you are what you eat a review of diets for autism treatment erika koelsch

You Are What You EatA Review of Diets for Autism Treatment

Erika Koelsch

Search Critera

PsychInfo, Academic Search Premiere, ERIC, MEDLINE

“autis*” and “diets”, “gluten”, “gluten-free”, “casein-free”, “Feingold”.

Google searches

“Autism and diets”, “gluten-free diets”, “casein-free diets”, “celiac disease”, “Defeat Autism Now”, “Feingold”.

What Diets are out there for Autism Treatment?

GFCF (Gluten-Free, Casein-Free)

Specific Carbohydrate Diet

Feingold Diet

Autism Research Institute Non-profit founded in 1967

Bernard Rimland, Ph.D

Conferences about GI disorders “impact a child’s sense of self, behavior, attention, speech, and general health and wellbeing. Our SCIENTIFIC principles and protocols apply to affected children of all ages, and varying conditions.” Jane Johnson, Managing Director, ARI

Credit ABA, OT and Speech however…..

“little true or lasting progress or benefit can be expected.”

Autism Research Institute. (2010). Retrieved from http://www.autism.com/

Autism Research Institute Conference. (2010). Retrieved from http://www.defeatautismnow.com/

Defeat Autism Now! (DAN! Project)

Sidney M. Baker, M.D. in 1994

biochemical, immunologic, and gastroenterological

Point to new biomedical treatments

Dr. Baker, Dr. Rimland and Dr. Jon Pangborn founded Defeat Autism Now!

Objectives of Defeat Autism Now!

Teach about biomedical treatments

Offer conferences about latest research on biomedical treatments for autism

Provides a list through ARI of DAN! Doctors in the US and outside


DAN! Doctors

From the ARI website, DAN! Doctors must meet these criteria to be placed on the list: “The clinician is a licensed healthcare provider.

The clinician must attend a Defeat Autism Now!® Clinician Seminar at least once every two years.

Starting in 2010, clinicians must attend a level I and a level II seminar to be listed on ARI's clinician registry.

ARI reserves the right at their sole discretion to not include, or to remove, a practitioner from the Clinician Registry.”

Doctors must also adhere to the Defeat Autism Now! Philosophy

Also lists for naturopaths and homeopaths and nutritionists


DAN! Conferences

http://www.autism.com/pro_categories.asp?con=Baltimore&Year=2010

Defeat Autism Now! October Conference Science Sessions

Mitochondria and Autism

Update on Gastrointestinal Topics in Autism

Redox Effects of Gluten/Casein Peptides and Neurotrophic Growth Factors and Their Implications for Autism

All Speakers are MDs or Ph.ds


RED FLAGS of ARI and DAN!

Remark on importance of biomedical without supporting details or evidence website … propaganda? Pseudoscience?

Big names and buzzwords

DAN! Doctors

Red Flag?


What is a Gluten Free Diet?

Often called GFCF (gluten-free, casein-free diet)

Removal of all gluten and casein from daily diet

What is a casein?

Casein is a protein found in milk

Gluten/Casein free diet consists of no gluten and no milk/dairy products including casein

Gluten-Free/Casein-Free Diets for Autism. (2010). WebMD. Retrieved from http://www.webmd.com/brain/ autism/gluten-free-casein-free-diets-for-autism

What is Celiac Disease?

Damage to the small intestine

Absorption of food difficulties

Gluten- protein in wheat, rye and barley

Gluten found in food or other products

Special considerations

Untreated can cause anemia, and cancer

Sometimes does not show symptoms

National Digestive Diseases Information Clearinghouse. (2010). Celiac Disease. Retrieved from http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/

Symptoms

Symptoms of Celiac Disease In Children and Infants:

Bloating or abdominal pain

Diarrhea

Vomiting

Constipation

In Adults: Anemia

Fatigue

Joint pain

Depression or anxiety

Seizures

Miscarriage/infertility

Co morbidityNational Digestive Diseases Information Clearinghouse. (2010). Celiac Disease. Retrieved from http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/

Treatment for Celiac Disease

GLUTEN-FREE DIET

Gluten-Free Diet Video

Elizabeth Hasselbeck

http://www.youtube.com/watch?v=oSJ-nrYETzs

Gluten-Free/ Casein-Free and ASDs

Why are gluten-free casein-free diets relevant to those with ASDs? Suggested that:

These diets reduce symptoms of autism

Assist with children who have a food allergy

Promote skill acquisition

Many parents have stated incredible success in their child with ASDs

Overall consistency between Vaccines and Diets

Biomedical model

The GFCF Diet Intervention - Autism Diet. (n.d.). Retrieved from http://www.gfcfdiet.com

How does this occur?

