You Are What You Eat

1
You Are What You Eat

• A Review of Diets for Autism Treatment

Erika Koelsch
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Search Critera

• PsychInfo, Academic Search Premiere, ERIC,
  MEDLINE
• autis and diets, gluten, gluten-free,
  casein-free, Feingold.
• Google searches
• Autism and diets, gluten-free diets,
  casein-free diets, celiac disease, Defeat
  Autism Now, Feingold.

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What Diets are out there for Autism Treatment?

• GFCF (Gluten-Free, Casein-Free)
• Specific Carbohydrate Diet
• Feingold Diet

4
Autism Research Institute

• Non-profit founded in 1967
• Bernard Rimland, Ph.D
• Conferences about GI disorders impact a childs
  sense of self, behavior, attention, speech, and
  general health and wellbeing. Our SCIENTIFIC
  principles and protocols apply to affected
  children of all ages, and varying conditions.
  Jane Johnson, Managing Director, ARI
• Credit ABA, OT and Speech however..
• little true or lasting progress or benefit can
  be expected.

Autism Research Institute. (2010). Retrieved
from http//www.autism.com/
Autism Research Institute Conference. (2010).
Retrieved from http//www.defeatautismnow.com/
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Defeat Autism Now! (DAN! Project)

• Sidney M. Baker, M.D. in 1994
• biochemical, immunologic, and gastroenterological
• Point to new biomedical treatments
• Dr. Baker, Dr. Rimland and Dr. Jon Pangborn
  founded Defeat Autism Now!
• Objectives of Defeat Autism Now!
• Teach about biomedical treatments
• Offer conferences about latest research on
  biomedical treatments for autism
• Provides a list through ARI of DAN! Doctors in
  the US and outside

Autism Research Institute. (2010). Retrieved from
http//www.autism.com/
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DAN! Doctors

• From the ARI website, DAN! Doctors must meet
  these criteria to be placed on the list
• The clinician is a licensed healthcare provider.
• The clinician must attend a Defeat Autism Now!
  Clinician Seminar at least once every two years.
• Starting in 2010, clinicians must attend a level
  I and a level II seminar to be listed on ARI's
  clinician registry.
• ARI reserves the right at their sole discretion
  to not include, or to remove, a practitioner from
  the Clinician Registry.
• Doctors must also adhere to the Defeat Autism
  Now! Philosophy
• Also lists for naturopaths and homeopaths and
  nutritionists

Autism Research Institute. (2010). Retrieved from
http//www.autism.com/
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DAN! Conferences

• http//www.autism.com/pro_categories.asp?conBalti
  moreYear2010
• Defeat Autism Now! October Conference Science
  Sessions
• Mitochondria and Autism
• Update on Gastrointestinal Topics in Autism
• Redox Effects of Gluten/Casein Peptides and
  Neurotrophic Growth Factors and Their
  Implications for Autism
• All Speakers are MDs or Ph.ds

Autism Research Institute Conference. (2010).
Retrieved from http//www.defeatautismnow.com/
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RED FLAGS of ARI and DAN!

• Remark on importance of biomedical without
  supporting details or evidence website
  propaganda? Pseudoscience?
• Big names and buzzwords
• DAN! Doctors
• Red Flag?

Autism Research Institute. (2010). Retrieved from
http//www.autism.com/
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Diets
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What is a Gluten Free Diet?

• Often called GFCF (gluten-free, casein-free diet)
• Removal of all gluten and casein from daily diet
• What is a casein?
• Casein is a protein found in milk
• Gluten/Casein free diet consists of no gluten and
  no milk/dairy products including casein

Gluten-Free/Casein-Free Diets for Autism. (2010).
WebMD. Retrieved from http//www.webmd.com/brain/
autism/gluten-free-casein-free-diets-for-autism
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What is Celiac Disease?

