Is There a Link Between Diet and Behavior?

Experts discuss efficacy of eating gluten-, casein-free food as a way to reduce behavioral problems

By Deborah Jeanne Sergeant

For years, parents of children on the autism spectrum have claimed that adjusting their child’s diet has helped reduce effects of autism.

Most do not claim to “cure” autism, a developmental disorder marked by a reduced capacity to communicate, interact and interpret sensory input.

But these parents give hope to parents of newly diagnosed children who want to reduce behavioral problems and improve their children’s chances of leading a more typical life.

Tanya Pellettiere, Ph.D., is a child and family psychologist with Liberty Post in East Syracuse. While she has read of accounts of parents adopting a gluten-free, casein-free (GFCF) diet for their child and experiencing big improvements, she remains skeptical that this is a specific mechanism for improving autistic behavior.

“If all of us change our diet, we’ll feel better, sleep better, focus improves and irritability goes down,” she said. “The research doesn’t suggest an autism-specific diet.

I’d say a good diet, good exercise, good outside time and good sleep are imperative for all children and especially kids with autism. But simply working on diet, sleep and exercise is not enough for kids on the spectrum. A comprehensive, integrative plan is best.”

Gluten is inherent to wheat, barley and rye; casein is part of milk and other dairy products. Little research supports eliminating these foods can improve the behavior of children on the autism spectrum.

Laurel Sterling, registered dietitian and educator with Carlson Labs in Canastota, said that research by physician Alessio Fasano indicates that “gluten impairs the gut lining integrity by interfering with the gap junctions between GI lining cells.” This can then make the gut “leakier” and allow certain particles and toxins to leak outside the GI tract which can affect the body in various ways.

“When they eliminate gluten, individuals have seen benefits as the gut lining gap junctions can tighten up and allow nutrients to be digested, absorbed, and eliminated more effectively,” Sterling said.

She added that other studies indicate that people on the autism spectrum are more likely to struggle to digest gluten, which may exacerbate autistic behaviors.

Physician Susan Stone has completed a fellowship in integrative medicine and is trained in medical acupuncture. She practices at Willow Health Integrative Medicine in Syracuse.

“I think changing the diet is worthwhile to try,” Stone said. “There is an important connection of the gut-brain. There is a fair amount of acknowledgement that people on the autism spectrum have some gut sensitivities. It’s low risk to try a special diet if you desire.”

Jason Zelenyis a master of science and is board-certified in behavior analysis at Upstate Golisano Children’s Hospital, said that several studies have looked at the gut biome and the severity of symptoms associated with autism.

“Some research has found a correlation between poor gut biome diversity and increased social withdrawal, worsening of inappropriate speech, and increased problematic GI symptoms in children with autism,” Zeleny said. “While other research indicates that changes in the gut biome may be a product of the worsening of the symptoms of autism through dietary preference or restriction.”

Autism is a brain developmental disorder and experts do not yet clearly understand the correlation between the severity of symptoms associated with autism and the gut biome. Zeleny added that the research findings in studies such as this tend to be inconsistent. But the higher prevalence of GI disturbances among people on the autism spectrum is widely known. This can include reflux, constipation, abdominal pain, pain while stooling and diarrhea. But it is not clear which factors influence the others.

Not all children on the spectrum experience GI symptoms, so it does not appear causal. Many children on the autism spectrum exhibit strong preferences and aversions for certain types of foods. This disordered eating may cause some of the GI disruptions they experience.

“Regardless, it is generally in each child’s interest to work toward a healthy diet with a wide variety of foods and food groups to benefit the child’s overall developmental growth, GI health, and gut biome,” Zeleny said.

This includes a consistent mealtime, presenting a wide variety of food types and textures from a young age (as long as they are age-appropriate), and encouraging children to try new foods.

“Working toward a healthful diet with a wide variety of foods and food groups will help to ensure their child’s gut biome is healthy,” Zeleny said. “If caregivers continue to work at the above suggestions but still feel they are making little to no progress, seek out professional help from a feeding specialist (e.g., speech-language pathologist, behavior analyst, occupational therapist).

“Every child and their needs are different and sometimes the help of another professional can give the child and their caregivers the tools and structure needed to help work toward a healthier diet,” Zeleny said.