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Gluten- and casein-free diet and autism spectrum disorders in children: a systematic review

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Abstract

Purpose

Effective treatments for core symptoms of autism spectrum disorders (ASD) are lacking. We systematically updated evidence on the effectiveness of a gluten-free and casein-free (GFCF) diet as a treatment for ASD in children.

Methods

The Cochrane Library, MEDLINE, and EMBASE databases were searched up until August 2016, for randomized controlled trials (RCTs); additional references were obtained from reviewed articles.

Results

Six RCTs (214 participants) were included. With few exceptions, there were no statistically significant differences in autism spectrum disorder core symptoms between groups, as measured by standardized scales. One trial found that compared with the control group, in the GFCF diet group there were significant improvements in the scores for the ‘communication’ subdomain of the Autism Diagnostic Observation Schedule and for the ‘social interaction’ subdomain of the Gilliam Autism Rating Scale. Another trial found significant differences between groups in the post-intervention scores for the ‘autistic traits’, ‘communication’, and ‘social contact’ subdomains of a standardized Danish scheme. The remaining differences, if present, referred to parent-based assessment tools or other developmental/ASD-related features. No adverse events associated with a GFCF diet were reported.

Conclusions

Overall, there is little evidence that a GFCF diet is beneficial for the symptoms of ASD in children.

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Author notes

  1. Anna Piwowarczyk and Andrea Horvath have contributed equally.

Authors and Affiliations

  1. Department of Paediatrics with Clinical Decisions Unit, The Medical University of Warsaw, Żwirki i Wigury 63a, 02-091, Warsaw, Poland

    Anna Piwowarczyk

  2. Department of Paediatrics, The Medical University of Warsaw, Żwirki i Wigury 63a, 02-091, Warsaw, Poland

    Andrea Horvath, Jan Łukasik & Hania Szajewska

  3. Department of Rehabilitation Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland

    Ewa Pisula

Authors
  1. Anna Piwowarczyk
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  2. Andrea Horvath
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  3. Jan Łukasik
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  4. Ewa Pisula
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  5. Hania Szajewska
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Contributions

AH initially conceptualized this study. AP and JŁ were responsible for data collection. HS and AH assumed the main responsibility for the writing of this manuscript. All authors were responsible for data analysis and data interpretation. All authors contributed to (and agreed upon) the final version of this manuscript.

Corresponding author

Correspondence to Andrea Horvath.

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Conflict of interests

AH and AP are the recipients of a grant from the Fundacja Nutricia (Nutricia Foundation) under Grant RG8/2013 to carry out the study on ASD and a gluten-free diet. Other authors declare no conflict of interests.

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Piwowarczyk, A., Horvath, A., Łukasik, J. et al. Gluten- and casein-free diet and autism spectrum disorders in children: a systematic review. Eur J Nutr 57, 433–440 (2018). https://doi.org/10.1007/s00394-017-1483-2

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  • DOI: https://doi.org/10.1007/s00394-017-1483-2

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