• Damage to the small intestine
• Absorption of food difficulties
• Gluten- protein in wheat, rye and barley
• Gluten found in food or other products
• Special considerations
• Untreated can cause anemia, and cancer
• Sometimes does not show symptoms

National Digestive Diseases Information
Clearinghouse. (2010). Celiac Disease. Retrieved
from http//digestive.niddk.nih.gov/ddiseases/pubs
/celiac/
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Symptoms

• Symptoms of Celiac Disease
• In Children and Infants
• Bloating or abdominal pain
• Diarrhea
• Vomiting
• Constipation
• In Adults
• Anemia
• Fatigue
• Joint pain
• Depression or anxiety
• Seizures
• Miscarriage/infertility
• Co morbidity

National Digestive Diseases Information
Clearinghouse. (2010). Celiac Disease. Retrieved
from http//digestive.niddk.nih.gov/ddiseases/pubs
/celiac/
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Treatment for Celiac Disease

• GLUTEN-FREE DIET

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Gluten-Free Diet Video

• Elizabeth Hasselbeck
• http//www.youtube.com/watch?voSJ-nrYETzs

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Gluten-Free/ Casein-Free and ASDs

• Why are gluten-free casein-free diets relevant to
  those with ASDs? Suggested that
• These diets reduce symptoms of autism
• Assist with children who have a food allergy
• Promote skill acquisition
• Many parents have stated incredible success in
  their child with ASDs
• Overall consistency between Vaccines and Diets
• Biomedical model

The GFCF Diet Intervention - Autism Diet. (n.d.).
Retrieved from http//www.gfcfdiet.com
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How does this occur?

• Various GI symptoms in those with autism
• Diarrhea, bloating, pain
• Associated with abnormalities in small intestine
  mucous and GI function
• In those with autism, the walls of the small
  intestine are leaky and therefore gluten and
  casein proteins go into blood stream
• The dietary gluten and casein in the bloodstream
  create peptides that are similar to opioid
  substances
• This induces antigenic responses which affects
  the central nervous system
• Opioid Excess theory of autism
• Reaction to pain, hunger and thirst

Munasinghe, S. A., Oliff, C., Finn, J., Wray,
J. A. (2010). Digestive Enzyme Supplementation
for Autism Spectrum Disorders A Double-Blind
Randomized Controlled Trial. Journal of Autism
and Developmental Disorders, 40, 1131-1138.
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ANDI

• Autism Network for Dietary Intervention
• Offers information for parents of children with
  autism on special diets
• Newsletters
• Sample Letter
• http//www.autismndi.com/

Autism Network for Dietary Intervention. (2010).
Retrieved from http//www.autismndi.com/
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AutismONE

• AutismOne
• Non-profit started by parents of children with
  autism
• Very disturbing website in many ways
• http//www.autismone.org/

AutismOne. (2010). Retrieved from
http//www.autismone.org/
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Talk About Curing Autism (TACA)

• Focuses on newly diagnosed children with autism
• Most successful combination
• Traditional Therapies
• Biomedical Therapies
• Keeping Family Healthy
• Mission
• To speed up time between diagnosis and
  appropriate intervention
• Connect parents and provide support

TACA Talk About Curing Autism . (2010).
Retrieved from http//www.talkaboutcuringautism.or
g/support/autism_intro.htm
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The TACA Spokeswoman.

• JENNY MCCARTHY
• http//www.youtube.com/watch?vzVZDPrgwZ78

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Julie Matthews

• Healthful Living
• With husband Martin Matthews created a lifestyle
  that promotes the health, healing, and happiness
  of all living things
• Martin Matthews
• Hypnotherapist
• Focuses on personal wellness, personal freedom,
  emotional trauma, and stress reduction
• Julie Matthews
• Certified Nutrition Consultant
• Focuses on ASDs, pregnancy wellness, womans
  health, digestion
• Nourishing Hope for Autism

Healthful Living. (2010). Retrieved from
http//www.healthfullivingsf.com/
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Nourishing Hope For Autism
Healthful Living. (2010). Retrieved from
http//www.healthfullivingsf.com/
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Julie Matthews

• Holistic Nutrition
• Uses basic needs of body
• Traditional Healing Foods
• Addresses the whole person
• The Flow-Chart
• http//www.healthfullivingsf.com/autism/
• Supports nutrition for healthy living--- AND
  autism dietary interventions
• http//www.prweb.com/releases/2007/10/prweb560337.
  htm

Healthful Living. (2010). Retrieved from
http//www.healthfullivingsf.com/
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Newsletter

• Reality Sandwich
• Various guests on upcoming radio show
• For example
• Hypno-Birthing

Healthful Living. (2010). Retrieved from
http//www.healthfullivingsf.com/
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Correspondence

