Casein-free Diet Research Articles

Impact of Gluten-Free and Casein-Free Diet on Behavioural Outcomes and Quality of Life of Autistic Children and Adolescents: A Scoping Review.

Gluten- and casein-containing foods could aggravate the symptoms of children and adolescents with autism spectrum disorder (ASD), and subsequently impact their quality of life. However, there is a mixed opinion among researchers concerning the impact of alternative diet on reducing ASD symptoms. This scoping review aimed at examining the impact of the "gluten-free, casein-free" (GFCF) diet on health outcomes and the quality of life among autistic children and adolescents. A scoping review of the literature was performed following the Joanna Briggs Institute (JBI) guidelines. Four databases, including EbscoHost, Medline, CINAHL, and ProQuest, were used to obtain subject-specific studies relevant to the research question and published between July 2013 and March 2024. A comprehensive search using keywords such as "autism spectrum disorder", "gluten-free diet", and "casein-free diet" was conducted to obtain articles related to the research focus area. Only full-text, peer-reviewed, written in English articles were selected. Data extraction and data analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-extension to Scoping Review (PRISMA-ScR) protocol. From the initial 586 studies, a total of 27 articles were included in the final analysis of the review. The thematic analysis included "GFCF diet and improvement of the core autistic symptoms", "the gut-brain link", "dietary interventions and autism", "possible side effects due to the GCFC diet", and "inconclusive studies and mixed opinions". A majority of the studies showed a positive effect of the GFCF diet on a variety of autistic symptoms, including positive changes in cognitive skills, behaviour, and gastrointestinal symptoms, while some showed conflicting evidence. The currently available evidence on the impact of the "GFCF" diet on the quality of life of autistic children and adolescents may warrant potentially effective interventions for alleviating symptoms of autism spectrum disorders. However, this scoping review highlights the need for more research to provide more reliable evidence on the health outcomes and quality of life of ASD sufferers to guide practice.

Complementary and Alternative Medicine for Autism - A Systematic Review.

Complementary and Alternative Medicine (CAM) is a therapeutic option currently used by autistic people with continued interest and uptake. There remains limited evidence regarding the efficacy of CAM use in autism. The aim of this systematic review is to comprehensively review published clinical trials to explore the efficacy of CAM in autism. A systematic literature review of available research published from June 2013 to March 2023 was conducted. Our literature search identified 1826 eligible citations, and duplications removed (n = 694) with 102 articles eligible for title/abstract screening. After full text review, 39 studies were included. The results of this systematic review identified that for autistic people, vitamin and mineral supplements may only be of benefit if there is a deficiency. The results also found that the main interventions used were dietary interventions and nutraceuticals, including targeted supplements, vitamins and minerals, omega 3s and prebiotics, probiotics and digestive enzymes. The evidence does not support some of the most frequently utilised dietary interventions, such as a Gluten Free Casein Free (GFCF) diet, and the use of targeted nutraceutical supplements may be of benefit, but more conclusive research is still required to direct safe and effective treatment.

Exploring the Gut Microbiome - Autism Spectrum Disorder Connection: Implications for Therapeutic Interventions and Future Directions

The gut microbiome, a diverse community of microorganisms in the gastrointestinal tract, is vital for human health and has a symbiotic relationship with the host. Autism spectrum disorder (ASD), a complex condition affecting social interaction, speech, and behavior, manifests early in life and affects 1 in 36 children globally. Research shows a significant link between the gut microbiome and ASD symptoms, with dysbiosis observed in individuals with ASD compared to neurotypical populations. Pathogenic gut microbiota can produce toxins that increase gut permeability, impair the intestinal barrier, and activate the immune system. The vagal nerve, influencing central nervous system (CNS) activity, can release peripheral cytokines inducing depression-like behaviors. Thus, dietary changes and treatments targeting the gut microbiota, such as Microbiota Transfer Therapy (MTT), offer promising methods for treating ASD symptoms. Current research focuses on dietary therapies like gluten-free and casein-free diets, ketogenic diets, and probiotics/prebiotics supplementation to modify the gut microbiota and enhance ASD treatment outcomes. However, more research is needed to fully understand the gut microbiota-ASD connection and establish evidence-based interventions. Individualized approaches are crucial for the safety and effectiveness of therapeutic strategies for ASD. Exploring the gut microbiome's role in ASD offers promising avenues for novel treatments and improved understanding of the disorder.

