Paediatric

Abstract

Background: Currently there is a paucity of quality evidence to support the use of restricted diets in Autism Spectrum Disorder (ASD) and NICE guidelines do not recommend the use of restricted diets to treat ASD (1) although there are considerable positive anecdotal reports on the efficacy of the Gluten Free Casein Free diet (GFCF). Moreover, since there is a lack of medical treatment available for autism, parents often turn to various complementary and alternative therapies including restrictive diets as a means of treating their children (2) . The aim of this study was to evaluate the use of four different types of restricted diet -the (GFCF), the Specific Carbohydrate Diet (SCD), the Gut and Psychology Syndrome (GAPS) and the Ketogenic Diet (KD) as a means of treating children with ASD. Methods: An unvalidated online questionnaire, with both open and closed questions, exploring aspects of diet in children with ASD was developed for this study by a paediatric dietitian and posted on the "Research Autism" website. Participants were also recruited via social media over two months in early 2016, following ethical approval by the Research Ethics Committee of London Metropolitan University. This study analysed a subset of this data, limiting inclusion to children based in the UK aged 19 years and under and to computer literate respondents.Results: Despite inviting respondents from across the UK, there were only 162 respondents representing approximately 0.023% of the total UK autism population. The mean age of children 11.2 years AE 4.0 years and 82.7% (n = 134) were male and 17.3% (n = 28) female reflecting the recognized male to female ratio of prevalence for ASD of 4:1. 30.8%, (n = 50) respondents had previously tried the GFCF diet and the 3% (n = 5) that had tried the SCD and GAPS diet had also tried the GFCF diet. No respondents had tried the KD. 58% (n = 29) parents for GFCF and 80% (n = 4) parents for SCD and GAPS diet hoped for 'improvements in general health and wellbeing' when commencing restriction diets. 46% (n = 23) and 50% (n = 25) of parents reported improvements in 'overall health and wellbeing' and 'participation in daily activities' on the GFCF diet respectively. 20% (n = 10) reported that 'range of food eaten' was negatively affected following GFCF diet. 60% (n = 3) of parents reported improvements on the SCD and GAPS diet in respect of 'participation in daily activities' and 'overall health and wellbeing'. Discussion: The results suggest that parental use of the GFCF diet (30.8%) is similar to that reported in a US parental internet survey (32.4%). This study is the first to evaluate parents views on the GAPS diet and one of the first to evaluate SCD although the small sample cannot be representative of the current ASD population. Following restrictive diets can risk nutritional adequacy, be costly and affect mealtime interactions and therefore it is vital that parents have appropriate support when considering commencing these diets. Conclusion: These findings add to the evidence that use of t...