Let’s Talk About….Gluten GF/CF Diet Part 2: The Gluten Factor
I am often asked if the Gluten and Dairy Free (GF/CF) diet is really necessary. While that answer really depends on each individual child, in my practice up to 80% of the children I see clearly benefit from removing foods that contain dairy and gluten!
What is Gluten?
That’s what my wife asked me when I first suggested that my son, Josh, needed to go on the Gluten free diet. Gluten is derived from the Latin word “glut” which means glue. Gluten is found in many of the common flours we use in baking. These flours include wheat, oats, rye, and barley. Gluten is a protein that gives baked products their elastic, stretchable, and “hold together” consistency. Imagine a pizza dough being tossed into the air as it is being formed, how it is so elastic it is almost rubbery. This dough is made from gluten enriched flour.
The potential problem for children on the spectrum of Autistic Disorders is that they are often unable to substantially break down gluten during the process of digestion. Instead, they end up with gliadorphins, also known as gluteomorphins. These gliadorphins can act as opiates and cause a range of potential behavioral modifications in children, the same range of behaviors that the casomorphins found in dairy can cause. These behaviors include:
• Constipation
• Cravings
• Diarrhea
• Sleepless nights
• Hyperactivity
• Bed-wetting
• Resistance to potty training
• Hyperactivity
• Aggressive behaviors
• Dark circles under the eyes
• Bloated belly
• Flatulence (lots of gas being passed)
• Irritability
• Self-injurious behaviors
• Severe self imposed dietary restriction (craving only milk containing products)
A urine test, called urine peptides, can detect if gluteomorphins are present. This laboratory test can tell us quickly if the child is not processing gluten containing products appropriately. If your child is not properly processing gluten, small proteins called “peptides”, derived from partial break down of gluten containing foods in the digestive tract, show up in the test results. These proteins act like opiates and have a profound impact on behaviors.
There are also a small number of children who are simply gluten intolerant, known as Celiac’s disease. This disease can show up many different ways, but classically, in a child, when gluten containing foods are introduced, the child just stops gaining weight and the growth curve just flattens out. This decline usually starts at about 7 months of age. The Celiac Website estimates this problem occurs in 1/133 people, so this condition is bound to affect some of our children on the spectrum as well. The treatment for this condition is just removal of gluten containing foods. This gluten free diet has been well studied and documented, and is quite safe. This diet should be considered with all our children on the spectrum for at least 3 months.
Stopping Gluten
It is important to keep in mind that during the transition away from gluten, there can be 2-3 weeks of increased problem behaviors that include worse tantrums, increased aggression, worse sleep, etc. Remember when I said that gluten can act like an opiate? If it is, your child is addicted to it. Josh, my son, would only eat a few gluten containing foods, but even so, when you remove an addict’s drug of choice, it is a bad thing around the house until they are finished detoxifying from it.
In our clinic, when children seem to be exhibiting these “special” behaviors of withdraw, we recommend, ibuprofen (like Advil, Motrin, etc), charcoal, and magnesium sulfate (Epsom Salts) baths.
Finally, since many patients don’t have access to laboratory testing, they will just do a 3 month trial of strict gluten removal from their child’s diet, usually after successfully removing dairy. Obviously, that means no pizza, fruit loops, or regular crackers. However, gluten containing products are very commonly used in packaged foods. Some packages will come out and tell you that the product contains no gluten, but every packaged food must be examined for all the “code names” of gluten. There is a wonderful website that can really assist you in understanding about gluten free products: www.gfcfdiet.com. I would encourage you to go there to check on the permissible flours and products.
In the meantime, there are aisles in the grocery stores and sections in the health food stores that have many ready to eat GF/CF products. Please keep in mind, many of these products do have huge amounts of sugar, so you will want to limit how much of them your child consumes.
And that’s my approach to removing gluten.