Liuliu Quan1, Xinjie Xu2, Yonghong Cui3, Heze Han1, Robert L Hendren4, Lidan Zhao1,5, Xin You1,5,6,7. 1. Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 2. Medical Science Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. 3. Department of Blood Immunity, General Hospital of Shanxi Datong Tongmei Group, Datong, China. 4. Department of Psychiatry, University of California, San Francisco, California, USA. 5. Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China. 6. National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China. 7. Autism Special Fund, Peking Union Medical Foundation, Beijing, China.
Abstract
CONTEXT: It has been suggested that a gluten-free and casein-free (GFCF) diet may alleviate the symptoms of autism spectrum disorder (ASD) and facilitate neurodevelopment of children with ASD. Studies to date have been inconclusive. OBJECTIVE: This study aimed to evaluate (through quantitative meta-analysis) the efficacy and safety of a GFCF diet for children with ASD. To our knowledge, this is the first time such an analysis has been carried out. DATA SOURCES: Eight electronic databases were searched, from the establishment of each database up to March 27, 2020: PubMed, Web of Science, Embase (Ovid), PsycINFO (Ovid), Cochrane Library, CNKI, Wanfang, and VIP databases. DATA EXTRACTION: Two authors independently performed the data extraction and risk-of-bias assessment. DATA ANALYSIS: A quantitative meta-analysis was performed with standard procedures by using Stata SE 15 software. Within the total of 8 studies, with 297 participants, 5 studies reported significant reductions in stereotypical behaviors [standard mean difference (SMD) = -0.41, 95% confidence interval (CI): -0.68 to -0.15], and 3 studies reported improvements in cognition (SMD = -0.46, 95% CI: -0.91 to -0.01) following GFCF dietary intervention . No statistically significant changes were observed in other symptomatic categories (all P > 0.05). CONCLUSION: The current meta-analysis showed that a GFCF diet can reduce stereotypical behaviors and improve the cognition of children with ASD. Though most of the included studies were single-blind, the benefits of a GFCF diet that have been indicated are promising. Additional studies on a larger scale are warranted. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42020177619.
CONTEXT: It has been suggested that a gluten-free and casein-free (GFCF) diet may alleviate the symptoms of autism spectrum disorder (ASD) and facilitate neurodevelopment of children with ASD. Studies to date have been inconclusive. OBJECTIVE: This study aimed to evaluate (through quantitative meta-analysis) the efficacy and safety of a GFCF diet for children with ASD. To our knowledge, this is the first time such an analysis has been carried out. DATA SOURCES: Eight electronic databases were searched, from the establishment of each database up to March 27, 2020: PubMed, Web of Science, Embase (Ovid), PsycINFO (Ovid), Cochrane Library, CNKI, Wanfang, and VIP databases. DATA EXTRACTION: Two authors independently performed the data extraction and risk-of-bias assessment. DATA ANALYSIS: A quantitative meta-analysis was performed with standard procedures by using Stata SE 15 software. Within the total of 8 studies, with 297 participants, 5 studies reported significant reductions in stereotypical behaviors [standard mean difference (SMD) = -0.41, 95% confidence interval (CI): -0.68 to -0.15], and 3 studies reported improvements in cognition (SMD = -0.46, 95% CI: -0.91 to -0.01) following GFCF dietary intervention . No statistically significant changes were observed in other symptomatic categories (all P > 0.05). CONCLUSION: The current meta-analysis showed that a GFCF diet can reduce stereotypical behaviors and improve the cognition of children with ASD. Though most of the included studies were single-blind, the benefits of a GFCF diet that have been indicated are promising. Additional studies on a larger scale are warranted. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42020177619.
Authors: Vincent T Ramaekers; Sheldon P Rothenberg; Jeffrey M Sequeira; Thomas Opladen; Nenad Blau; Edward V Quadros; Jacob Selhub Journal: N Engl J Med Date: 2005-05-12 Impact factor: 91.245
Authors: Pablo José González-Domenech; Francisco Díaz Atienza; Carlos García Pablos; María Luisa Fernández Soto; José María Martínez-Ortega; Luis Gutiérrez-Rojas Journal: J Autism Dev Disord Date: 2020-03