08. Should You Go Gluten Free?
Is the gluten-free diet right for your child with autism?
If your child is on the autism spectrum it is almost inevitable to not hear about going gluten-free. While the topic of gluten allergies, sensitivities, and intolerances is vast, there is a lot of research that supports going gluten-free in children with autism.
Listen along as I dig further into the topic of going gluten-free, and how it may or may not be for your child!
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IN THIS EPISODE
What does the research say about gluten-free diets for children on the autism spectrum?
Different types of gluten allergies and sensitivities
Deciding if the gluten-free diet is right for your child
LINKS
Learn more about the Gluten-Free Diet for autism
Join the Autism Nutrition Library
Follow @AutismDietitian on Instagram
TRANSCRIPT
Welcome to the Nourishing Autism Podcast where you take a deep dive into the research on autism and dietary changes, nutrition supplements, and lifestyle modifications. Every week, we break down nutrition topics and an easy-to-understand way for you to feel less overwhelmed and feel confident on your nutrition journey with autism.
Hello everyone! And welcome to the Nourishing Autism Podcast. I'm your host, Brittyn Coleman, the autism dietitian. And this week we are talking about the gluten-free diet. This is a huge topic in the world of autism and nutrition. And we're going to talk about if you should follow it, if you should not. We're going to talk about all the pros and cons and everything that you need to know about this diet, and it's the diet that you should follow.
If you should go all in to the gluten-free diet for your child on the spectrum? So to get started, you need to know what gluten is, and it's almost inevitable to not hear about gluten these days. It's become a huge topic in the world of nutrition. The gluten-free diet is most known for its use in celiac disease, which is an autoimmune condition in which gluten triggers a person's immune system to attack their own bodies, their own intestines. But you can also have non-celiac gluten sensitivity, which would also require a gluten-free diet, but is not an autoimmune condition.
And not to make things more complicated, but somebody with a wheat allergy. Could likely eat other grains with gluten sometimes not. They might also have an allergy to those gluten-containing grains. But they just can't eat wheat. So there's a lot of different reactions that you can have to either the grains themselves or the protein inside these grains. Now, commonly, we are talking about non-celiac gluten sensitivity. Not an allergy, typically not celiac disease.
When we are talking about nutrition for autism. Now, there are some cases where it's a good idea to get tested for celiac disease, because we see some signs of severe intolerance of gluten, and you can always get tested for allergies too, with your pediatrician to rule out anything.
A 100% adherence to this diet is absolutely necessary for those who have a food allergy to gluten-containing grains or who have celiac disease. Those with gluten sensitivity may be able to tolerate small amounts of contamination. A lot of times, this means going completely gluten-free in the beginning. And then later down the road, 6 months, 12 months down the road, introducing some gluten back into the diet and seeing how they respond. Is there's a threshold?
So it's thought that gluten can damage your gut lining and lead to intestinal permeability, which you might've heard is called leaky gut syndrome. This can happen to many people and not just those with autism, basically, they're saying that gluten proteins are difficult to digest and when they're not properly broken down, the result is large undigested peptides, and these can be absorbed through the gut lining and can even have an opioid-like effect the brain making you feel very addicted to them if you have leaky gut. So this can happen!
However, for some people who are not sensitive to gluten and gluten is not causing them an inflammatory response. This may not be the case. Everybody is different. Our guts look different. Our immune systems are going to be different. The foods we react to are going to be different. We are so incredibly different.
However, if you know that you have some kind of reaction from gluten, it causes inflammation or you have an autoimmune disease, like celiac. It's going to continually cause inflammation in your gut and body and can lead to leaky gut issues. Or just inflammation throughout the body. So we want to figure out, is this an issue?
Is there a gluten sensitivity and if so, let's do something about it. Let's reduce gluten, take out gluten. If there's not any kind of reaction, you may not have to remove it. So I want to talk about autism specifically because there's really polarizing research. You can look into it and some research will say, yes, kids with autism are successful with this diet.