Various GI symptoms in those with autism

Diarrhea, bloating, pain

Associated with abnormalities in small intestine mucous and GI function

In those with autism, the walls of the small intestine are “leaky” and therefore gluten and casein proteins go into blood stream

The dietary gluten and casein in the bloodstream create peptides that are similar to opioid substances

This induces “antigenic” responses which affects the central nervous system

“Opioid Excess” theory of autism

Reaction to pain, hunger and thirstMunasinghe, S. A., Oliff, C., Finn, J., & Wray, J. A. (2010). Digestive Enzyme Supplementation for Autism Spectrum Disorders: A Double-Blind Randomized Controlled Trial. Journal of Autism and Developmental Disorders, 40, 1131-1138.

ANDI

Autism Network for Dietary Intervention

Offers information for parents of children with autism on special diets

Newsletters

Sample Letter

http://www.autismndi.com/

Autism Network for Dietary Intervention. (2010). Retrieved from http://www.autismndi.com/

AutismONE

AutismOne

Non-profit started by parents of children with autism

Very disturbing website in many ways

http://www.autismone.org/

AutismOne. (2010). Retrieved from http://www.autismone.org/

Talk About Curing Autism (TACA)

Focuses on newly diagnosed children with autism

Most successful combination

Traditional Therapies

Biomedical Therapies

Keeping Family Healthy

Mission:

To speed up time between diagnosis and appropriate intervention

Connect parents and provide support

TACA: Talk About Curing Autism . (2010). Retrieved from http://www.talkaboutcuringautism.org/support/autism_intro.htm

The TACA Spokeswoman….

JENNY MCCARTHY

http://www.youtube.com/watch?v=zVZDPrgwZ78

Julie Matthews

Healthful Living

With husband Martin Matthews created a “lifestyle that promotes the health, healing, and happiness of all living things”

Martin Matthews Hypnotherapist

Focuses on personal wellness, personal freedom, emotional trauma, and stress reduction

Julie Matthews Certified Nutrition Consultant

Focuses on ASDs, pregnancy wellness, woman’s health, digestion

Nourishing Hope for Autism

Healthful Living. (2010). Retrieved from http://www.healthfullivingsf.com/

Nourishing Hope For Autism


Julie Matthews

Holistic Nutrition Uses basic needs of body

Traditional “Healing” Foods

Addresses the whole person

The Flow-Chart http://

www.healthfullivingsf.com/autism/

Supports nutrition for healthy living--- AND autism dietary interventions

http://www.prweb.com/releases/2007/10/prweb560337.htm


Newsletter

“Reality Sandwich”

Various guests on upcoming radio show

For example:

Hypno-Birthing


Correspondence

GFCF website

Ellie Fried ( North Jersey Chapter of R.O.C.K- Raising our Celiac Kids)

"Raising Our Celiac Kids (R.O.C.K.)" We welcome families of children with autistic spectrum disorders who are using a gluten-free/casein-free dietary intervention program.

http://www.gfcfdiet.com/communitybulletinboard.htm

Correspondence

Julie Matthews

Referred me to her book, Nourishing Hope for Autism

Another example of self-citing

Felix

29 year old

Lives in Denmark

Has Asperger’s Syndrome

Chronicles Gluten-Casein Free Diet journey on YouTube

http://www.youtube.com/user/BumsenDK#p/a/u/0/FEjdCFPK3Jk

BumsenDk's Channel. (2010). Retrieved from http://www.youtube.com/user/BumsenDK#p/a/u/0/FEjdCFPK3Jk

What does Gluten-Free, Casein-Free diets claim to do?

By not eating gluten or casein, eliminate the proteins from entering the bloodstream

Eliminating opiod effects and autism symptoms

Munasinghe, S. A., Oliff, C., Finn, J., & Wray, J. A. (2010). Digestive Enzyme Supplementation for Autism Spectrum Disorders: A Double-Blind Randomized Controlled Trial. Journal of Autism and Developmental Disorders, 40, 1131-1138.

