Increased intake of health-promoting foods as a benefit of the exclusion of gluten and casein from the diet of ASD patients
Main Article Content
Keywords
autism, gluten-free diet, casein-free diet, nuts, berry fruits
Abstract
The high intake of nuts, seeds, berries and cruciferous vegetables has beneficial effects on the immune system, as well as communication skills and behaviour. Gluten- and/or casein-free diets are the most common interventions in ASD patients; however, scientific evidence for their use is poor. Previous research has not yet examined the effect of the change in the frequency of consumption of nuts, seeds, berries and cruciferous vegetables following the implementation of elimination diets in ASD children. A sample of 88 ASD patients and their mothers was followed for 12 months after making their free choice of a gluten-free diet, a gluten- and casein-free diet or a regular diet. Children with ASD on a gluten- and casein-free diet have significantly higher intake of seeds, berry fruits and cruciferous vegetables than controls, while patients on a gluten-free diet consumed more frequently seeds and cruciferous vegetables. In both groups, after dietetic intervention, the frequency of nut consumption tended to be higher than in patients on a regular diet. Unflagging interest and frequently reported subjective feelings of improvement in parents of autistic children on elimination diets may be due to the healthy balance of modified diets and their multidirectional impact.
References
1. Lord C, Elsabbagh M, Baird G, Veenstra-Vanderweele J. Autism spectrum disorder. Lancet 2018; 392(10146):508-520.
2. Zeidan J, Fombonne E, Scorah J, Ibrahim A, Durkin MS, Saxena S, Yusuf A, Shih A, Elsabbagh M. Global prevalence of autism: A systematic review update. Autism Res 2022; 15:778-790.
3. Lenart A, Pasternak J. Resources, problems and challenges of autism spectrum disorder diagnosis and support system in Poland. J Autism Dev Disord 2023; 53: 1629-1641.
4. Whiteley P, Rodgers J, Shattock P. Feeding patterns in autism. Autism 2000; 4: 207-211.
5. van der Horst K, Deming DM, Lesniauskas R, Carr BT, Reidy KC. Picky eating: associations with child eating characteristics and food intake. Appetite 2016; 103: 286-293.
6. Zeybek SG, Yurttagül M. Nutrient status, diet quality and growth parameters of children with autism spectrum disorder in Northern Cyprus. Progress Nutr 2020;22: e2020020.
7. Evans EW, Must A, Anderson SE. Dietary patterns and body mass index in children with autism and typically developing children. Res Autism Spectr Disord 2012; 6: 399-405.
8. Canals-Sans J, Esteban-Figuerola P, Morales-Hidalgo P, Arija V. Do children with autism spectrum disorders eat differently and less adequately than those with subclinical ASD and typical development? EPINED Epidemiological Study. J Autism Dev Disord 2022; 52: 361-375.
9. Masi A, Glozier N, Dale R, Guastella AJ. The immune system, cytokines, and biomarkers in autism spectrum disorder. Neurosci Bull 2017; 22: 194-204.
10. Gładysz D, Krzywdzińska A, Hozyasz KK. Immune abnormalities in autism spectrum disorder – could they hold promise for causative treatment? Mol Neurobiol 2018; 55: 6387-6435.
11. Robinson-Agramonte ML, Noris Garcia E, Fraga Guerra J, et al. Immune dysregulation in autism spectrum disorder: What do we know about it? Int J Mol Sci 2022; 23: 3033.
12. George ES, Daly RM, Tey SL, Brown R, Wong TH, Tan SY. Perspective: Is it time to expand research on “nuts” to include “seeds”? Justifications and key considerations. Adv Nutr 2022; 13: 1016-1027.
13. Hill CR, Shafaei A, Balmer L, Lewid JR, Hodgson JM, Blekkenhorst LC. Sulfur compounds: From plants to humans and their role in chronic disease prevention. Crit Rev Food Sci Nutr 2022;5:1-23.
14. Pribis P, Shukitt-Hale B. Cognition: the new frontier for nuts and berries. Am J Clin Nutr 2014; 100(suppl.): 347S-352S.
15. Yeung AW, Tzvetkov NT, Zengin G, et al. The berries on the top. J Berry Res 2019; 9: 125-139.
16. Abellán A, Domiguez-Perles R, Moreno DA, Garcia-Viguera C. Sorting out the value of cruciferous sprouts as sources of bioactive compounds for nutrition and health. Nutrients 2019; 11: 429.