And you'll see, also a lot of practitioners who say it is a non-negotiable to go gluten-free with autism. And it has helped so many people, not only my clients, but people on Instagram reach out to me all this time saying that this is a game-changer for them, and their child feels so much better, so much more focused. But then we see the other side of research and there's a lot of research that says, no, there's no success with going gluten-free for autism.
There may be a lot of children who are not sensitive. And then in the research it says, there's no success, but they don't have a sensitivity. And if we're using this diet to treat somebody who doesn't have a sensitivity, makes sense to why we're seeing no success.
So that's just my thought, and what I would love to see in the research. I haven't seen any research articles that study that, unfortunately, but my hope is that there will be over the next few years. There's also research that kind of meets in the middle and says, you know, going gluten-free for autism is helpful for some
And not helpful for others. And this is the camp that I am in. So I do see many people who have outstanding progress going gluten-free. It does make a huge change for those who are sensitive. We can see more focus, fewer GI issues, a lot of my clients will say their children just look less puffy or inflamed, and kids just doing so much better in therapies and in school. But then I also see kids who have been on the gluten-free diet for years without seeing any kind of progress. And so it's important that we look at every individual as an individual and there's no one size fits all. There's no one diet that's going to work for every single person.
Now looking into the research, there was one research study that found that gluten intolerance occurs in 40 to 50% of children with autism. This was just one study, but it is interesting and driving home the point that it's not going to be all children with autism, but that is nearly half of the kids with autism that may be sensitive to gluten.
What they also said in that research study, was that the nature of the intolerance should be clarified, so the diet can be tail. Tailored appropriately. What I really love about this is that they're saying this should be individualized. There's no one size fits all. And I completely agree to find the diet that works for your child. You know, it takes some digging and it takes some tailoring, but there is an approach that's going to work the best for your child that might not work for somebody else or somebody else's approach might not work for you.
So does everyone with autism need to follow this diet? My answer's no.
But is there increased odds that your child may benefit from it? If they have autism? Yes.
There was also an increased risk of other kinds of food reactions like dairy, soy, corn, and other foods as well. Gluten is the one that gets the most attention, but sensitivities to dairy, soy, and corn are also pretty common. If you are going to try to remove these from the diet, I recommend doing one at a time so that you can know which one is making a difference because if you don't have to be gluten-free, or dairy-free or soy or corn-free, it's great to have a wide variety of foods that your child can eat.
Now, if you were going to try this diet, give it at least six weeks. Which is my absolute minimum. But likely up to six months to see full benefits. What I see a lot of times is people will go gluten-free for a few weeks and say, oh, that didn't help my child. But a lot of times it's just not long enough. So definitely give yourself enough time. Dietary changes, take time. It takes time to get gluten in different foods out of the system and to start seeing those benefits. So it definitely takes time.
For people I've worked with who this diet was a good fit, they did see really great improvements. I often see around the six to eight-week mark, but it differs for everybody. They saw improvements in focus, attention, bowel movements, skin quality, and eczema reduction. The reduction of those bumps on the backs of the arms, keratosis pilaris, decrease in headaches. And a lot of times I see headaches can also show up as headbanging, and some other behaviors too.
So sometimes if your kid can't tell you what they're feeling, this can show in different symptoms like headbanging or hitting their stomach, showing that they're in some kind of discomfort. I was to see a decrease in gas and bloating among many other improvements. It's going to vary from person to person.
I do want to address going gluten-free with a really picky eater because if your child is only eating a few different foods and all of those foods are gluten-containing. Do not advise, changing everything overnight. So the goal with expanding diet for kids with autism is to gain trust, help them gain confidence in trying those new foods, and removing all of their safe foods overnight is not going to do that. In fact, this can often backfire. They can lose a lot of trust in you and the foods they become even more limited, and they are not going to try those new foods.