Gluten Free Casein Free Diet for Children with Autism Spectrum Disorder – A Review

Autism Spectrum Disorder is a group of neurodevelopmental conditions characterized by social and repetitive behaviour. As per WHO it is estimated that worldwide 1 in 160 children has ASD. Based on epidemiological studies conducted over the past 50 years, the prevalence of ASD appears to be increasing globally. Delayed speech, frequent repetition of set words and phrases, no social interactions, sensory changes etc. are the main symptoms of ASD. There is no known cure for ASD, but many different approaches are used to treat the symptoms of the disorders, for example, visual aids are used to improve communication, social stories interventions are used to teach appropriate social behaviour, and medication is used to ameliorate specific symptoms like aggression. Dietary intervention as a tool for maintaining and improving physical health and wellbeing for ASD is a widely researched and discussed topic. Studies have depicted that there is a link between diet, gut epithelial changes and altered immune response in the spectrum disorders exhibited by children with Autism. A gluten-free casein-free diet is also known as the GFCF diet. It is one of several alternative treatments for children with autism. When following this strict elimination diet, all foods containing and casein are removed from the child's daily food intake. Foods that contained proteins such as gluten and casein causes hypersensitivity to children with ASD. The children cannot digest these proteins properly. This result to increase the level of urinary small peptides. These peptides bind to opioid receptors and become biologically active, which results excess of opioid and leads to an increase of the behavioural difficulties seen in the children. Dietary interventions with the exclusion of gluten, casein or both is thought to have a positive effect on behavioural symptoms because of the elevated levels of peptides seen in the urinary analyses. Since the chemical structure of gluten and casein are very similar to each other, it is very likely that having a sensitivity to one of them means having a sensitivity to both, even though one could be worse than the other. This paper provide an overview of the gluten free casein free diet and its positive and negative results of Gluten free Casein free diet on the basis of reviewing case studies.

Studi Komparatif Tingkat Hiperaktif Pada Diet Gluten Free, Casein Free Anak Autis Di SLB Briliant Kota Batam

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that has certain characteristics. One of them is the diagnosis of autistic comorbidity, namely Attention Deficit Hyperactivity Disorder (ADHD), nonpharmacological treatments are considered quite effective including dietary interventions. Hyperactive behavior in autistic children that has an impact in the form of difficulty in poor attention span to impulsiveness. Gluten free diet, casein free diet is recommended in the application of therapy in autistic people, this diet is one type of complementary therapy, which is carried out by regulating consumption patterns in autistic children. Objective: to determine the difference in the level of hyperactivity of autistic children between groups who apply gluten free, casein free diet with not applying gluten free, casein free diet. Method: comparative study by looking at the comparison between two groups with a total sampling technique of 20 people. Results: The level of hyperactivity in children on a gluten free diet, casein free as many as 9 (45%) respondents and 11 (55%) respondents did not do a gluten free diet, casein free obtained Mann Whitney U test results with a p-value of 0.027 where the p-value <0.05 or (0.027<0.05). Conclusion: Autistic children who apply a gluten free, casein free diet seem to have quite good attention than autistic children who do not apply a gluten free casein free diet. Suggestion: It is hoped that parents who have autistic children can adopt a gluten free diet, casein free as an alternative therapy.

The Effects of a Gluten-Free/Casein-Free Diet on Behavioral Indices in Children with Autism Spectrum Disorder: A Systematic Review and Meta-analysis

Introduction: Autism is a neurological disorder that has seen an increase in prevalence in recent years. It is hypothesized that diet may influence mental health and improve the behavioral symptoms of autism. Objectives: The purpose of this study is to examine the effects of gluten-free and casein-free diets on children with autism. Data Sources: International databases such as Google Scholar, PubMed, Cochrane, and Science Direct were searched using keywords including Autism, Gluten-free, Casein, Diet, and Autistic Disorder, without any time restriction. Study Selection: Ultimately, 8 articles were selected for the final analysis. Data Extraction: The study revealed that gluten-free/casein-free (GF/CF) diets had a significantly positive effect on the behavior index of autistic children. In terms of the behavior index, the effect size was a standard mean difference (SMD) of -0.27 (P = 0.001) with a 95% confidence interval (CI) of -0.424 to -0.116. A meta-analysis comparing intervention and control groups indicated that the GF/CF diet had an effect size of SMD = -0.27 (P = 0.001) with a 95% CI of -0.429 to -0.112 on the behavior index. Results: The results of these studies were synthesized using the fixed effects model of meta-analysis with STATA version 14. Conclusions: Given the positive impact of the GF/CF diet on improving the behavior of autistic children, this dietary approach can be considered as a means to enhance behavioral symptoms in these children.