17. Moaaz M, Youssry S, Elfatatry A, El Rahman MA. Th17/Treg cells imbalance and their related cytokines (IL-17, Il-10 and TGF-ß) in children with autism spectrum disorder. J Neuroimmunol 2019;337:577071.
18. Barone R, Rizzo R, Tabbi G, Malaguarnera M, Frye RE, Bastin J. Nuclear peroxisome proliferator-activated receptors (PPARs) as therapeutic targets of resveratrol for autism spectrum disorder. Int J Mol Sci 2019;20:1878.
19. Jyonouchi H, Geng L, Rose S, Bennuri SC, Fry RE. Variations in mitochondrial respiration differ in IL-1ß/IL-10 ratio based subgroups in autism spectrum disorders. Front Psychiatry 2019;10:71.
20. Kuo M-Y, Ou H-C, Lee WJ, et al. Ellagic acid inhibits oxidized low-density lipoprotein (OxLDL)-induced matallproteinase (MMP) expression by modulating the protein kinase C-α/extracellular signal-regulated kinase/peroxisome proliferator-activated receptorγ/nuclear factor-ĸB (PKC-α/ERK/PPAR-γ/NFĸB) signalling pathway in endothelial cells. Agric Food Chem 2011;59:5100-5108.
21. van Elst K, Bruining H, Birtoli B, Terreaux C, Buitelaar JK, Kas MJ. Food for thought: Dietary changes in essential fatty acid ratios and the increase in autism spectrum disorders. Neurosci Biobehav Rev 2014;45:369-378.
22. Hurwitz S. The gluten-free, casein-free diet and autism. Limited return on family investment. J Early Interv 2013; 35: 3-19.
23. Gonzalez-Domenech PJ, Diaz-Atienza F, Gutierrez-Rojas L, Fernandez-Soto ML, Gonzalez-Domenech CM. A narrative review about autism spectrum disorders and exclusion of gluten and casein from the diet. Nutrients 2022; 14:1797.
24. Winburn E, Charlton J, McConachie H, et al. Parents’ and child health professionals’ attitudes towards dietary interventions for children with autism spectrum disorders. J Autism Dev Disord 2014;44:747-757.
25. Wądołowska L. [Validation of food frequency questionnaire-FFQ. Reproducibility assessment]. Bromat Chem Toksykol 2005; 38: 27-33 (in Polish).
26. Niedzwiedzka L, Wadolowska L, Kowalkowska J. Reproducibility of a non-quantitative Food Frequency Questionnaire (62-item FFQ-6) and PCA-driven dietary pattern identification in 13-21- year-old females. Nutrients 2019;11:2183.
27. Wadolowska L, Kostecka M, Kowalkowska J, et al. Sustainability of a Multi-Component Education Program (ABC of Healthy Eating) after three months and nine months. The socioeconomical context in improving nutrition knowledge in Polish teenagers. Nutrients 2021;13: 1661.
28. Jąder K. [Changes in production and consumption of vegetables and their relationships in a regional perspective]. Intercathedra 2019;39:141-151 (in Polish).
29. Łuczaj Ł, Szymański WM. Wild vascular plants gathered for consumption in the Polish countryside: a review. J Ethnobiol Ethnomed 2007;17:3.
30. Hozyasz KK. From rediscovered “niche” to “mainstream” – Glyceria fluitans as candidate grain for manufacturing premium food products. Plants People Planet 2020; 2: 104-106.
31. Šamec D, Urlić B, Salopek-Sondi B. Kale (Brassica oleracea var. acephala) as a superfood: Review of the scientific evidence behind the statement. Crit Rev Food Sci Nutr 2019; 59: 2411-2422.
32. Ayadin H, Kilicasan F, Koyuncu I, Celik H, Güzelcicek A, Kirmit A. Impaired thiol/disulphide homeostasis in children diagnosed with autism: A case-control study. J Mol Neurosci 2021; 71: 1394-1402.`
33. Cordain L, Miller JB, Eaton SB, Mann N, Holt SH, Speth JD. Plant-animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets. Am J Clin Nutr 2000; 71: 682-692
34. Keng H. Economic plants of ancient North China as mentioned in Shih Ching (Book of Poetry). Econ Botany 1973; 28: 391-410.
35. Dreher ML, Maher CV, Kearney P. The traditional and emerging role of nuts in healthful diets. Nutr Rev 1996; 54: 241-245.