• GFCF website
• Ellie Fried ( North Jersey Chapter of R.O.C.K-
  Raising our Celiac Kids)
• "Raising Our Celiac Kids (R.O.C.K.)" We welcome
  families of children with autistic spectrum
  disorders who are using a gluten-free/casein-free
  dietary intervention program. 
• http//www.gfcfdiet.com/communitybulletinboard.htm
  

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Correspondence

• Julie Matthews
• Referred me to her book, Nourishing Hope for
  Autism
• Another example of self-citing

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Felix

• 29 year old
• Lives in Denmark
• Has Aspergers Syndrome
• Chronicles Gluten-Casein Free Diet journey on
  YouTube

• http//www.youtube.com/user/BumsenDKp/a/u/0/FEjdC
  FPK3Jk

BumsenDk's Channel. (2010). Retrieved from
http//www.youtube.com/user/BumsenDKp/a/u/0/FEjdC
FPK3Jk
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What does Gluten-Free, Casein-Free diets claim to
do?

• By not eating gluten or casein, eliminate the
  proteins from entering the bloodstream
• Eliminating opiod effects and autism symptoms

Munasinghe, S. A., Oliff, C., Finn, J., Wray,
J. A. (2010). Digestive Enzyme Supplementation
for Autism Spectrum Disorders A Double-Blind
Randomized Controlled Trial. Journal of Autism
and Developmental Disorders, 40, 1131-1138.
29
Special Carbohydrate Diet

• Dr. Haas pioneered the Haas diet in 1951
• Fungi and Bacteria in GI track
• Renews toxin removal system
• Supported by Dr. Sidney Baker
• Removal of starches and complex sugars
• This removal helps kill major yeast and
  bacterial overgrowth. Mal-absorption decreases,
  rebalancing gut flora and encouraging healing.
• http//www.pecanbread.com/

http//www.The Scientific Diet for GI Problems,
Autism, and Other Conditions. (n.d.). Retrieved
from http//pecanbread.com/ .pecanbread.com
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What does Special Carbohydrate Diet claim to do?

• Heal GI tract by removing starches that damage it
  over time
• Deal with gluten/casein intolerance rather than
  resolve symptoms
• Combat celiac disease by curing intolerance

http//www.The Scientific Diet for GI Problems,
Autism, and Other Conditions. (n.d.). Retrieved
from http//pecanbread.com/ .pecanbread.com
31
Feingold Diet (Feingold Association of the United
States)
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Feingold Diet

• Dr. Ben F. Feingold
• Linked diet and behavior in 1960s
• Later in life, he travelled the US to spread the
  message of the Feingold Diet to those areas that
  were not yet exposed.

Feingold Association of the United States.
(2010). Retrieved from http//www.feingold.org/
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What is the Feingold Diet?

• Originally used for ADHD, however now used for
  other disorders/conditions
• Elimination of artificial additives
• Artificial (synthetic) coloring
• Artificial (synthetic) flavoring
• Aspartame (NutraSweet, an artificial sweetener)
• Artificial (synthetic) preservatives BHA, BHT,
  TBHQ
• http//www.youtube.com/watch?vUptp94xLchk

Feingold Association of the United States.
(2010). Retrieved from http//www.feingold.org/
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What is involved?

• Program materials (82.50)
• Food and shopping list
• Feingold member book
• Supplement guide
• Mail order guide
• Fast Food Guide
• Pure Facts Newsletter
• Members section on website
• Help-Line
• Email alerts
• http//www.feingold.org/DOCS/brochure.pdf

Feingold Association of the United States.
(2010). Retrieved from http//www.feingold.org/
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What does the Feingold Diet Claim to do?

• Commonly helps
• Behavior
• Learning
• Health

Feingold Association of the United States.
(2010). Retrieved from http//www.feingold.org/
36
Behavior

• Marked Hyperactivity
• Inability to sit still
• Wiggling
• Running
• Impulsive Actions
• Poor self-control
• Disruptive behavior
• Abusive behavior (e.g., unkindness to pets)
• Destructive behavior
• Excessive, loud talking
• Inappropriate noise

• Compulsive Actions
• Aggression
• Perseveration
• Excessive touching
• Picking skin
• Workaholic habits
• Emotional Concerns
• Attention
• Irritability
• Mood swings
• Depression
• Panics and nervousness
• Suicidal thoughts