Special Carbohydrate Diet

Dr. Haas pioneered the Haas diet in 1951

Fungi and Bacteria in GI track Renews toxin removal system Supported by Dr. Sidney Baker Removal of starches and

complex sugars “This removal helps kill major

yeast and bacterial overgrowth. Mal-absorption decreases, rebalancing gut flora and encouraging healing.”

http://www.pecanbread.com/

http://www.The Scientific Diet for GI Problems, Autism, and Other Conditions. (n.d.). Retrieved from http://pecanbread.com/ .pecanbread.com

What does Special Carbohydrate Diet claim to do?

Heal GI tract by removing starches that damage it over time

Deal with gluten/casein intolerance rather than resolve symptoms

Combat celiac disease by curing intolerance

http://www.The Scientific Diet for GI Problems, Autism, and Other Conditions. (n.d.). Retrieved from http://pecanbread.com/ .pecanbread.com

Feingold Diet (Feingold Association of the United States)

Feingold Diet

Dr. Ben F. Feingold

Linked diet and behavior in 1960s

Later in life, he travelled the US to spread the message of the Feingold Diet to those areas that were not yet exposed.

Feingold Association of the United States. (2010). Retrieved from http://www.feingold.org/

What is the Feingold Diet?

Originally used for ADHD, however now used for other disorders/conditions

Elimination of artificial additives

Artificial (synthetic) coloring

Artificial (synthetic) flavoring

Aspartame (NutraSweet, an artificial sweetener)

Artificial (synthetic) preservatives BHA, BHT, TBHQ

http://www.youtube.com/watch?v=Uptp94xLchk


What is involved?

Program materials ($82.50) Food and shopping list

Feingold member book

Supplement guide

Mail order guide

Fast Food Guide

Pure Facts Newsletter

Members section on website

Help-Line

Email alerts

http://www.feingold.org/DOCS/brochure.pdf


What does the Feingold Diet Claim to do?

Commonly helps

Behavior

Learning

Health


Behavior

Marked Hyperactivity Inability to sit still

Wiggling

Running

Impulsive Actions Poor self-control

Disruptive behavior

Abusive behavior (e.g., unkindness to pets)

Destructive behavior

Excessive, loud talking

Inappropriate noise

Compulsive Actions Aggression

Perseveration

Excessive touching

Picking skin

Workaholic habits

Emotional Concerns Attention

Irritability

Mood swings

Depression

Panics and nervousness

Suicidal thoughtsFeingold Association of the United States. (2010). Retrieved from http://www.feingold.org/

Learning

Short Attention Span

Impatience

Distraction

Inability to listen

Inability to follow directions

Inability to complete projects

Cognitive and Perceptual Disturbances

Auditory memory deficits

Visual memory deficits

Difficulty in comprehension

Difficulty in Spatial Orientation

Difficulties in reasoning

Neuromuscular Involvement

Accident prone

Poor muscular coordination

Difficulty writing and drawing

Dyslexia

Speech difficulties

Difficulty with sports

Eye muscle disorders

Tics

Seizures


Health

Frequent Physical Complaints Ear infections

Asthma

Bedwetting

Daytime wetting

Stomachaches

Headaches

Hives/Rashes

Eczema

Leg aches

Congestion

Seizures

Sleep Problems Resistance going to

bed

Difficulty going to sleep

Restless erratic sleep

Nightmares


MORE on the Reputable Feingold Website… Research

Many references for different disorders/conditions

A list of references published by Dr. Feingold himself

The Feingold Shop

Totes

T-shirts

Mugs

Christmas stockings

“I’m 100% Natural”

“Artificial Colors are Good for Crayons”

“If you love me, please don’t feed me junk”


Research to Support these Claims? Few studies however, none with statistical significance

Digestive Enzyme Supplementation for Autism Spectrum Disorders: A Double Blind Randomized Controlled Trial

Munasighe, et al.

The Gluten-Free, Casein-Free Diet in Autism: Results of a Preliminary Double Blind Clinical Trial

Elder, et al.

Review article: the concept of entero-colonic encephalopathy, autism and opiod receptor ligands

A.J. Wakefield, et al.


Purpose:

Does digestive enzyme supplement (Peptizyde) improve expressive language, behavior and other symptoms in ASDs

Participant

43 children, 3-8 years-old, with ASD

Method

Two groups-

Sequence 1- Enzyme, washout, Placebo

Sequence 2- Placebo, washout, Enzyme

.



