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How to Implement the GFCF Diet: Tips for Parents of Autistic Children

A lot has been said about the gluten-free, casein-free (GFCF) diet and its use to help kids on the autism spectrum. There is growing interest in the link between autism spectrum disorders and gastrointestinal ailments. 
 
Research studies have revealed the following:
  • autistic kids were more likely to have antibodies to gluten than typically-developing kids, which may point to immune and/or intestinal abnormalities in those kids
  • kids on the autism spectrum were more likely to have abnormal immune responses to wheat, milk, and soy than typically-developing kids
  • kids on the autism spectrum were 7 times more likely to have diarrhea or colitis than children with no disorder



In a different study, researchers used survey information from moms and dads to conclude that the GFCF diet may improve behavior and GI symptoms in some autistic children.

One theory suggests that some autistic children can’t properly digest gluten and casein, which results in the formation of peptides (i.e., substances that act like opiates in the body). The peptides then alter the child's perceptions, behavior, and responses to his or her environment. Also, some researchers now believe that peptides trigger an unusual immune system response in certain children. Studies have found peptides in the urine of a significant number of autistic kids.

A theory behind the use of the GFCF diet in autism is that if a child is having GI responses to gluten and casein, the resulting inflammation can damage the lining of the intestine, thus leading to absorption of molecules that are not normally absorbed by healthy intestines. Evidence suggests that these molecules (or the inflammation they cause) may interact with the child’s brain in ways that cause significant problems (e.g., mood abnormalities, anxiety, mental difficulties) that worsen the behavioral symptoms of autism.

If your youngster has gastrointestinal problems and sensitivity to certain foods that contain gluten or casein, then the GFCF diet is worth considering. If you do decide to embark on a trial of the diet, the first thing you should do is make a list of the benefits you want to see (e.g., better sleeping patterns, less acting-out behaviors, increased ability to focus, etc.). Make this list a week before you start your youngster on the diet.  

Next, keep a diary of the behaviors or other symptoms of concern to you. For instance, if you hope the diet will improve your child’s diarrhea, you need to know exactly where you are starting (e.g., he or she has diarrhea 7 days a week). Then, continue to log relevant information in the diary as your youngster starts the diet. Two weeks later, does he or she still have diarrhea 7 times a week? If not, then the diet may be beneficial.

This procedure is called “establishing a baseline.” The problem with NOT establishing a baseline is that you and your physician are left with uncertainties about the effectiveness of the diet. This makes it difficult to decide whether to continue with the diet or not. So, take the time to establish a baseline.

In addition to establishing a baseline, you may want to discuss the diet with your youngster’s physician.  Some physicians are more familiar than others with the GFCF diet’s popularity in treating the symptoms of autism.  But, most physicians understand the dietary restrictions involved and how they interact with a youngster’s unique nutritional needs and health conditions.

Also, a nutritionist can provide guidance around the GFCF diet. Some parents believe they are providing a GFCF diet, but actually continue to offer their child foods that contain gluten or casein. These proteins can be in some foods that parents don’t suspect.

How long should you continue the GFCF diet with your child? It can take months for your child’s gut to heal with clear improvements in gastrointestinal symptoms.  So, a trial of 3 to 6 months should be enough to see the benefits. If you do continue with the diet beyond the 3 month period, your youngster should take a daily multivitamin supplement to ensure adequate amounts of recommended vitamins and minerals.

Some advocates of the GFCF diet suggest removing one food from the diet at a time so you will know which food was causing a problem. It's often recommended to remove milk first, because your child’s body will clear itself of milk/casein the quickest. Then, gluten can be removed a month or so after eliminating milk. Also, it is helpful to ask other adults (e.g., teachers, babysitters, etc.) who know your child and see him or her frequently – and who do not know about the dietary change – if they see any improvements after a couple months.

Try to find a substitute for milk that your youngster can tolerate (e.g., almond milk, coconut or rice milk). Also, you can find gluten-free flours in many grocery, specialty and health food stores (e.g., waffles, pretzels, pasta made of rice, crackers, cookies, cereal, bread, etc.). Many products are already gluten-free and casein-free (e.g., rice, quinoa, amaranth, potatoes, buckwheat flour, corn, fruits, vegetables, beans, tapioca, meat, poultry, fish, shellfish, nuts, eggs, sorghum, etc.).