Gluten-Free, Casein-Free Diet for Children with Autism Spectrum Disorder: A Case-Controlled Study.

Numerous therapeutic and dietary interventions have been examined in the last thirty years for pediatric patients diagnosed with autism spectrum disorder (ASD). Our interventional study aimed to assess the effectiveness of the gluten-free, casein-free (GFCF) diet in a cohort of Egyptian children with ASD. The present clinical trial was conducted as a prospective 12-month, open-label, case-controlled interventional study. Thirty-six ASD children who were newly diagnosed and had not taken any prior psychiatric or rehabilitation therapy were included in this study. The patients were randomly assigned into two groups: group A, which received the GFCF diet, and group B, which served as the control group and was not restricted to food containing gluten and casein for 12 months. All patients were followed up for 1 year. Following the implementation of the GFCF diet in group A, significant improvements in CARS scores were observed compared to group B after 6-month and 1-year follow-up periods. The introduction of the GFCF diet could be helpful and promising for autistic children. Conclusive evidence regarding the effectiveness of the GFCF diet remains a subject of controversy. Nonetheless, our study contributes some evidence supporting its potential benefits for children with ASD. It is recommended that future research on the GFCF diet employ a more sophisticated research design, incorporating a consistent baseline measure that can effectively assess the therapeutic effects of these interventions for individuals with ASD.

The Gluten-Casein-Free Diet in Children with Autism: A Clinical Results of the Ophthalmic and Behavioral Manifestations

Aim: To evaluate the ophthalmic and behavioral effects of a gluten-free casein-free diet (GCFD) in autism spectrum disorder (ASD). Method: The study was conducted from November 2020 to January 2023. We designed an 8-week clinical trial of GCFD on corneal reflex, pupil size, body mass index (BMI), weight, Autistic Disorder Index, Communication, Social interaction, and Stereotype Behavior. Results: A total of thirty participants completed the trial. GCFD reduced BMI [%95 CI -4.8895 to -2.1305 (P < 0.0001)], weight [%95 CI -8.5153 to -0.0647 (P = 0.0467)], Autistic Disorder Index [%95 CI -28.0359 to -16.2841 (P < 0.0001)], Communication [%95 CI -3.3325 to -1.6675 (P < 0.0001)], Social Interaction [%95 CI -4.3190 to -2.4010 (P < 0.0001)], and Stereotype Behavior [%95 CI -2.3939 to -0.2461 (P =0.01)] significantly. GCFD also reduced left [%95 CI -2.2421 to -1.6779 (P <0.0001)] and right pupil size [%95 CI -2.2999 to -1.7201 (P <0.0001)] significantly. Conversely, corneal reflex was significantly increased [95% CI 0.2159 to 2.1241 (P = 0.01)]. No differences were observed for IPD. Conclusion: This study suggested that the GCFD can effectively control ASD behaviors as well as regulate autonomic functions related to ophthalmic markers such as pupil size and corneal reflex, but more research is needed.

Glutensiz ve Kazeinsiz Diyet Yaklaşımı

A gluten-free and casein-free diet (GFCF) involves completely eliminating wheat, barley, rye, oats, and other grains containing gluten, as well as dairy products containing casein from an individual's diet. The foundations of GFCF are based on the opioid mechanism. Consequently, applications of GFCF have been explored in conditions such as autism spectrum disorder (ASD), schizophrenia, nephrotic syndrome (NS), and diabetes. According to the obtained data, positive behavioral changes and several favorable effects, such as a reduction in hospitalization duration, have been observed in these conditions following GFCF interventions. However, it is important to note that these studies often have methodological limitations and may be subject to nutritional challenges arising from the elimination process. It is premature to consider GFCF as a nutritional therapy for these conditions. Considering the limitations in previous studies and the opioid mechanism, new research should be planned. Additionally, to prevent inadequacies arising from both the disease itself and the dietary process, there is a significant need to focus on the development of gluten-free and casein-free products.