Feingold Association of the United States.
(2010). Retrieved from http//www.feingold.org/
37
Learning

• Short Attention Span
• Impatience
• Distraction
• Inability to listen
• Inability to follow directions
• Inability to complete projects
• Cognitive and Perceptual Disturbances
• Auditory memory deficits
• Visual memory deficits
• Difficulty in comprehension
• Difficulty in Spatial Orientation
• Difficulties in reasoning

• Neuromuscular Involvement
• Accident prone
• Poor muscular coordination
• Difficulty writing and drawing
• Dyslexia
• Speech difficulties
• Difficulty with sports
• Eye muscle disorders
• Tics
• Seizures

Feingold Association of the United States.
(2010). Retrieved from http//www.feingold.org/
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Health

• Frequent Physical Complaints
• Ear infections
• Asthma
• Bedwetting
• Daytime wetting
• Stomachaches
• Headaches
• Hives/Rashes
• Eczema
• Leg aches
• Congestion
• Seizures

• Sleep Problems
• Resistance going to bed
• Difficulty going to sleep
• Restless erratic sleep
• Nightmares

Feingold Association of the United States.
(2010). Retrieved from http//www.feingold.org/
39
MORE on the Reputable Feingold Website

• Research
• Many references for different disorders/conditions
  
• A list of references published by Dr. Feingold
  himself
• The Feingold Shop
• Totes
• T-shirts
• Mugs
• Christmas stockings
• Im 100 Natural
• Artificial Colors are Good for Crayons
• If you love me, please dont feed me junk

Feingold Association of the United States.
(2010). Retrieved from http//www.feingold.org/
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Research to Support these Claims?

• Few studies however, none with statistical
  significance
• Digestive Enzyme Supplementation for Autism
  Spectrum Disorders A Double Blind Randomized
  Controlled Trial
• Munasighe, et al.
• The Gluten-Free, Casein-Free Diet in Autism
  Results of a Preliminary Double Blind Clinical
  Trial
• Elder, et al.
• Review article the concept of entero-colonic
  encephalopathy, autism and opiod receptor ligands
• A.J. Wakefield, et al.

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Digestive Enzyme Supplementation for Autism
Spectrum Disorders A Double Blind Randomized
Controlled Trial
.

• Purpose
• Does digestive enzyme supplement (Peptizyde)
  improve expressive language, behavior and other
  symptoms in ASDs
• Participant
• 43 children, 3-8 years-old, with ASD
• Method
• Two groups-
• Sequence 1- Enzyme, washout, Placebo
• Sequence 2- Placebo, washout, Enzyme

Munasinghe, S. A., Oliff, C., Finn, J., Wray,
J. A. (2010). Digestive Enzyme Supplementation
for Autism Spectrum Disorders A Double-Blind
Randomized Controlled Trial. Journal of Autism
and Developmental Disorders, 40, 1131-1138.
42
Digestive Enzyme Supplementation for Autism
Spectrum Disorders A Double Blind Randomized
Controlled Trial

• Rating Scales- completed monthly
• Global Behavior Rating Scale (GBRS)- effects of
  synthetic secretion on behavior and
  communication.
• Ordinal scale- 1) much worse, 4) no change, 7)
  much better
• Additional Rating Scale (ARS)- GI symptoms
• Quality of stools, Abdominal pain,
  diarrhea/constipation
• Therapist Rating Scale
• Teacher rating
• Language Development Survey
• Results?
• No significant difference!!
• Food variety score, parent behavior score, GI
  symptoms, Sleep quality, therapist engagement,
  Vocabulary score, sentence length score.

Munasinghe, S. A., Oliff, C., Finn, J., Wray,
J. A. (2010). Digestive Enzyme Supplementation
for Autism Spectrum Disorders A Double-Blind
Randomized Controlled Trial. Journal of Autism
and Developmental Disorders, 40, 1131-1138.
43
The Gluten-Free, Casein-Free Diet in Autism
Results of a Preliminary Double Blind Clinical
Trial

• Purpose
• Study gluten-free, casein-free diet in treating
  autism
• Participants
• 15 children, 2-16 years-old with ASD
• Method
• 2 Groups
• Group A- Baseline, Diet 1 (regular diet), Diet 2
  (GFCF diet)
• Group B- Baseline, Diet 2 (GFCF), Diet 1 (regular
  diet)