I talk about this a little bit in one of my previous episodes where we talk about the starve it out method and how that is a very outdated and oftentimes harmful approach for kids who are picky eaters with autism. Because sensory issues, one of the most common reasons for picky eating, is not going to just resolved with hunger. Or if they don't have the right muscle tone to chew their food, that is not going to resolve with hunger. Gastrointestinal issues are not going to resolve with hunger. So it's important that we are addressing the reason why they're a picky eater and work on that.
Let's gradually expand. Let's find alternatives of their favorite foods that may be gluten-free, work on adding that in with a dietitian or a feeding therapist to help them gradually switch. It does not have to be black and white and taking that gradual approach for a really selective eater. It's going to be the way that you're going to be the most successful. It is going to take longer, but this is my recommended approach. People will tell you to take everything out and go gluten-free overnight.
I don't recommend that method and I don't believe that that's the right course to take, but if that works for you, by all means. But just make sure that your kid is still getting the nutrients that they require. There are many case studies of children ending up in hospitals after using this starve it out method. So, I want to make sure that you're doing this diet change in a healthy way. In a way that isn't going to put your child at more risk for health concerns. So if you are making big dietary changes, please do it with the guidance of a healthcare practitioner.
Just to remember that going gluten-free. It doesn't have to be black and white at first. Of course, to see the most benefits of going gluten-free, you are going to have to remove gluten completely. But it doesn't have to be that way. In the very beginning, if you're working on getting your toes wet, the small reduction can help in gluten, but to see those full benefits, eventually, we do want to go gluten-free completely, you may see some benefits by a gluten reduction though.
So keep that in mind and keep track, keep a food journal and see how your child is doing with this diet. If you're wondering if your child is sensitive, there are some common signs that someone might be sensitive to gluten, and that often includes abdominal pain, cramping bloating and gas, diarrhea and constipation skin rashes, acne, joint pain, headaches, or dizziness.
Brain fog is a really common reaction, and people who experience all of the above reactions to gluten-containing foods are most likely to benefit from this diet. Now, keep in mind that you can have a reaction up to 72 hours after consuming a gluten-containing food. If you have a gluten sensitivity. So sometimes it can be hard to catch if you're having a delayed reaction.
But all of these reactions discussed indicate an inflammatory response within the body and removing the food, removing those offending foods, may mitigate these symptoms. You can also test for gluten sensitivity or celiac disease. And my recommended ways to test for gluten sensitivity are either through a food sensitivity test called the MRT, which stands for mediator release test.
Or a stool panel that tests for anti-gliadin, IGA, like the GI MAP. I use both of these tests with many of my clients. If you asked your doctor to run a test for gluten sensitivity, they'll either say they won't do it, or they will run a wheat allergy test, which is not the same as sensitivity testing. So you likely will have to either go to a functional medicine practitioner or find a dietician who offers a food sensitivity testing with the MRT.
Keep in mind that it's also completely possible to figure out if you're gluten-sensitive without doing any kind of testing, you can do. An elimination, diet and test, and see if you notice improvements with removing gluten and adding it back in. So. Just keep in mind that you don't have to do testing in order to see the benefits of a gluten-free diet and give it a try.
You can be sensitive, but not allergic to gluten. So if your practitioner runs a wheat allergy test and it comes back negative, you can still react to gluten with a sensitivity. But it's not going to show up on an allergy test because those are completely different testing.
It's also important to note that not all food sensitivity testing is created equal. So you might get ads for some food sensitivity tests. You do not want to spend your money on something that does not work. So, definitely recommend if you are going to do the food sensitivity testing, to work with a practitioner who can guide you through this and can do a reputable test like the MRT.
So, if you do decide to go gluten-free, it can be confusing and overwhelming at first, but you eventually settled into a new normal. There is a misconception around which grains contain gluten. So grains like oats, rice, quinoa, and corn are naturally gluten-free. Sometimes there can be a contamination with these grains. So if you do have a severe sensitivity or celiac disease, you need to make sure that you buy these grains gluten-free certified.