Nutritional medical therapy in autism spectrum disorder

Objectives. This study aimed to assess the effectiveness of commonly used nutritional medical therapies in children with autism spectrum disorder (ASD). Method. The study explores the intricate relationship between ASD and nutritional medical therapy. Individuals with ASD often exhibit compromised gastrointestinal (GI) health, including issues with intestinal motility, adverse reactions to certain foods, and nutrient absorption deficiencies. These problems may be caused or exacerbated by restrictive eating behaviors, food preferences, and nutritional deficiencies. Those with GI conditions often display heightened behavioral deficits and imbalances in the overall composition of the intestinal microbiome. Results. The research underscores the importance of an individually tailored approach, considering the diverse nutritional needs and unique preferences of individuals with ASD. Analysis of current studies highlights the potential impact of personalized diets on the quality of life within the complex context of GI conditions associated with ASD. The benefits of current nutritional therapies are summarized, and the mixed results in addressing ASD are analyzed. Gluten-free and casein-free diets, the ketogenic diet, supplementation with fatty acids, and the use of pre-/probiotics demonstrate improvements in managing GI and behavioral symptoms associated with ASD. Customizing the diet is recommended as a multidisciplinary approach, given the complexity of GI-related conditions within the ASD diagnosis and their association with behavioral and neurological deficits. The significance of the results lies in supporting a personalized approach in managing specific ASD symptoms, with a focus on individual nutritional needs. Conclusions. Managing ASD symptoms requires a personalized approach, considering individual nutritional needs, food preferences, and different clinical manifestations.

Pengenalan Sayur dan Buah untuk Anak Autis berbasis Multimedia Augmented Reality

Autism is a neurobiological developmental disorder that affects the social, communication, and interaction abilities of children. Difficulty accepting and interacting with healthy foods, such as vegetables and fruits, is a common challenge for children with autism. To address this challenge, researchers propose the use of augmented reality (AR) technology as an interactive and enjoyable method to introduce vegetables and fruits to children with autism. This study aims to investigate the effectiveness of using AR in increasing the interest and acceptance of vegetables and fruits in children with autism by suggesting the use of augmented reality technology and applying the Picture Exchange Communication System (PECS) technique. The PECS method is a communication training technique that uses pictures or symbols to assist children with autism in communication. This application is designed using the Unified Modelling Language (UML) tools. Testing of this application is conducted through alpha and beta testing. The results of alpha testing using black box testing conclude that the application runs smoothly without any functionality issues. The results of beta testing, with an average of 82.50%, suggest that the use of the PECS method and AR technology can enhance communication skills and motivation in introducing vegetables and fruits and can help children with autism follow a gluten-free casein-free (GFCF) diet to reduce the symptoms experienced by children with autism.

Dietary Factors Impact Developmental Trajectories in Young Autistic Children.

The purpose of this research was to investigate the impact of dietary factors on developmental trajectories in young autistic children. A gluten-free and casein-free diets, as well as six types of food (meat and eggs, vegetables, uncooked vegetables, sweets, bread, and "white soft bread that never molds") were investigated observationally for up to three years in 5,553 children 2 to 5 years of age via parent-report measures completed within a mobile application. Children had a parent-reported diagnosis of Autism Spectrum Disorder (ASD); 78% were males; the majority of participants resided in the USA. Outcome was monitored on five orthogonal subscales: Language Comprehension, Expressive Language, Sociability, Sensory Awareness, and Health, assessed by the Autism Treatment Evaluation Checklist (ATEC) (Rimland & Edelson, 1999) and Mental Synthesis Evaluation Checklist (MSEC) (Arnold & Vyshedskiy, 2022; Braverman et al., 2018). Consumption of fast-acting carbohydrates - sweets, bread, and "white soft bread that never molds" - was associated with a significant and a consistent Health subscale score decline. On the contrary, a gluten-free diet, as well as consumption of meat, eggs, and vegetables were associated with a significant and consistent improvement in the Language Comprehension score. Consumption of meat and eggs was also associated with a significant and consistent improvement in the Sensory Awareness score. The results of this study demonstrate a strong correlation between a diet and developmental trajectories and suggest possible dietary interventions for young autistic children.

