The Gluten-Casein-Free Diet in Children with Autism: A Clinical Results of the Ophthalmic and Behavioral Manifestations

Abstract

Aim: To evaluate the ophthalmic and behavioral effects of a gluten-free casein-free diet (GCFD) in autism spectrum disorder (ASD). Method: The study was conducted from November 2020 to January 2023. We designed an 8-week clinical trial of GCFD on corneal reflex, pupil size, body mass index (BMI), weight, Autistic Disorder Index, Communication, Social interaction, and Stereotype Behavior. Results: A total of thirty participants completed the trial. GCFD reduced BMI [%95 CI -4.8895 to -2.1305 (P < 0.0001)], weight [%95 CI -8.5153 to -0.0647 (P = 0.0467)], Autistic Disorder Index [%95 CI -28.0359 to -16.2841 (P < 0.0001)], Communication [%95 CI -3.3325 to -1.6675 (P < 0.0001)], Social Interaction [%95 CI -4.3190 to -2.4010 (P < 0.0001)], and Stereotype Behavior [%95 CI -2.3939 to -0.2461 (P =0.01)] significantly. GCFD also reduced left [%95 CI -2.2421 to -1.6779 (P <0.0001)] and right pupil size [%95 CI -2.2999 to -1.7201 (P <0.0001)] significantly. Conversely, corneal reflex was significantly increased [95% CI 0.2159 to 2.1241 (P = 0.01)]. No differences were observed for IPD. Conclusion: This study suggested that the GCFD can effectively control ASD behaviors as well as regulate autonomic functions related to ophthalmic markers such as pupil size and corneal reflex, but more research is needed.