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Autism treatment includes many diet-based therapies that address underlying issues inside the body.
One of the roles of the gastrointestinal system is to act as the “first-line of defense” for our immune systems. When the “gut” is weakened, it cannot properly perform this duty, which leads to other physiological and biochemical disturbances. By healing the gut, we begin to heal the body.
Autism Diets: The First Step to Biomedical Intervention and Autism Recovery
By Julie Matthews, Autism Nutrition Specialist
The road to autism recovery begins with diet. That is, choosing foods to add and remove from their diet is the first step to improving the health and well being of children with autism. Certain food substances (most notably gluten and casein) are known to be problematic for the child with autism, and should be avoided – and other foods rich in healing nutrients are beneficial when added to children’s diets. Attention to these factors is intended to help balance biochemistry, affect systemic healing, and provide relief of autism symptoms. In simple terms, these are the underlying tenets of diets for autism. Download PDF Article
Gluten-Free/Casein-Free (GFCF) Diet:
Foods and nutrients can impact the symptoms of autism. Autism is a whole-body disorder, the gut-brain connection is an important area for parents to understand. The foods and substances that children eat directly impact what happens in their brain—and parents’ food choices can have a direct affect. These GFCF basics can help you get started with this important dietary approach. With a little practice and familiarity, GFCF can easily become a regular part of your family’s health and healing program.
Basics of Implementing a GFCF (Gluten Free Casein Free) Diet
Parents are becoming increasingly aware of the many benefits children see when they implement the GFCF diet. Removal of gluten and casein—the gluten-free and casein-free (GFCF) diet—is a great way to begin nutritional intervention for autism, the diet is not difficult to do, and with some basic insights you can get started right away.
Gluten is the protein in wheat, as well as other grains including rye, barley, spelt, kamut, and commercial oats, and casein is the protein in dairy. These proteins have been found to be problematic for many children on the spectrum, eating foods containing them can affect their body’s physical and cognitive functions. Eliminating those foods (and ingredients containing these food proteins) from your child’s diet can help improve many symptoms of autism. It can help children feel and learn better by reducing inattentiveness and hyperactivity, improving speech and language, decreasing digestive disturbances, and much more.
When going GFCF you need to look out for hidden sources—gluten or casein can be a hidden ingredient within processed food. With a few pointers it’s not difficult to ensure you are fully avoiding these substances.
Sources of GLUTEN to Avoid
- Oats (commercial)
- GF oats are available
Gluten Containing Ingredients and Foods:
- Hydrolyzed Vegetable Proteins *
- Dextrin and maltodextrin *
- Artificial flavors & coloring *
- “Spices” *
- Soy sauce (unless wheat-free) *
- Potato chips/fries *
- Sauces and gravies *
- Bologna and hot dogs *
- * May contain gluten, unless specified gluten-free
Sources of CASEIN to Avoid
Casein is found in all animal milk products (cow, goat, sheep milk, etc.), such as:
- Yogurt and kefir
- Ice cream
- Sour cream
Casein Containing Ingredients and Foods:
- Milk chocolate
- Casein, Caseinate
- Lactose in seasoning
- Lactalbumin, as natural flavor Artificial butter flavor
- Cool Whip
- Lactic acid *
- Canned tuna *
- Seasoned potato chips *
- Hot dogs and bologna (may contain) *
- * May contain casein
It is pretty easy to substitute your child’s favorite foods with gluten-free options—GF waffles, GF pancakes, GF muffins, GF pasta are all readily available in stores. GFCF hotdogs and chicken nuggets are also pretty close to the original gluten containing versions, and easy to substitute. Breads are more difficult to substitute, since gluten’s texture makes bread more difficult to duplicate with gluten-free flours. As you try different brands of GFCF bread, consider making some of your own. Gluten-free breads, with and without yeast, taste much better and have a fresher texture when made at home.
Some aspects of going casein-free are also easy to change: butter substitutes such as ghee and coconut oil are delicious, healthy, and available in most health food stores. Coconut yogurt (by So Delicious) is dairy-free and soy-free, casein-free pudding and ice cream is also nearly indistinguishable from the dairy versions. Milk can be slowly diluted over time with dairy-free milk. Mac and cheese can be made fairly easily without any cheese substitute at all. Melted cheese such as on GF pizza is harder to mimic because of its gooey texture. Fortunately, Galaxy Foods makes a Vegan Rice cheese that is free of casein and caseinate, as well as soy-free, that can be used when you simply must have pizza.
Here Are Some Initial Steps for Implementing GFCF:
1. Experiment. Before removing anything, introduce GFCF alternatives such as rice pasta, GF waffles, and other GFCF foods and snacks-this will support the elimination portion later. Try some prepared foods and mixes. Find options you child likes and that you can substitute later during implementation.