Effect of Gluten Free Casein Free Diet on Maladaptive Behavior in Autistic Children: Meta-Analysis

Background: Children with Autism tend to experience gastrointestinal disorders more often. Interactions between the gut and brain microbiome influence mood and behavior in health and disease. Diet therapy, specifically the gluten and case-free diet (GFCF) is an elimination diet that involves removing certain proteins from the normal diet, such as gluten and casein. The right intervention can change behavior for the better and through the right handling. This study aims to estimate the effect of a case-free gluten-free diet on maladaptive behavior in autistic children, through a meta-analysis of primary studies conducted by previous authors. Subjects and Method: This study is a systematic review and meta-analysis with the following PICO, population: Autism children, intervention: gluten-free case-free diet, comparison: no case-free gluten-free diet, outcome: maladaptive behavior. The articles used in this study were obtained from three databases, namely PubMed, Google Scholar, and Science Direct, using the search key “Diet Gluten Free Casein Free” OR “NonDiet Gluten Free Casein Free” OR “GFCF” AND “Autism” OR “Autism” AND “Maladaptive” AND “Randomize Controlled Trial” OR “RCT”. The included article is a full-text Randomized Controlled Trial study designed from 2002 to 2022 and reports the mean and SD in multivariate analysis. The selection of articles is done using PRISMA flow diagrams. Articles were analyzed using the Review Manager 5.4 application. Results: A total of 7 randomized controlled trial studies conducted in the Americas, Europe, and Asia were selected for meta-analysis. Autistic children who received casein-free gluten-free had an average score of 0.11 units of maladaptive behavior lower than those who were not given a diet (SMD= 0.11 95% CI= .035 to 0.13; p= 0.360). Conclusion: The casein-free gluten-free diet has an effect on reducing the risk of maladaptive behavior in children with autism. Keywords: casein free gluten-free diet, gfcf, maladaptive behavior, autism Correspondence: Ruliany Yuni Nurul Hakim. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A Surakarta 57126, Central Java, Indonesia. Email: Ruliany27@gmail.com. Ponsel +6282124886320. Indonesian Journal of Medicine (2023), 08(03): 286294

A review of dietary and nutritional interventions available for management of autism spectrum disorder symptoms in children and adolescents - Kenya

Research on the challenges of raising a child with autism is mostly reported from Europe, North America and Australia. There is limited autism spectrum disorder (ASD) research in Kenya and families lack support as the etiology is linked to witchcraft and sorcery. Research indicates an increase in ASD prevalence globally and in Africa. Malnutrition and neuro-disability are major public health problems in Africa. Approximately one billion people, 15% of the world’s population, have a disability of some kind and 80% live in Low- and Middle-Income countries (LMICs). Of these, 53 million are children aged below 5 years living in sub-Saharan Africa. In Kenya, 2.2% (0.9 million people) live with some form of disability. Children diagnosed with autism spectrum disorder (ASD) suffer from neuro disabilities eliciting: altered sensory processing, restricted interests, and behavioral rigidity. Autism spectrum disorders have no cure, management is by use of interventional targeting autistic symptoms such as linguistic development, non-verbal cognitive development, and motor development. The objectives of this review were: to identify dietary and nutritional interventions available for the management of ASD symptoms in children and adolescents - Kenya, and to analyze the results of existing research in this area in order to understand and describe the characteristics and results of these studies to enable their use in the management of ASD symptoms. Cochrane Library, PubMed, PMC, Google scholar, and Free Full databases were searched to identify studies published between September 2011 and September 2021. Included were studies on nutrition or dietary interventions given to ASD children and adolescents that assessed autistic behavior and/or gastrointestinal symptoms. Excluded were those articles that evaluated surrogate outcomes as the primary outcome such as urinary peptide excretion and other neuro-disabilities other than ASD. Eighteen articles were included: 12 randomized case-control trials, 3 open-label trials, one 2×2 factorial study, and 2 cross-over trials. The following dietary and nutritional interventions were evaluated: gluten and casein-free diet, ketogenic diets; probiotic supplements, specific carbohydrate diets, polyunsaturated fatty acids, vitamin and mineral supplantation (A, B6, B12, D, magnesium, folic acid), and alternative diets. Authors report improvements in the symptoms associated with ASD individuals receiving nutritional interventions such as vitamin and mineral supplementation however, their safety and efficacy needs to be evaluated. The study findings will help policymakers and implementers to understand the consistency and precision and impact of these interventions. These findings will contribute to improving the safety and efficacy of these interventions, positively impacting the health and nutrition outcomes of children and adolescents with ASD. These study findings indicate that more research targeting ASD dietary and Nutritional Interventions for management of ASD symptoms is required in Kenya and other resource constrained settings. Key words: autism spectrum disorder, nutritional intervention, diet therapy, child, adolescent, Kenya

