Anna Piwowarczyk1, Andrea Horvath2, Jan Łukasik3, Ewa Pisula4, Hania Szajewska3. 1. Department of Paediatrics with Clinical Decisions Unit, The Medical University of Warsaw, Żwirki i Wigury 63a, 02-091, Warsaw, Poland. 2. Department of Paediatrics, The Medical University of Warsaw, Żwirki i Wigury 63a, 02-091, Warsaw, Poland. andrea.hania@gmail.com. 3. Department of Paediatrics, The Medical University of Warsaw, Żwirki i Wigury 63a, 02-091, Warsaw, Poland. 4. Department of Rehabilitation Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland.
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.
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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