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Gluten- and casein-free diet and autism spectrum disorders in children: a systematic review.

European journal of nutrition
March 1, 2018
Anna Piwowarczyk et al. (5 authors)
Journal ArticleReviewSystematic ReviewHuman Study
Study Details

Study Goal

The researchers aimed to determine whether a gluten-free and casein-free (GFCF) diet improves core symptoms of autism spectrum disorder (ASD) in children.

Results Summary

The study found little evidence that a GFCF diet significantly improves ASD core symptoms, with only minor improvements in specific subdomains (communication, social interaction) in some trials. No adverse events were reported, but overall efficacy was limited.

Population

Children with autism spectrum disorder (214 participants across six RCTs).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (7)
InterventionDirectionEndpointPopulationDosageImpactClaim #
gluten-free and casein-free (GFCF) diet
no change
autism spectrum disorder core symptoms
children
-
no statistically significant differences
#1
gluten-free and casein-free (GFCF) diet
increase
scores for the 'communication' subdomain of the Autism Diagnostic Observation Schedule
children
-
significant improvements
#2
gluten-free and casein-free (GFCF) diet
increase
scores for the 'social interaction' subdomain of the Gilliam Autism Rating Scale
children
-
significant improvements
#3
gluten-free and casein-free (GFCF) diet
increase
post-intervention scores for the 'autistic traits' subdomain of a standardized Danish scheme
children
-
significant differences
#4
gluten-free and casein-free (GFCF) diet
increase
post-intervention scores for the 'communication' subdomain of a standardized Danish scheme
children
-
significant differences
#5
gluten-free and casein-free (GFCF) diet
increase
post-intervention scores for the 'social contact' subdomain of a standardized Danish scheme
children
-
significant differences
#6
gluten-free and casein-free (GFCF) diet
no change
-
children
-
no adverse events associated
#7
Abstract

PURPOSE: Effective treatments for core symptoms of autism spectrum disorders (ASD) are lacking. We systematically updated evidence on the effectiveness of a gluten-free and casein-free (GFCF) diet as a treatment for ASD in children. METHODS: The Cochrane Library, MEDLINE, and EMBASE databases were searched up until August 2016, for randomized controlled trials (RCTs); additional references were obtained from reviewed articles. RESULTS: Six RCTs (214 participants) were included. With few exceptions, there were no statistically significant differences in autism spectrum disorder core symptoms between groups, as measured by standardized scales. One trial found that compared with the control group, in the GFCF diet group there were significant improvements in the scores for the 'communication' subdomain of the Autism Diagnostic Observation Schedule and for the 'social interaction' subdomain of the Gilliam Autism Rating Scale. Another trial found significant differences between groups in the post-intervention scores for the 'autistic traits', 'communication', and 'social contact' subdomains of a standardized Danish scheme. The remaining differences, if present, referred to parent-based assessment tools or other developmental/ASD-related features. No adverse events associated with a GFCF diet were reported. CONCLUSIONS: Overall, there is little evidence that a GFCF diet is beneficial for the symptoms of ASD in children.

Medical Subject Headings (MeSH)
Autism Spectrum DisorderCaseinsChildChild Nutritional Physiological PhenomenaCommunication DisordersDiet, Gluten-FreeDiet, Protein-RestrictedEvidence-Based MedicineHumansRandomized Controlled Trials as TopicReproducibility of ResultsSeverity of Illness IndexSocial Behavior Disorders
Study Links
Quality Scores
Safety100
Efficacy30/10
Quality70/10
Citation Metrics
Total Citations47
Citations/Year6.7
Relative Citation Ratio3.15
NIH Percentile86%
Research Impact Scores
APT Score0.95
Weight Score2.09
Normalized Score0.66
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