Roads Less Taken

By: Sabiha Toni 

Alternative medicine and therapy has always been a
controversial field in science, often because there is no conclusive evidence
supporting many of the options offered. The legitimacy of alternative
treatments are still argued by scientists and doctors—while some are in support
of certain therapies, others find no reason to accept them. Patients, parents,
or relatives swear by them from personal experience, or others’ experiences.
The same is applicable for ASD treatments. Hypotheses are proposed and
experimented to explain autism’s unclear mechanism in the brain and its complex
set of causes. In the process, novel treatments are developed based on these
theories, even before convincing evidence has been shown of their validity.

One such theory is the Opioid Excess Theory, which attempts
to explain the physiological mechanism of autistic behavior. It proposes that certain
proteins from diets are broken down incorrectly in the body and reabsorbed by
an abnormally permeable gut. Some of these byproducts cross through the
blood-brain barrier and act as opiates (Shattock, Whiteley, 2002). Further
studies show the correlation between this improper metabolism and certain
autistic behaviors in rat models (Sun, Cade, 1999). These opiate-like peptides
can be derived from two proteins called casein and gluten, which are found in
common foods such as wheat bread or milk.

Thus, a dietary option called gluten-free, casein-free diet
(GFCF diet) was offered as a treatment plan. Foods that contain gluten, such as
wheat, rye, barley and oats, and those that have casein (most dairy products)
are excluded from an autistic individual’s diet. If the Opioid Excess Theory is
valid, by eliminating dietary intake of proteins that act as opiates in the
brain, one can expect certain signs of autism to lessen over time.

Though the GFCF diet is sometimes recommended as a treatment
approach to ASDs, there is controversy surrounding the effectiveness of the
treatment. While experiments show that GFCF diet may in fact be helpful for an
autistic individual, others show no significant findings. Scientific articles
that evaluate research done about the effectiveness of GFCF found conflicting
data on the subject (Mulloy et al., 2009). Since it is difficult to reproduce
results for the GFCF diet, the evidence remains inconclusive.

However, many parents and relatives feel that every approach
should be taken advantage of, especially if it is as simple as changing a diet.
Research suggests that constricting an individual’s diet to gluten-free and
casein-free products may contribute to nutritional deficiencies in children
(Mulloy et al., 2009). Children with autism who were subjected to GFCF diets
were shown to have deficient amounts of essential amino acids than those who
were not on a restricted diet (Arnold, Hyman, Mooney, Kirby, 2009).

Gluten-free, casein-free diets have risen in popularity
among individuals with autism because of the convenience of such a treatment
approach. Although there is some scientific basis to alternative treatments, it
is important to keep in mind that the effectiveness of restricted diets has not
been established in ASD patients. It is also essential to consider the health
risks associated with such treatments, which may hinder development in younger
autistic individuals. These options are available, however, and may even prove
effective with further research.


Arnold, G., Hyman, S., Mooney, R., & Kirby, R. Plasma
amino acids profiles in children with autism: Potential risk of nutritional
deficiencies. Journal of Autism and Developmental Disorders. 2003; 33(4):

Millward, C., Ferriter, M., Calver, S., Connell-Jones, G.
Gluten- and casein-free diets for autistic spectrum disorder. Cochrane Database
System Rev. 2008; (2).

Mulloy, A., Lang, R., O’Reilly, M., Sigafoos, J., Lancioni,
G., Rispoli, M. Gluten-free and casin-free diets in the treatment of autism
spectrum disorders: A systematic review. Research in Autism Spectrum Disorders
2010; 4(3): 328-339.

Shattock, P., Whiteley, P. Biochemical aspects in autism
spectrum disorders: updating the opioid-excess theory and presenting new
opportunities for biomedical intervention. Expert Opin. Ther. Targets. 2002;
6(2): 175-83.


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