A new Penn State survey showing that a gluten-free, casein free diet helps autism will come as a surprise to some and a relief to others. If you believe that autism is a hopeless lifelong brain condition, it seems ridiculous to imagine that diet could make any difference. If you are a parent who has seen your child “wake up” on this diet, you may feel relieved that these scientists took it seriously and asked 387 parents about their observations.
For those of you following the science of the “gut microbiome,” immune-brain and gut-brain relationships, these findings may surprise you less than they would have a few years ago. Our immune systems and our so-called “gut bugs” – the billions of microorganisms that live in our GI tract – are turning out to have huge impacts on our health, including what diseases we get, how much we weigh, and – yes – how our brains function.“There are strong connections between the immune system and the brain, which are mediated through multiple physiological symptoms,” senior author Laura Cousino Klein, associate professor of biobehavioral health and human development and family studies, said in a statement. “A majority of the pain receptors in the body are located in the gut, so by adhering to a gluten-free, casein-free diet, you’re reducing inflammation and discomfort that may alter brain processing, making the body more receptive to ASD therapies.”In the survey it seemed to make a difference what choices parents made. Children who eliminated both gluten – the protein in wheat and some other grains – as well as the milk protein casein from their diet, and who stuck with it six months or more, seemed to do the best. Gluten is in more than wheat, and casein is in more than milk and cheese, so this takes hard work and discipline, but for many it seems to pay off.Some parents of people with autism – and people with autism themselves – report even greater benefit from eliminating fast-metabolizing starches, like sugars, grains and starchy vegetables including potatoes, which may feed noxious gut bugs. Still other diets address various metabolic glitches that seem to trouble some subgroups of people with autism. People with autism can be quite different from one another, and some appear to need lots more, or lots less, of various substances.To me, it is a breath of fresh air for researchers to get this kind of exploratory data. Good science needs to have a solid basis in naturalistic observations so that we at least ask questions that make sense.What’s next? Starting with the observation that many autistic people do better on this type of elimination diet (and probably also other diets as well), what kinds of research would be useful to push the envelope and move diet intervention toward being part of the standard of care for the autism spectrum?
Here are some questions for researchers to pursue:
- Can we use modern metabolomic methods to identify profiles to help figure out which types of diets will work for which people?
- What is it about the diet that leads to behavioral and functional improvement? This means that we need to ask how the diet might impact the brain. Is it eliminating allergic irritation? Is it eliminating noxious byproducts from gut bugs that may be “intoxicating” the brain and obstructing its function? Is it changing the balance of gut flora?
- Could it be reducing immune irritants or immune triggers? What triggers and what do they trigger in the brain? Do they interfere with optimal synaptic function? Do they change brain waves? How?
- Are diet and food issues related to growing numbers of people diagnosed with autism? We certainly don’t eat like our grandparents did.
These are all important questions whose answers may simultaneously help us understand how autism works and how we can help. They also can help us move toward treating autism as a dynamic condition where hidden potentials can be liberated from what is getting in their way so people with autism have a better shot at reaching their full potential.
These findings teach us to take diet seriously, and not just for autism. A recent New York Times Magazine headline asked “should we all go gluten-free?” Good question. Perhaps “we are what we eat” in more ways than we might ever have imagined.
To learn more:
Dr. Harumi Jyonouchi, a pediatric allergist at the University of Medicine & Dentistry of New Jersey, is one of the pioneers in understanding allergies and food sensitivities in young children. Some of her research can be found in chapter 19 of “Autism – A Neurodevelopmental Journey from Genes to Behaviour,” which can be downloaded for free here.