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Influence of a Combined Gluten-Free and Casein-Free Diet on Behavior Disorders in Children and Adolescents Diagnosed with Autism Spectrum Disorder: A 12-Month Follow-Up Clinical Trial

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Abstract

The use of alternative interventions, such as gluten-free and casein-free (GFCF) diets, is frequent due to limited therapies for Autism Spectrum Disorder (ASD). Our aims were to determine the influence of a GFCF diet on behavior disorders in children and adolescents diagnosed with ASD and the potential association with urinary beta-casomorphin concentrations. Thirty-seven patients were recruited for this crossover trial. Each patient consumed a normal diet (including gluten and casein) for 6 months and a GFCF diet for another 6 months. The order of the intervention (beginning with normal diet or with GFCF diet) was assigned randomly. Patients were evaluated at three time-points (at the beginning of the study, after normal diet and after GFCF diet). Questionnaires regarding behavior and autism and dietary adherence were completed and urinary beta-casomorphin concentrations were determined at each time-point. No significant behavioral changes and no association with urinary beta-casomorphin concentrations were found after GFCF diet. A 6-month GFCF diet do not induce significant changes in behavioral symptoms of autism and urinary beta-casomorphin concentrations. Further studies with a long follow-up period similar to ours and including placebo and blinding elements are needed to identify better those respondents to GFCF diets.

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Acknowledgments

We thank University of Granada, in particular, Professor Manuel Gurpegui Fernández de Legaria for his advices and suggestions regarding this manuscript. The authors acknowledge Nutraceutical Translations for translating this manuscript into English.

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Authors and Affiliations

  1. Child and Adolescent Mental Health Unit, Virgen de las Nieves University Hospital, Granada, Spain

    Pablo José González-Domenech, Francisco Díaz Atienza & Carlos García Pablos

  2. Department of Psychiatry, University of Granada, Granada, Spain

    Pablo José González-Domenech, José María Martínez-Ortega & Luis Gutiérrez-Rojas

  3. Department of Medicine, University of Granada, Granada, Spain

    María Luisa Fernández Soto

  4. Psychiatry Service, Hospital Clínico San Cecilio, Granada, Spain

    Luis Gutiérrez-Rojas

  5. CTS-549 Research Group, Institute of Neuroscience, Granada, Spain

    Luis Gutiérrez-Rojas

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PJG-D has participated in the design of the study, collected the data, participated in the statistical analysis, the interpretation of the data and the drafting of the article; he approved the final version of the manuscript. FDA, CGP, JMM-O, LG-R has participated in the statistical analysis, the interpretation of the data and the drafting of the article; she approved the final version of the manuscript. MLFS has participated in the design of the study, the statistical analysis, the interpretation of the data and the drafting of the article; he approved the final version of the manuscript.

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Correspondence to Luis Gutiérrez-Rojas.

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González-Domenech, P.J., Díaz Atienza, F., García Pablos, C. et al. Influence of a Combined Gluten-Free and Casein-Free Diet on Behavior Disorders in Children and Adolescents Diagnosed with Autism Spectrum Disorder: A 12-Month Follow-Up Clinical Trial. J Autism Dev Disord 50, 935–948 (2020). https://doi.org/10.1007/s10803-019-04333-1

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