2. Explore GFCF resources (books, cookbooks, videos, autism websites) to become familiar with the diet and learn helpful ideas, what to expect, and what foods are allowed. Watch instructional videos – many available at YouTube.
3. Create a meal plan—a list of gluten-free and casein-free foods, meals, and snacks your child will eat or that you would like to make on GFCF.
4. Shop for foods according to meal plan, as well as purchasing GFCF flours, milks, and other cooking staples.
5. Then, begin eliminating one at a time:
Start with the elimination of casein—for two weeks, then...
Remove gluten and continue both (gluten-free and casein-free) for three to six months.
After You Plan and Are Ready to Implement the Diet, Consider These Additional Factors:
Substitute the same foods your child likes with gluten/casein-free options. For example, if they eat waffles every morning, buy rice flour waffles.
Do not increase the amount of sugar in the diet. When going GFCF, it is common to start substituting anything gluten-free, including high sugar cookies. If you need to continue to use higher sugar foods (if they are already in the diet) during the transition, it is fine; however, you will want to take them out as soon as possible. Therefore, best to avoid them if you can.
If the package does not say “gluten-free” and “casein-free,” call the manufacturer to be sure. “Wheat- free” and “dairy-free,” do not necessarily mean GFCF. Even if there are no gluten or casein ingredients, you cannot assume GFCF – there may be trace ingredients that do not need to be listed. Also, remember to check that any gluten-free products are also casein-free.
For younger kids, just make the changes when you can. Put gluten and dairy free options into your usual containers, i.e. put rice milk in the milk container. Make this transition—slowly diluting the dairy to non-dairy over a week or two.
To aid digestion of wheat and dairy, try using a digestive enzyme with DPPIV. While it will not take the place of doing the diet, it can help children ease their way into the diet and help with cross- contamination until the diet is being implemented fully.
When following a GFCF diet, it is common to over-substitute corn and soy in place of gluten and casein. Corn and soy are also very common food sensitivities, and removing these foods as well can make a remarkable difference on the health, behavior, and attention for children with autism. I suggest soy-free and corn-free, or only organic corn.
Make sure your child’s nutritional needs are met. Diet choices should be as healthy as possible, and add a calcium supplement and/or a proper multivitamin/mineral formula to make sure a child’s vitamin and mineral needs are met. Consider working with a nutrition professional to ensure all nutritional needs, including protein intake and calories, are met. My book, Nourishing Hope for Autism, will help guide your efforts.
As you get the hang of the diet and your child is GFCF, begin to strategize on how you can introduce healthier foods such as vegetables and fresh vegetable juices, fermented foods, antioxidant-rich foods and other nutrient-dense choices. See Cooking To Heal for many tips, recipes and demonstrations.
Be Aware of Cross-Contamination
Preventing cross-contamination can get so “nit-picky” and overwhelming that it causes some parents not implement a special diet at all – this needn’t be. To keep things simple, initially just be concerned with the major cross-contamination offenders such as: bulk foods, commercial fryers that fry breaded foods, the toaster, and wooden cutting boards or wooden utensils that can get gluten and casein lodged in the porous wood. Everything else that is non-porous can be washed well.
Foods your child can eat on a GFCF Diet GFCF (soy-free and corn-free) oils:
- Ghee (made from butter but casein-free)
- Coconut oil
- Olive oil
- Sesame oil
- Lard or other animal fat
Casein-Free (and soy-free) Milk Substitutes:
- Rice milk
- Nut milks
- Coconut milk
- Potato milk
Gluten-free Grains and Flours:
- Sorghum flour
- Tapioca flour
- Potato starch and flour
- Nut and seed flours
- Bean flours
- Corn (organic only)
Vinegar. Rice vinegar, apple cider vinegar, red and white wine vinegars, and balsamic vinegar are gluten-free. Distilled vinegars are also gluten-free because of the manufacturing process. Be careful at restaurants; cheap brands of vinegar that use colors or flavors may contain gluten.
Ketchup and mustard are made with vinegar so you’ll want to check with the brand to ensure they’re gluten-free. French’s mustard is gluten-free. Dijon mustard is also gluten-free. Heinz and Westbrae ketchups are gluten-free. Always check with the company to confirm they don’t use any gluten- containing ingredients.
Vanilla extract may or may not be gluten-free depending on the alcohol used. Frontier and McCormick’s are gluten-free and most gluten-free vanilla says so right on the label.