Some people who are gluten sensitive can manage the cross-contamination of grains and they don't react to that. But gluten can be pretty tricky because it can also be found and a lot of unsuspecting foods like soy sauces and dressings, and marinades, gravies, cream sauces, and different soups. Of course, it's found in pastas, breads, pastries, bagels, all of those delicious, but very glutinous foods. If you need a go-to guide on how to follow a gluten-free diet, we do have an entire guide on the gluten-free diet, and how to follow that for kids with autism. Inside my membership is called the Autism Nutrition Library. We have all the foods to consume, the foods to not consume, and then we also have research on the gluten-free diet and autism and just all the information that you need to know all in one place. Outside of gluten-free diet, we have a lot of other diets to look into like the dairy-free diet. And we also have supplements foods, conditioned, symptoms, you name it all related to autism. It's your one-stop nutrition resource for autism.
So, the take away a message today. Do you have to go gluten-free if you have a child with autism? No. But is it likely to be helpful? Sure. So if your child has a varied diet and accepts most foods easily, it could be worth it to go all in and do a full six weeks, at minimum trial right off the bat.
However, if your child is really selective and all their preferred foods contain gluten let's work on transitioning to alternative foods first, rather than taking away all of their preferred foods overnight. I do recommend getting a feeding therapist, and /or a dietitian on board to help support you through this.
And the same goes for any other suspected sensitivities like dairy. Like if they rely on milk for the majority of their nutrition and only eat a few other foods, we don't want to pull their primary nutrition overnight because that can cause more issues. And they're likely to not accept some new food to replace that preferred food, if they are really selective eater.
Just remember that everyone is extremely different autism or not. And I do recommend getting support from a functional medicine practitioner, a dietitian. To make this transition, especially if your child is a selective eater, and then bring on a feeding therapist, preferably credentialed in SOS approach to feeding. I find that that is the best approach for kids with autism and sensory issues.
So the bottom line, given the potential for improvements with the gluten-free diet, especially for those that have those negative symptoms after consuming gluten that I had listed previously in this episode, I believe this diet is well worth a try. And if you want more guidance to follow that, gluten-free diet checkout the gluten-free diet note in the Autism Nutrition Library for everything that you need to know.
And I also have all my favorite gluten-free products like bread, pasta, tortillas, baking mixes, flowers all listed in the library. I, myself, have been gluten-free for a long, long time; nearly 20 years. So, I have seen gluten-free through its worst times and it's gotten pretty good. So I do have some recommendations of different products that I've tried if you did decide to go gluten-free.
You can join or log in to the Autism Nutrition Library by visiting autismnutritionlibrary.com. And that's it for this week! I look forward to seeing you next week as we take the guesswork out of nourishing autism.
This podcast is brought to you by the Autism Nutrition Library, a one-stop hub and community for all things autism nutrition created to help you explore evidence-based nutrition approaches that have proved to be effective to help individuals with autism feel their best, do their best, and be their best.
Join now by clicking Autism Nutrition Library or by stopping by my Instagram @AutismDietitian. See you next week.
Transcribed by Descript
ABOUT Brittyn Coleman, MS, RDN/LD, CLT
I’m a Registered Dietitian, Autism Nutrition Expert, and the Creator of the Autism Nutrition Library.
I work with parents of children with autism to optimize their child’s diet, supplements, and lifestyle based on their unique needs. I help expand accepted foods for picky eaters, improve digestion and gut health, find the root causes of many symptoms, and ultimately help them feel their best so that they can do their best and be their best.
Not only do I relate to families on a professional level, but also on a personal level. I have been a part of the autism community for over 20 years, as my younger brother was diagnosed on the spectrum at a young age.
I look forward to working with you to uncover the root cause of your child’s symptoms and help your child be the best version of themselves!
