On Monday, 11 August 2008, The Straits Times in Singapore published a damning report on alternative treatments for autism titled: Autism ‘cures’: Helpful or Harmful? The report is a culmination of a series of actions by mainstream medical doctors, using their influence on the government and the media, first to curb our activities and now to portray us as crooks who are out to cheat desperate parents of large sums of money. Part of the report read:
To help parents steer clear of dangerous, expensive and ineffective treatments, a 19-member committee of pediatricians and other health professionals is now scrutinizing overseas research on the efficacy of the various therapies.
Pediatrician Lim Sok Bee, who heads the committee, says the biggest risk comes from invasive therapies in which a child is made to take pills, syrups or even injections, or is denied food such as milk and wheat, which are essential for growth.
She warns: ‘Parents should be aware that if not properly monitored, the child could end up being malnourished – this, in turn, may cause convulsions.
A search of the medical research portal PubMed on key words like Casein, Gluten and Autism will show up a number of published trials that show the GFCF diet to be useful in reducing some of the symptoms of autism. These are just some of the papers available online:
- Murch, S. 2005. “Diet, Immunity and Autistic Spectrum Disorders.” J Pediatr. 146(5):582-584.
- Reichelt, K.L., and A.M. Knivsberg. 2003. “Can the Pathophysiology of Autism be Explained by the Nature of the Discovered Urine Peptides?” Nutr.Neurosci. 6(1):19-28.
- Christison, G.W., and K. Ivany. 2006. “Elimination Diets in Autism Spectrum Disorders: Any Wheat Amidst the Chaff?” J Dev Behav Pediatr. 27(2 Suppl):S162-S171.
- Millward, C., et al. 2004. “Gluten- and Casein-Free Diets for Autistic Spectrum Disorder.” Cochrane. Database. Syst. Rev. (2):CD003498.
The suggested mechanism at work is the effects of morphine-like compounds known as casein (found in milk) and gluten (found in wheat) on the brains of autistic children. It is thus curious that Dr. Lim is quoted as saying that autistic children denied milk and wheat are at risk.
We beg to disagree that milk and wheat are essential for growth. Carbohydrates, protein and fats are essential for growth. Milk and wheat are not the only foods that supply these nutrients. So if avoiding such foods can help reduce autistic symptoms, why is such a diet considered risky and invasive? In fact, some autistic children could be put at risk by constant exposure to casein and gluten.
Reichelt and Knivsberg (Ref above) specifically explains how casein and gluten could cause stereotyped behavior, lack of social involvement, epilepsy, self-destructive or pain-inflicting behavior, immune system problems and sleep problems. One of mothers interviewed felt milk might have triggered a seizure in her son.
We have found no evidence that the GFCF diet could cause malnutrition and trigger a convulsion. One study found that there was no significant difference between the nutritional intakes of children on the GFCF diet and those not on the diet. (Cornish, E. 2002. “Gluten and Casein Free Diets in Autism: A Study of the Effects on Food Choice and Nutrition.” J Hum.Nutr.Diet. 15(4):261-269.)
The GFCF diet is generally safe and potentially useful for autistic children. We cannot wait for the medical gold standard of a double blind placebo control trial before making a general recommendation to autistic children to be put on a trial diet. Such a day will never come because of lack of interest in funding a trial, even if it is possible to design such a trial.
It is about time we use our common sense to judge the usefulness of the GFCF diet as part of autism therapy. We are aware that implementing such a diet is not easy and many families are stressed by it. It does not help the situation to have the national press run a report that describes an evidence-based therapy with emotive words like “bizarre”, “bewildering”, “harmful” and “invasive”.
John Yeo, MSc
15 August 2008