36. Langgut D. Prestigious fruit trees in ancient Israel: first palynological evidence for growing Juglans regia and Citrus medica. Israel J Plant Sci 2015; 62: 98-110.
37. Mahdipour R, Ebrahimzadeh-Bideskan A, Hosseini M, et al. The benefits of grape seed extract in neurological disorders and brain aging. Nutr Neurosci 2022; 28: 1-15.
38. Chan AS, Sze S, Han YM, Cheung M. A Chan dietary intervention enhances executive functions and anterior cingulate activity in autism spectrum disorders: a randomized controlled trial. Evidence-Based Complem Altern Med 2012: 262136.
39. Lynch R, Diggins EL, Connors SL, et al. Sulforaphane from broccoli reduces symptoms of autism: A follow-up case series from a randomized double-blind study. Global Adv Health Med 2017; 6: 1-7.
40. Bakheet SA, Alzahrani MZ, Ansari MA, et al. Resveratrol ameliorates dysregulation of Th1, Th2, Th17, and T regulatory cell-related transcription factor signalling in a BTBR Y+ tf/J mouse model of autism. Mol Neurobiol 2017; 54: 5201-5212.
41. Shanmugam H, Ganguly S, Priya B. Plant food bioactives and its effects on gut microbiota profile modulation for better brain health and functioning in autism spectrum disorder individuals. Food Frontiers 2022;3: 124-141.
42. Sharpe DL, Baker DL. Financial issues associated with having a child with autism. J Fam Econ Iss 2007; 28: 247-264.
43. Rzepkowska A. When salts turns bitter and the tablecloth must be blue. On food in autism. Łodzkie Studia Etnograficzne 2015;54:33-51.
44. Ślifirczyk A, Krajewska-Kułak E, Krukowska M, Maciorkowska E. Knowledge of parents of children with autism from Poland, Belarus and France concerning their child’s condition. Health Prob Civ 2019; 13: 114-122.
45. Cooper S, Begley A. WA health practitioners and cooking: How well do they mix? Nutr Diet 2011; 68: 65-69.
46. Marsden RE, Francis J, Garner I. Use of GFCF diets in children with ASD. An investigation into parents’ beliefs using the theory of planned behaviour. J Autism Dev Disord 2019; 49: 3716-3731.
47. Harris HA, Mou Y, Dieleman GC, Voortman T, Jansen PW. Child autistic traits, food selectivity, and diet quality: A population based study. J Nutr 2022;152:856-862.
2. Zeidan J, Fombonne E, Scorah J, Ibrahim A, Durkin MS, Saxena S, Yusuf A, Shih A, Elsabbagh M. Global prevalence of autism: A systematic review update. Autism Res 2022; 15:778-790.
3. Lenart A, Pasternak J. Resources, problems and challenges of autism spectrum disorder diagnosis and support system in Poland. J Autism Dev Disord 2023; 53: 1629-1641.
4. Whiteley P, Rodgers J, Shattock P. Feeding patterns in autism. Autism 2000; 4: 207-211.
5. van der Horst K, Deming DM, Lesniauskas R, Carr BT, Reidy KC. Picky eating: associations with child eating characteristics and food intake. Appetite 2016; 103: 286-293.
6. Zeybek SG, Yurttagül M. Nutrient status, diet quality and growth parameters of children with autism spectrum disorder in Northern Cyprus. Progress Nutr 2020;22: e2020020.
7. Evans EW, Must A, Anderson SE. Dietary patterns and body mass index in children with autism and typically developing children. Res Autism Spectr Disord 2012; 6: 399-405.
8. Canals-Sans J, Esteban-Figuerola P, Morales-Hidalgo P, Arija V. Do children with autism spectrum disorders eat differently and less adequately than those with subclinical ASD and typical development? EPINED Epidemiological Study. J Autism Dev Disord 2022; 52: 361-375.
9. Masi A, Glozier N, Dale R, Guastella AJ. The immune system, cytokines, and biomarkers in autism spectrum disorder. Neurosci Bull 2017; 22: 194-204.
10. Gładysz D, Krzywdzińska A, Hozyasz KK. Immune abnormalities in autism spectrum disorder – could they hold promise for causative treatment? Mol Neurobiol 2018; 55: 6387-6435.
11. Robinson-Agramonte ML, Noris Garcia E, Fraga Guerra J, et al. Immune dysregulation in autism spectrum disorder: What do we know about it? Int J Mol Sci 2022; 23: 3033.