In addition to gluten and casein, some moms and dads report that removing soy or corn led to equal or greater improvements in their autistic kids. Since soy protein is similar to gluten and casein, some diet advocates suggest removing it if the youngster seems very sensitive or does not improve on the GFCF diet.

Sample GFCF Diet Plan—

Week 1:
  • Monday: Hamburgers, Ore-Ida French Fries
  • Tuesday: Honey Chicken Thighs, Honey Roasted Carrots, Mashed Potatoes
  • Wednesday: Spaghetti Squash Marinara, Salad
  • Thursday: Ham, Pineapple, Green Beans
  • Friday: Catalina Chicken
  • Saturday: Turkey Chili served over Fritos, Fruit Salad
  • Sunday: Franks ‘n’ Beans, Corn

Week 2:
  • Monday: Honey Mustard Fish, Sugar Snap Peas, Rice
  • Tuesday: Tacos, Refried Beans, Mexican Rice
  • Wednesday: Creamy Penne Pasta
  • Thursday: Barbecue Brisket, Potato Salad
  • Friday: Shepherd’s Pie
  • Saturday: Red Honey Chicken Drumsticks, Peas, Mac & Cheese 
  • Sunday: Honey Orange Pork Chops, Butternut Crunch

Week 3:
  • Monday: Chicken Nuggets, Pasta Salad, Mango slices
  • Tuesday: Meatloaf, Roasted New Potatoes, Broccoli
  • Wednesday: Sweet Wine Fish, Edamame, Sushi rice
  • Thursday: Barbecue Chicken, Corn on the cob, Watermelon
  • Friday: Pork Chops with Pears, Mashed potatoes
  • Saturday: Beef Stir Fry
  • Sunday: Pot Roast

Week 4:
  • Monday: Almond-Crusted Chicken, Salad, Cinnamon Apples
  • Tuesday: Greek Wraps with Cucumber Tzatziki
  • Wednesday: Vegetable Soup, Corn Bread 
  • Thursday: Turkey Meatballs, Green beans, GFCF Rolls
  • Friday: Banh Bao, Spring Rolls
  • Saturday: Tandoori Chicken with Potatoes
  • Sunday: Lemon Chicken, Asparagus, Sautéed Mushrooms

Week 5:
  • Monday: Cajun Fish
  • Tuesday: Greek Flank Steak, Sautéed Peppers and Onions, Stuffed Tomatoes
  • Wednesday: Pulled Pork Sandwiches, Coleslaw Salad
  • Thursday: Fish Tacos
  • Friday: Green Chicken Curry
  • Saturday: Chicken and Rice Casserole, Sliced Peaches
  • Sunday: Mexican Pizza

More information on diet plans for autistic children can be found here:

Resources for parents of children and teens on the autism spectrum:
 
 


BEST COMMENT:
 
Almost 2 years ago now we were at our wits-end trying to find a medication/treatment that would alleviate my son's constant anger & irritability. He has been taking Risperdal for many years & it has helped, but it wasn't a "miracle" situation that seemed to solve everything. We went GLUTEN-FREE. It is known that gluten, an un-digestable protein found in wheat & other grains, is a "poison" for the brain & body..especially for those with neurological conditions such as Aspergers or ADHD. It was our last-ditch effort. It seemed daunting because there are many things you just can't eat..but nowadays almost every store or restaurant you may go to has gluten-free foods & options. Anyway..It took a few weeks to "kick-in" but my son's anger & irritability literally WENT AWAY! His general mood was happy & at-ease rather than on a constant short fuse. His hyperactivity did not go away..but his antics became more silly & fun in nature instead of mischievous & problematic. He absolutely loves all the food too! So as I mentioned my son has other mental issues that simply going gluten-free will not resolve but as far as his general mood on a day-to-day basis, it has made an amazing difference!

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