Beslenme Yaklaşımlarının ve Besin Takviyelerinin Otizm Üzerindeki Etkileri

ASDs (Autism Spectrum Disorders); is a neurodevelopmental disorder in which the symptoms and effects are different in each individual and there is an increase in prevalence worldwide. The increase in ASDs prevalence may be due to the increase in diagnostic criteria. The causes of ASDs are thought to be genetic, environmental and neurobiological factors. In recent years, studies have been conducted on the effect of dietary approaches on improving ASDs symptoms. Researchers are studying on dietary approaches based on the interaction between the brain and the gut. This review includes studies on the most popular dietary approach, the gluten-free and casein-free diet, and the effects of Omega 3, vitamin D, vitamin B12, folic acid and probiotic supplements on ASDs core symptoms. The results of the studies are evaluated according to special ASDs symptom criteria scores. The limited number of studies, the low number of participants in some studies and the lack of significant improvements are seen as limiting aspects of the studies.

Nutrition Therapy Approaches in Children with Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that occurs in the early stages of development, characterized by limitations in social communication and interaction behaviors, repetitive limiting behaviors, and limited interests. Nutritional problems and gastrointestinal complaints seen in ASD have been known since the first diagnosis of the disease and are considered a feature of the disease. It is known that children with ASD have feeding problems five times more often than children with normal development. The most common nutritional problems seen in children with ASD are food selectivity, difficulty in eating skills, selective, strange, and unusual eating behavior, sensitivity to a particular presentation of food, avoidance of new foods, excessive and persistent intake of one type of food and meal time behavioral problems. Dietary approaches such as gluten-free, casein-free, ketogenic, special carbohydrate, Feingold, Candida body ecology, and eliminated allergy diets are applied. However, the evidence for these practices is limited. Therefore, it is recommended to monitor children with ASD in terms of inadequate and unbalanced nutrition and to consider feeding problems and malnutrition in applying restrictive and special diets.

Особенности пищевого поведения у детей с расстройством аутистического спектра

Objective. To study the effect of nutrition and psychopathological traits on the development of eating behavior in children with autism spectrum disorder (ASD). Patients and methods. A comparative analysis of the features of nutrition and eating behavior in 40 children with ASD and 40 neurotypical controls was performed. Two patient groups were comparable in age (3–8 years). The methods used to assess nutrition included retrospective dietary recall, analysis of the frequency of consumption of specific foods or meals, and a 24-hour dietary recall survey. For retrospective analysis of children’s nutrition, we developed a questionnaire for parents, considering the characteristics of eating behavior in both children with ASD and neurotypical controls. Results. The introduction of first complementary foods in children with ASD did not differ significantly from neurotypical controls. The first peculiarities of eating behavior in children with ASD began to manifest themselves when trying to expand the variety of complementary foods. In 57.5% of children with ASD, clear disorders of eating behavior coincided with the onset of regression in neuropsychological development. There appeared food selectivity (in 72.5% of children with ASD), picky eating (in 22.5%), gagging at the sight, consistency, and color of food (in 42.5%) and a limited range of foods (in 70%), which was practically impossible to expand. The nutrition of children in the control group was diverse. They were interested in new tastes and consistency of foods, and food selectivity was noticed only in 16.7% of cases and was not so categorical. An attempt to influence the health status of children with ASD, primarily to reduce psychomotor agitation, was manifested in the use of elimination diets (gluten-free and/or casein-free) in 37.5% of children with ASD, which demonstrated a positive effect in most children. However, the indications for their use and duration were commonly not coordinated with a physician, which created a risk of deterioration in children’s health. Conclusion. Eating disorders are not always noticed by specialists in time and require special attention, as they can be both symptoms of ASD and contribute to disease aggravation. Refusal of children with ASD from previously consumed foods, selectivity, and picky eating commonly coincide with regression in neuropsychological development. The use of gluten-free and/or casein-free elimination diets in children with ASD should be justified. Restricted and unbalanced diets prescribed by parents without medical supervision may exacerbate the nutritional and health problems in children with ASD. Key words: autism spectrum disorder, children, eating behavior, nutrition, gluten-free diet, casein-free diet

