Dietary Supplementation in Children with Autism Spectrum Disorders: Common, Insufficient, and Excessive

Stewart, Patricia A.; Hyman, Susan; Schmidt, Brianne; Macklin, Eric A.; Reynolds, Ann; Johnson, Cynthia R.; James, S. Jill; Manning-Courtney, Patricia

doi:10.1016/j.jand.2015.03.026

“…In the Autism Treatment Network, 19% of participants followed a gluten-free casein-free diet. 18 A study of these children did not reveal micronutrient deficiencies when on a multivitamin; however, iodine status was not assessed 19 20 Typical iodine stores may be able to maintain normal thyroid function for up to 3 months, after which a decline in function may manifest. 18 With the growing popularity of voluntarily restricted diets, we recommend obtaining a thorough dietary history in cases of primary hypothyroidism without evidence of autoimmunity.…”

Section: Discussionmentioning

confidence: 98%

Iodine Deficiency and Hypothyroidism From Voluntary Diet Restrictions in the US: Case Reports

Booms¹,

Hill²,

Kulhanek

³

et al. 2016

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Iodine deficiency is rare in the United States today, and this is largely due to the effectiveness of iodization in the general food supply. Recent trends among specific populations of children in the United States include adopting food restrictions, such casein-free and gluten-free diets. Although the effect of these types of diets on overall nutrition status and certain micronutrients has been studied in children with autism spectrum disorder, the effect of these limitations on iodine levels in children has not been assessed. We present here 2 cases of iodine deficiency resulting from severe food restriction and associated primary hypothyroidism. In 1 case a classic presentation with a goiter was seen. These children were able to discontinue thyroid hormone treatment once iodine levels were normalized. There were no adverse events or unanticipated outcomes. The occurrence of these cases of iodine deficiency in the United States points to the need for thyroid function testing in children with severe food restrictions, especially those who have limited exposure to dairy, baked goods, and table salt.

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“…Probably, this imbalance is associated with GI symptoms [19,[26][27][28][29]. Dietary interventions are known to be able to restore the gut microbiota composition and toxin production by which they can positively affect the symptoms of ASD [19,27,30,31], although still is still debated [32,33].…”

Section: Gut Microbiota Dysbiosis In Asdmentioning

confidence: 99%

Treating Autism Spectrum Disorder with Gluten-Free and Casein-Free Diet: The Underlying Microbiota-Gut-Brain Axis Mechanisms

Cieślińska

¹

,

Kostyra

²

,

Savelkoul

³

2017

CIIT

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There is a rising interest in the use of dietary interventions to ameliorate prevalent brain diseases, including Autism Spectrum Disorder (ASD). Nowadays, the existence of communication between gut and brain is well accepted and thus diet can influence brain functioning. A well-known nutrition based intervention for ASD is the gluten-free and casein-free diet. However, only some of the patients experience a relief in symptoms and thus efficacy seems to be limited to certain phenotypes. However, not much is known about the mechanism of action through which this diet might work, or about interpersonal differences that could lead to variation in response to the diet. Current evidence for efficacy of the GFCF diet is poor. Large scale, good quality randomized controlled trials are needed. Genetic and environmentally induced interpersonal differences were found in intestinal membrane permeability and blood brain barrier integrity as well as in activity of peptidase enzymes. These differences probably affect responsiveness to the diet. In addition, age and duration of the dietary intervention play a role in the efficacy of the gluten-free and casein-free diet. This is the reason why all these factors need to be taken into account to give appropriate advice about whether or not to follow this diet.have extensive effects in the rest of the body through the Microbiota-Gut-Brain axis (MGB axis).Citation:

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“…Only few children needed most of the micronutrients while in many others excess intake of vitamin A, folate, and zinc was often observed. However, even when supplements were used, careful attention should be given to adequacy of vitamin D, calcium, potassium, pantothenic acid, and choline intake [33]. Another concern upon starting an elimination diet is the increased risk of social rejection.…”

Section: Risks Associated With Gfcf Diets In Asd Patientsmentioning

confidence: 99%

“…Probably, this imbalance is associated with GI symptoms [19,[26][27][28][29]. Dietary interventions are known to be able to restore the gut microbiota composition and toxin production by which they can positively affect the symptoms of ASD [19,27,30,31], although still is still debated [32,33]. …”

mentioning

confidence: 99%

Untitled

2015

HCIIN

0

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There is a rising interest in the use of dietary interventions to ameliorate prevalent brain diseases, including Autism Spectrum Disorder (ASD). Nowadays, the existence of communication between gut and brain is well accepted and thus diet can influence brain functioning. A well-known nutrition based intervention for ASD is the gluten-free and casein-free diet. However, only some of the patients experience a relief in symptoms and thus efficacy seems to be limited to certain phenotypes. However, not much is known about the mechanism of action through which this diet might work, or about interpersonal differences that could lead to variation in response to the diet. Current evidence for efficacy of the GFCF diet is poor. Large scale, good quality randomized controlled trials are needed. Genetic and environmentally induced interpersonal differences were found in intestinal membrane permeability and blood brain barrier integrity as well as in activity of peptidase enzymes. These differences probably affect responsiveness to the diet. In addition, age and duration of the dietary intervention play a role in the efficacy of the gluten-free and casein-free diet. This is the reason why all these factors need to be taken into account to give appropriate advice about whether or not to follow this diet.Keywords: Autism spectrum disorder; Casein-free; Casomorphin; Diet; Gluten-free; Intervention; Opioid; Peptides; Permeability Treating Autism Spectrum Disorder with Gluten-free and Casein-free Diet: The underlying Microbiota-Gut-Brain Axis MechanismsCitation: Cieślińska A, Kostyra E, Savelkoul HFJ (2017) Treating Autism Spectrum Disorder with • (GFCF) diet is strongly promoted while there are additional diets without salicylates and phenols, and anti-candida diets since many ASD patients are affected by this yeast [17]. However, so far it has been difficult to prove the effectiveness of this diet in all patients [10,18]. Limited information is available on the underlying mechanism as well as explanatory factors of differences in response to the GFCF diet. Here, we focus on the mechanism of action underlying this dietary intervention as well as the origin of differences in response to the GFCF diet. Gluten-Free and Casein-Free Diet Might Alleviate Autism Spectrum Disorder SymptomsPeople with ASD are often in need of intensive care and guidance, leading to loss of parental productivity and high emotional and economic costs [8,19]. Therefore it is important to investigate potential treatments that alleviate the symptoms or preferably cure the disease. So far, sometimes life long, educational and behavioral interventions are used, although these therapies have limited efficacy for ASD [6,20]. Currently, there is growing interest in nutritional interventions for this disorder and there are promising mechanisms underlying the putative success of such interventions [19].In 1983 it was suggested that gluten and casein containing products could cause autism-like symptoms by altering the functioning of the brain. It was propo...

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Dietary Supplementation in Children with Autism Spectrum Disorders: Common, Insufficient, and Excessive

Cited by 78 publications

References 25 publications

Iodine Deficiency and Hypothyroidism From Voluntary Diet Restrictions in the US: Case Reports

Iodine Deficiency and Hypothyroidism From Voluntary Diet Restrictions in the US: Case Reports

Treating Autism Spectrum Disorder with Gluten-Free and Casein-Free Diet: The Underlying Microbiota-Gut-Brain Axis Mechanisms

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