology specially Google, they can check for restaurants that serve gluten-free and casein-free menus or even look for gluten-free and casein-free options in the menu. If the menu is not available in the websites, look for contact details and clear the queries by calling the restaurant.
When ordering a meal in the restaurant or any food outlets, parents must cross check with the method of preparation (like not cooking in butter or removing dairy), ingredients and customize it as required. For instance, if ordering pizza for a child, know what crust is made of and what type of cheese or veggies and seasonings will be added.
GFCF diet is an elimination diet therapy for autistic children which has been in use for many years by health experts. It helps to improve behavioral and cognitive problems by eliminating gluten and casein. Care should be taken while planning this to closely monitor the behavior and inclusion of supplements or altered food choices when required.
Gluten-free diets are mostly combined with casein-free diet to manage children with autism. Eliminating gluten from the diet improves physiological symptoms and autism behavior in kids.
There are different types of flour available to meet the requirements of gluten-free food such as almond flour, tapioca flour, rice flour (white rice and brown rice), millet flour.
A well-balanced GFCF diet with emphasis on lean proteins, dietary fiber and healthy fats is an incredible diet plan for an autistic child. This diet, if planned under supervision of health practitioners and dietitians, will support gut health and brain development.
Children with autism metabolize peptides and proteins found in gluten. Their brain interprets these substances as synthetic opiate-like compounds. The compounds then travel all over the body damaging the gut, causing symptoms such as bloating, diarrhea or even develop sensitivity toward gluten.
There are many food sources that offer a variety of nutrients. Foods such as walnuts, fish provide omega-3 fatty acids which reduces inflammation and supports brain development. Spinach, banana, cashews, and almonds are good sources of magnesium and vitamin B6 that helps in speech development. Fruits and other vegetables provide fiber and vitamin C.
Children with autism can have citrus fruits such as oranges, lime and fruits like apple, papaya, and berries. These fruits are rich in antioxidants that reduces inflammation and improves overall being.
Children with autism can have plant-based milk namely almond milk, coconut milk, and rice milk. They are lactose-free, casein-free and fortified with calcium and Vitamin D so that the child is not deprived of these nutrients.
References
With a background in Mass media and journalism, Smita comes with rich and vast experience in content creation, curation, and editing. As a mom of a baby girl, she is an excellent candidate for writing and editing parenting and pregnancy content. The content she writes and edits is influenced by her own journey through pregnancy and motherhood. When not writing- She can be found curled up with a book. Or, bingeing on Netflix.Read more.
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