Herbs and Spices. Good quality herbs and spice brands such as Frontier, Penzy, even McCormick are gluten-free for the most part. For these brands, herbs and spices that are single spices such as “basil,” “cinnamon,” or “onion powder,” are gluten-free. However, spice blends, even for these higher end brands, are typically not gluten-free, such as apple pie spice, Mexican seasoning, and chili powder (such is a blend of chilis).
GFCF baking powder – Rumford brand is GFCF and aluminum-free
Breakfast Meal Ideas
Always try to serve some protein such as eggs or sausage at breakfast. Try two or three of these ideas together such as: scrambled eggs, with bacon and a piece of fruit—unless breakfast already contains fat, carbohydrate, and protein such as French toast or a smoothie.
- Eggs, scrambled eggs, an omelet, any style without milk
- Breakfast sausage. Store bought or simply a homemade meat patty (with no nitrates/ites)
- GFCF waffle or pancake
- GFCF toast with nut butter or ghee and/or coconut oil (butter substitute)
- GFCF cereal or other GFCF breakfast granola
- French toast (GF bread)
- Fruit Smoothie - Non-dairy milk, frozen fruit such as blueberries, bananas, peaches, and pear,
- honey, protein powder (if not in conjunction with other protein), non-dairy yogurt
Lunch & Dinner Ideas
Include a protein, vegetable, some fat, and a starch (the starch is not necessary and is eliminated on certain diets). Have hot leftover dinner for lunch by using a Thermos.
- Ground beef
- Lamb or any meat
- Burger – beef, chicken, turkey, veggie
- Ground chicken, beef, turkey, or other meat
- GFCF, nitrate/ite-free hotdog and sausage
- Homemade GF chicken nuggets
- Any roasted chicken or meat
- Steamed or boiled vegetables with ghee or coconut oil melted on top
- Stir-fry vegetables
- Salad or carrot sticks
- Raw sauerkraut
- Fresh fruit - cooked into a sauce like apple sauce or pear sauce
- GF pasta
- Sweet potato or potato fries
- Rice or quinoa
- GF crackers, bread, or rice cakes
Additional Lunch and Dinner Ideas:
- GF sandwich with sliced lunchmeat
- GF sandwich with sunflower seed butter and jelly (a peanut/nut-free PB&J)
- Stews & soups – Pureed or broth soup
- Chicken nuggets or chicken pancakes
- Celery or apple with nut butter
- Vegetables with hummus
- Potato chips or other chips (ideally with guacamole or other healthy dip)
- Carrot chips
- Vegetable latkes with apple sauce on top
- Smoothie (or frozen into popsicles)
- Vegetable juice (fresh made)
- GF French toast strips with coconut oil and a bit of salt (not sweet if possible)
- Fruit or apple/pear sauce
*To learn more about implementing the GFCF diet, visit NourshingHope.com for a deeper study on diet and nutrition for autism.
Specific Carbohydrate Diet (SCD):
Removes all complex sugars and starches in addition to gluten and casein. Eliminating sugars and starches starves out the yeast and bad bacteria (which feed on complex sugars) and therefore helps alleviate side effects created by yeast and bacteria overgrowth, which include gastrointestinal issues, headaches and hyperactivity.
Body Ecology Diet (BED):
Based on the concept of a natural balance of microorganisms that are involved in a range of functions in the body, and that this balance might be lacking in individuals with autism. The three basic elements are adding cultured foods (such as yogurt and fermented vegetables), integrating “good” fats (flaxseed and extra virgin olive oil), and significantly reducing carbohydrate and sugar intake.
Low Oxalate Diet:
Limits or eliminates foods with high oxalates. Oxalates are sharp crystals that can lead to oxidative damage and contribute to gut inflammation in individuals with issues processing them. High oxalate foods include beans, potatoes, spinach, berries and chocolate.
Eliminates foods containing phenols and salicylates, including tomatoes, apples, peanuts, bananas, oranges, cocoa, red grapes and milk. It also eliminates foods with artificial ingredients, colorings and flavorings. Phenols and salicylates can lead to hyperactivity and behavior issues.
Lutein-Free Diet (aka Sara’s Diet):
Eliminates lutein, a pigment nutrient found in some fruits and vegetables such as spinach, corn, carrots, oranges and peaches. Lutein has been found to trigger severe allergic reactions, which often express themselves as gastrointestinal issues. This diet also incorporates removal of soy and restriction of gluten and casein.
As you explore these diet-based therapies, also consider:
Eliminating Foods: Removing common food allergens one-at-a-time can help pinpoint the root of a body’s issues and disturbances.
Rotation of Foods: Within each of these diet-based therapies, there is the potential to overload on any one food (especially those used as “substitutes” for gluten and dairy). For some, these overloads lead to new allergic reactions and body responses. By varying the promoted foods within the diet, these potential issues can be avoided.