CONCOMITANT SOMATIC DISEASES IN CHILDREN WITH AUTISTIC SPECTRUM DISORDERS: CHALLENGING ISSUES OF MEDICAL OBSERVATION BY PEDIATRICIANS (LITERATURE REVIEW)

An analysis of modern medical literature carried out to study the main concomitant pathology in children with autism spectrum disorders gas revealed what concomitant diseases are more common in children with autism than in the general population. The structure of concomitant somatic pathology of children with autism includes disturbances from the gastrointestinal tract, sleep disturbances, the risk of overweight and obesity that affects the quality of life and complicates the manifestations of the main disease. The review of the current scientific literature has provided preliminary evidence that targeting the gut ecosystem has the potential to influence both autism spectrum disorders symptoms and gastrointestinal symptoms. The use of prebiotics and probiotics to correct behaviour and treat gastrointestinal diseases in children with autism has had limited effectiveness. The effectiveness and safety of using a gluten-free and casein-free diet in autism spectrum disorder is remaining controversial: a number of studies have reported no significant changes in autism symptoms, and the risk of developing nutrient deficiencies limits its clinical use. A combination of behavioural interventions and the use of the paediatric slow-release melatonin molecule are effective in the treatment of sleep disorders in children with autism.
 Conclusion. The high prevalence of concomitant somatic pathology in children with autism affects the course of the main disease, requiring a comprehensive examination of these children for its timely diagnosis and treatment. Taking into account the polyetiological nature of the etiopathogenetic mechanism of the development of autism spectrum disorder, the treatment of children with autism by a paediatrician should be carried out using evidence-based methods, with multidisciplinary support by specialists in the profile of existing concomitant disorders.

A narrative review on manifestations of gluten free casein free diet in autism and autism spectrum disorders.

Autism and Autism Spectrum Disorder (ASD) are specific neurological disorders that affect the brain, frequently characterised by challenging paediatric behaviour. The current narrative review using PubMed and Google Scholar was conducted in line with the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols, and comprised randomised controlled trials and clinical control trials with gluten-free, casein-free (GFCF) diets published till 2020. Of the 80 studies selected, 7(8.75%) were included in the review. It was observed that the gluten-free, casein-free diet was safe with therapeutic benefits in autistic children. Therefore, a tailored dietary approach can be a beneficial management regimen. The trials related to utility of gluten-free, casein-free diet among autistic children are sparse, with limited sampling size, and indication of bias in the findings. Therefore, larger cohort studies on gluten-free, casein-free trials are required to provide further insight into the therapeutic benefits of the diet.

Effect of elimination diets on the functioning of children with autism in the opinion of parents

Introduction. The autism spectrum disorder is more and more common in the world and is diagnosed in the early years of childhood. This disorder is impossible to cure, so parents are increasingly looking for the best therapies for their children. The most popular are the use of elimination diets, including gluten-free and casein-free diet. Material and methods. The study was conducted on a group of 95 people: 68 women and 27 men. The Cole index was used to assess the nutritional status of children with ASD. Taking into account the interpretation, it can be concluded that almost half of children with ASD have a normal nutritional status.There are 65 children with ASD who have complaints of impaired gastrointestinal function, the most common symptoms are gas, constipation, bloating and abdominal pain. Results. The most common and popular of the alternative treatment support methods for a child with ASD used by parents are elimination diets. Among the most commonly used can be a diet that is either casein-free, gluten-free, sugar-free, or a diet with elimination of specific ingredients. In our study, we found that there is a significant relationship between the use of an appropriate nutritional strategy and improved digestive functioning in a child with ASD. Conclusions. Based on the results, it was concluded that there is a significant correlation between the use of a gluten-free diet and / or a non-dairy diet, and the improvement in the functioning of the digestive system, quality of life and behavior of children with autism. According to the subjective opinion of parents, a gluten-free and dairy-free diet improves the quality of life and behavior of a child with ASD.