5 Reasons I Don't Use the GFCF Diet

Within autism parenting groups, I feel like I'm a member of a tiny minority. All the other special-needs parents I know are constantly exchanging diet tips for the increasingly popular GFCF (gluten-free, casein-free) diet, which is widely touted for its purported ability to reduce autism symptoms-- or, some say, "cure" the condition altogether. But despite its popularity, I won't be switching my child to the GFCF diet at any point in the foreseeable future. Here's why:
1. There's no proof that it works. The Cochrane Collaboration, an unbiased nonprofit that investigates the evidence behind health-related treatments, looked at all the available evidence for the GFCF diet for autism. They found that it's one of many very commonly used treatments for autism, but that, so far, there's not much reason to think that it works. Drawing from the pool of all available research, the organization concluded, "Current evidence for efficacy of these diets is poor. Large scale, good quality randomised controlled trials are needed."

Similarly, Elsevier published a review and concluded that GFCF diets shouldn't be used for autism: "Critical analysis of each study's methodological rigor and results reveal that the current corpus of research does not support the use of GFCF diets in the treatment of ASD."
2. I don't want to encourage an eating disorder. Autistic children are notoriously picky eaters and, in some cases, picky eating can turn into a serious eating disorder. Believe me, I've been there and done that, as a survivor of orthorexia. There's evidence that people with eating disorders have very high rates of autism-like symptoms, and even that autism and anorexia might be the exact same condition. Why take a child who is already at a high risk of developing an eating disorder and enforce an even more strict diet on them? My daughter already has her share of unhealthy behaviors when it comes to food, and I don't want to encourage food aversions or compulsions by unnecessarily restricting her list of "safe" foods.
3. There are serious health consequences of the GFCF diet for autism. GFCF diets for autism aren't risk-free; they can cause serious nutritional deficiencies. The systematic review in Elsevier found that autistic children on GFCF diets may be at a higher risk for bone problems. A GFCF diet can also lead to many deficiencies in vitamins and minerals and can lead to either severe weight gain or weight loss, both of which can be serious in children. And many people adhering to the GFCF diet develop diarrhea or constipation, which can be especially problematic for autistic kids, who are already prone to these discomforts. My daughter's picky eating has already led to some run-ins with anemia in the past, and I'm not going to chance putting her at a high risk for future deficiencies. Why chance it, especially when there's no proof it works?
4. Several healthy alternatives to the GFCF diet exist. There isn't much evidence to support the GFCF diet, but there are many other dietary changes that might benefit kids with autism. The Feingold Diet in particular, which eliminates food coloring, artificial flavor, and petroleum-based additives, is very low-risk and much healthier than the GFCF diet. Although it was created for children with ADHD, it could theoretically help autistic children, as well, and doesn't carry the same kinds of nutritional risks as GFCF diets. Does it work? Probably not. And it's certainly not going to cure autism. But if you want to give a dietary change a try, it's best to start with one that won't hurt. It's possible to switch your kids to a healthier diet without leaving the nutritional gaps associated with gluten-free and casein-free lifestyles.
5. I don't want a cure. When I hear other parents talking about "curing" their kids' autism, or the miraculous treatments that supposedly make it vanish overnight, I cringe. I don't want to change who my daughter is or separate her from her neurology. I do not want a cure for autism because I don't think it is a flaw or a defect. So, even if I knew that a GFCF diet for autism would "cure" my daughter overnight, I wouldn't pursue it unless it was a choice she made independently of me. And, considering that it doesn't seem particularly safe or effective anyway, I don't think I'm missing out on much. I'm not going to restrict my child's food intake in some desperate attempt to alter her identity.
I'm happy for now having my family follow a balanced, minimally processed diet, and to help my daughter through any struggles she has using more effective means. If you're considering using a GFCF diet for autism, get in touch with your child's pediatrician so she can help you evaluate the benefits and risks. You can make the best possible decision for your family only when you have enough information to do so.

2 comments:

  1. Our child's pediatrician gave us info on sources of calcium. All dairy - no greens. The list included ice cream. Seriously?

    I agree with you about the GFCF diet, but a fair bit of the population doesn't make the enzyme to digest lactose, so um maybe some collards would be better?

    I don't want to dis pediatricians, but the sad fact is my home econ teacher years ago had more formal training in nutrition that most MDs. Medical schools mostly don't even carry courses. When they do it's an elective.

    Nutritionists actually study this stuff. Pediatricians just pass along papers handed to them, too frequently created using information out out by industry.

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  2. The gfcf diet may help some children with autism. Here's a 2013 review article on it: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3540005/

    It isn't proven to help, but it hasn't been proven not to help either.

    It may be that the gfcf diet helps some children, in a way that's not specific to autism. Maybe some children have delayed reaction food allergies *and* autism, and for those children, the gfcf diet helps them.

    Special hypoallergenic diets - whether gfcf or resulting from a hypoallergenic elimination diets / food challenges process - may help people (not just children) with a wide variety of psychiatric and neurological problems.

    Maybe children with autism are more likely to have delayed reaction food allergies, but I don't know of any evidence for this.

    Also, gfcf diets can be nutritionally adequate. I've heard that the traditional Japanese diet was naturally gfcf, for example; and such a diet can be very healthy.

    Yes, one has to be careful not to get nutritional deficiencies when cutting foods out of the diet. For example, if you stop drinking milk, you've lost a major source of vitamin D, which could cause problems.

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