Rating Scales- completed monthly Global Behavior Rating Scale (GBRS)- effects of synthetic

secretion on behavior and communication. Ordinal scale- 1) much worse, 4) no change, 7) much better

Additional Rating Scale (ARS)- GI symptoms Quality of stools, Abdominal pain, diarrhea/constipation

Therapist Rating Scale Teacher rating

Language Development Survey

Results? No significant difference!!

Food variety score, parent behavior score, GI symptoms, Sleep quality, therapist engagement, Vocabulary score, sentence length score.



Purpose:

Study gluten-free, casein-free diet in treating autism

Participants

15 children, 2-16 years-old with ASD

Method

2 Groups

Group A- Baseline, Diet 1 (regular diet), Diet 2 (GFCF diet)

Group B- Baseline, Diet 2 (GFCF), Diet 1 (regular diet)

Elder, J. H., Shankar, M., Shuster, J., Theriaque, D., Burns, S., & Sherrill, L. (2006, April). The Gluten-Free, Casein-Free Diet in Autism: Results of a Preliminary Double Blind Clinical Trial. Journal of Autism and Developmental Disorders, 36(3), 413-420.


Rating Scales

CARS- Childhood Autism Rating Scale

ADI-R- Autism Diagnostic Interview, Revised

In home observations

UPL- Urinary Peptide Levels

ECO- Ecological Communication Orientation (Language Sampling Summary)

No statistically significant difference on any of the rating scales

Elder, J. H., Shankar, M., Shuster, J., Theriaque, D., Burns, S., & Sherrill, L. (2006, April). The Gluten-Free, Casein-Free Diet in Autism: Results of a Preliminary Double Blind Clinical Trial. Journal of Autism and Developmental Disorders, 36(3), 413-420.

Review article: the concept of entero-colonic encephalopathy, autism and opiod receptor ligands

Gut development and autism

Reported:

46% of children out of 385 with autism had GI symptoms

10% of children 385 typically developing

Description of autism…?

Described many studies with autism and GI symptoms

Connection between Opiods and CNS

No real research or connections, just review of previous research

Wakefield, A. J., Puleston, J. M., Montgomery, S. M., Anthony, A., O'Leary, J. J., & Murch, S. H. (2002). Review article: the concept of entero-colonic encephalopathy, autism and opiod receptor ligands. Ailment Pharmacological Therapy, 16, 663-674.

Are Diets Worth It?

NO!

For autism Treatment, no!

No scientific evidence to prove its effects

Healthy lifestyle? Vs Diets for treatment

To quote Dr. Sharon Reeve…

In Conclusion…

http://www.youtube.com/watch?v=3zEXgQIYCWU&feature=related

Any Questions?

THANK YOU!

References

Autism Network for Dietary Intervention. (2010). Retrieved from http://www.autismndi.com/



AutismOne. (2010). Retrieved from http://www.autismone.org/ Elder, J. H., Shankar, M., Shuster, J., Theriaque, D., Burns, S., &

Sherrill, L. (2006, April). The Gluten-Free, Casein-Free Diet in Autism: Results of a Preliminary Double Blind Clinical Trial. Journal of Autism and Developmental Disorders, 36(3), 413-420.


Glutein-Free/Casein-Free Diets for Autism. (2010). WebMD. Retrieved from http://www.webmd.com/brain/ autism/gluten-free-casein-free-diets-for-autism

References Cont.

The GFCF Diet Intervention - Autism Diet. (n.d.). Retrieved from http://www.gfcfdiet.com



TACA: Talk About Curing Autism . (2010). Retrieved from http://www.talkaboutcuringautism.org/support/ autism_intro.htm The Scientific Diet for GI Problems, Autism, and Other Conditions. (n.d.). Retrieved from http://pecanbread.com/

Wakefield, A. J., Puleston, J. M., Montgomery, S. M., Anthony, A., O'Leary, J. J., & Murch, S. H. (2002). Review article: the concept of entero-colonic encephalopathy, autism and opiod receptor ligands. Ailment Pharmacological Therapy, 16, 663-674.

YouTube. (2010). Retrieved from http://www.youtube.com

you are what you eat a review of diets for autism treatment erika koelsch

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