Elder, J. H., Shankar, M., Shuster, J.,
Theriaque, D., Burns, S., Sherrill, L. (2006,
April). The Gluten-Free, Casein-Free Diet in
Autism Results of a Preliminary Double Blind
Clinical Trial. Journal of Autism and
Developmental Disorders, 36(3), 413-420.
44
The Gluten-Free, Casein-Free Diet in Autism
Results of a Preliminary Double Blind Clinical
Trial

• Rating Scales
• CARS- Childhood Autism Rating Scale
• ADI-R- Autism Diagnostic Interview, Revised
• In home observations
• UPL- Urinary Peptide Levels
• ECO- Ecological Communication Orientation
  (Language Sampling Summary)
• No statistically significant difference on any of
  the rating scales

Elder, J. H., Shankar, M., Shuster, J.,
Theriaque, D., Burns, S., Sherrill, L. (2006,
April). The Gluten-Free, Casein-Free Diet in
Autism Results of a Preliminary Double Blind
Clinical Trial. Journal of Autism and
Developmental Disorders, 36(3), 413-420.
45
Review article the concept of entero-colonic
encephalopathy, autism and opiod receptor ligands

• Gut development and autism
• Reported
• 46 of children out of 385 with autism had GI
  symptoms
• 10 of children 385 typically developing
• Description of autism?
• Described many studies with autism and GI
  symptoms
• Connection between Opiods and CNS
• No real research or connections, just review of
  previous research

Wakefield, A. J., Puleston, J. M., Montgomery, S.
M., Anthony, A., O'Leary, J. J., Murch, S. H.
(2002). Review article the concept of
entero-colonic encephalopathy, autism and opiod
receptor ligands. Ailment Pharmacological
Therapy, 16, 663-674.
46
Are Diets Worth It?

• NO!
• For autism Treatment, no!
• No scientific evidence to prove its effects
• Healthy lifestyle? Vs Diets for treatment
• To quote Dr. Sharon Reeve

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In Conclusion

• http//www.youtube.com/watch?v3zEXgQIYCWUfeature
  related

48
Any Questions?

• THANK YOU!

49
References

• Autism Network for Dietary Intervention. (2010).
  Retrieved from http//www.autismndi.com/  
• Autism Research Institute. (2010). Retrieved from
  http//www.autism.com/  
• Autism Research Institute Conference. (2010).
  Retrieved from http//www.defeatautismnow.com/
• AutismOne. (2010). Retrieved from
  http//www.autismone.org/  
• Elder, J. H., Shankar, M., Shuster, J.,
  Theriaque, D., Burns, S., Sherrill, L. (2006,
  April). The Gluten-Free, Casein-Free Diet in
  Autism Results of a Preliminary Double Blind
  Clinical Trial. Journal of Autism and
  Developmental Disorders, 36(3), 413-420.  
• Feingold Association of the United States.
  (2010). Retrieved from http//www.feingold.org/  
• Glutein-Free/Casein-Free Diets for Autism.
  (2010). WebMD. Retrieved from http//www.webmd.com
  /brain/ autism/gluten-free-casein-free-diets-
  for-autism

50
References Cont.

• The GFCF Diet Intervention - Autism Diet. (n.d.).
  Retrieved from http//www.gfcfdiet.com  
• Healthful Living. (2010). Retrieved from
  http//www.healthfullivingsf.com/  
• Munasinghe, S. A., Oliff, C., Finn, J., Wray,
  J. A. (2010). Digestive Enzyme Supplementation
  for Autism Spectrum Disorders A Double-Blind
  Randomized Controlled Trial. Journal of Autism
  and Developmental Disorders, 40, 1131-1138.  
• TACA Talk About Curing Autism . (2010).
  Retrieved from http//www.talkaboutcuringautism.or
  g/support/ autism_intro.htm  The Scientific
  Diet for GI Problems, Autism, and Other
  Conditions. (n.d.). Retrieved from
  http//pecanbread.com/  
• Wakefield, A. J., Puleston, J. M., Montgomery, S.
  M., Anthony, A., O'Leary, J. J., Murch, S. H.
  (2002). Review article the concept of
  entero-colonic encephalopathy, autism and opiod
  receptor ligands. Ailment Pharmacological
  Therapy, 16, 663-674.
• YouTube. (2010). Retrieved from
  http//www.youtube.com