12. George ES, Daly RM, Tey SL, Brown R, Wong TH, Tan SY. Perspective: Is it time to expand research on “nuts” to include “seeds”? Justifications and key considerations. Adv Nutr 2022; 13: 1016-1027.
13. Hill CR, Shafaei A, Balmer L, Lewid JR, Hodgson JM, Blekkenhorst LC. Sulfur compounds: From plants to humans and their role in chronic disease prevention. Crit Rev Food Sci Nutr 2022;5:1-23.
14. Pribis P, Shukitt-Hale B. Cognition: the new frontier for nuts and berries. Am J Clin Nutr 2014; 100(suppl.): 347S-352S.
15. Yeung AW, Tzvetkov NT, Zengin G, et al. The berries on the top. J Berry Res 2019; 9: 125-139.
16. Abellán A, Domiguez-Perles R, Moreno DA, Garcia-Viguera C. Sorting out the value of cruciferous sprouts as sources of bioactive compounds for nutrition and health. Nutrients 2019; 11: 429.
17. Moaaz M, Youssry S, Elfatatry A, El Rahman MA. Th17/Treg cells imbalance and their related cytokines (IL-17, Il-10 and TGF-ß) in children with autism spectrum disorder. J Neuroimmunol 2019;337:577071.
18. Barone R, Rizzo R, Tabbi G, Malaguarnera M, Frye RE, Bastin J. Nuclear peroxisome proliferator-activated receptors (PPARs) as therapeutic targets of resveratrol for autism spectrum disorder. Int J Mol Sci 2019;20:1878.
19. Jyonouchi H, Geng L, Rose S, Bennuri SC, Fry RE. Variations in mitochondrial respiration differ in IL-1ß/IL-10 ratio based subgroups in autism spectrum disorders. Front Psychiatry 2019;10:71.
20. Kuo M-Y, Ou H-C, Lee WJ, et al. Ellagic acid inhibits oxidized low-density lipoprotein (OxLDL)-induced matallproteinase (MMP) expression by modulating the protein kinase C-α/extracellular signal-regulated kinase/peroxisome proliferator-activated receptorγ/nuclear factor-ĸB (PKC-α/ERK/PPAR-γ/NFĸB) signalling pathway in endothelial cells. Agric Food Chem 2011;59:5100-5108.
21. van Elst K, Bruining H, Birtoli B, Terreaux C, Buitelaar JK, Kas MJ. Food for thought: Dietary changes in essential fatty acid ratios and the increase in autism spectrum disorders. Neurosci Biobehav Rev 2014;45:369-378.
22. Hurwitz S. The gluten-free, casein-free diet and autism. Limited return on family investment. J Early Interv 2013; 35: 3-19.
23. Gonzalez-Domenech PJ, Diaz-Atienza F, Gutierrez-Rojas L, Fernandez-Soto ML, Gonzalez-Domenech CM. A narrative review about autism spectrum disorders and exclusion of gluten and casein from the diet. Nutrients 2022; 14:1797.
24. Winburn E, Charlton J, McConachie H, et al. Parents’ and child health professionals’ attitudes towards dietary interventions for children with autism spectrum disorders. J Autism Dev Disord 2014;44:747-757.
25. Wądołowska L. [Validation of food frequency questionnaire-FFQ. Reproducibility assessment]. Bromat Chem Toksykol 2005; 38: 27-33 (in Polish).
26. Niedzwiedzka L, Wadolowska L, Kowalkowska J. Reproducibility of a non-quantitative Food Frequency Questionnaire (62-item FFQ-6) and PCA-driven dietary pattern identification in 13-21- year-old females. Nutrients 2019;11:2183.
27. Wadolowska L, Kostecka M, Kowalkowska J, et al. Sustainability of a Multi-Component Education Program (ABC of Healthy Eating) after three months and nine months. The socioeconomical context in improving nutrition knowledge in Polish teenagers. Nutrients 2021;13: 1661.
28. Jąder K. [Changes in production and consumption of vegetables and their relationships in a regional perspective]. Intercathedra 2019;39:141-151 (in Polish).
29. Łuczaj Ł, Szymański WM. Wild vascular plants gathered for consumption in the Polish countryside: a review. J Ethnobiol Ethnomed 2007;17:3.
30. Hozyasz KK. From rediscovered “niche” to “mainstream” – Glyceria fluitans as candidate grain for manufacturing premium food products. Plants People Planet 2020; 2: 104-106.
31. Šamec D, Urlić B, Salopek-Sondi B. Kale (Brassica oleracea var. acephala) as a superfood: Review of the scientific evidence behind the statement. Crit Rev Food Sci Nutr 2019; 59: 2411-2422.
32. Ayadin H, Kilicasan F, Koyuncu I, Celik H, Güzelcicek A, Kirmit A. Impaired thiol/disulphide homeostasis in children diagnosed with autism: A case-control study. J Mol Neurosci 2021; 71: 1394-1402.`
33. Cordain L, Miller JB, Eaton SB, Mann N, Holt SH, Speth JD. Plant-animal subsistence ratios and macronutrient energy estimations in worldwide hunter-gatherer diets. Am J Clin Nutr 2000; 71: 682-692
34. Keng H. Economic plants of ancient North China as mentioned in Shih Ching (Book of Poetry). Econ Botany 1973; 28: 391-410.
35. Dreher ML, Maher CV, Kearney P. The traditional and emerging role of nuts in healthful diets. Nutr Rev 1996; 54: 241-245.
36. Langgut D. Prestigious fruit trees in ancient Israel: first palynological evidence for growing Juglans regia and Citrus medica. Israel J Plant Sci 2015; 62: 98-110.
37. Mahdipour R, Ebrahimzadeh-Bideskan A, Hosseini M, et al. The benefits of grape seed extract in neurological disorders and brain aging. Nutr Neurosci 2022; 28: 1-15.
38. Chan AS, Sze S, Han YM, Cheung M. A Chan dietary intervention enhances executive functions and anterior cingulate activity in autism spectrum disorders: a randomized controlled trial. Evidence-Based Complem Altern Med 2012: 262136.
39. Lynch R, Diggins EL, Connors SL, et al. Sulforaphane from broccoli reduces symptoms of autism: A follow-up case series from a randomized double-blind study. Global Adv Health Med 2017; 6: 1-7.
40. Bakheet SA, Alzahrani MZ, Ansari MA, et al. Resveratrol ameliorates dysregulation of Th1, Th2, Th17, and T regulatory cell-related transcription factor signalling in a BTBR Y+ tf/J mouse model of autism. Mol Neurobiol 2017; 54: 5201-5212.
41. Shanmugam H, Ganguly S, Priya B. Plant food bioactives and its effects on gut microbiota profile modulation for better brain health and functioning in autism spectrum disorder individuals. Food Frontiers 2022;3: 124-141.
42. Sharpe DL, Baker DL. Financial issues associated with having a child with autism. J Fam Econ Iss 2007; 28: 247-264.
43. Rzepkowska A. When salts turns bitter and the tablecloth must be blue. On food in autism. Łodzkie Studia Etnograficzne 2015;54:33-51.
44. Ślifirczyk A, Krajewska-Kułak E, Krukowska M, Maciorkowska E. Knowledge of parents of children with autism from Poland, Belarus and France concerning their child’s condition. Health Prob Civ 2019; 13: 114-122.
45. Cooper S, Begley A. WA health practitioners and cooking: How well do they mix? Nutr Diet 2011; 68: 65-69.
46. Marsden RE, Francis J, Garner I. Use of GFCF diets in children with ASD. An investigation into parents’ beliefs using the theory of planned behaviour. J Autism Dev Disord 2019; 49: 3716-3731.
47. Harris HA, Mou Y, Dieleman GC, Voortman T, Jansen PW. Child autistic traits, food selectivity, and diet quality: A population based study. J Nutr 2022;152:856-862.
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Jun 30, 2023
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Hozyasz K, Jessa J. Increased intake of health-promoting foods as a benefit of the exclusion of gluten and casein from the diet of ASD patients . Progr Nutr [Internet]. 2023 Jun. 30 [cited 2024 Nov. 28];25(2):e2023001. Available from: https://mattioli1885journals.com/index.php/progressinnutrition/article/view/9393
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How to Cite
1.
Hozyasz K, Jessa J. Increased intake of health-promoting foods as a benefit of the exclusion of gluten and casein from the diet of ASD patients . Progr Nutr [Internet]. 2023 Jun. 30 [cited 2024 Nov. 28];25(2):e2023001. Available from: https://mattioli1885journals.com/index.php/progressinnutrition/article/view/9393
