Over the past few years, many diet regimens have been studied for efficacy in improving the symptoms of patients with autism spectrum disorder (ASD). The gluten free casein free diet (GFCF) is a popular diet that has been used for ameliorating gastrointestinal manifestations of ASD such as bloating, diarrhea, and discomfort that often occurs in autistic children, however, it has not been proven to effectively impact behavior in controlled clinical studies. While the ketogenic diet is gaining attention due to its proven effect on neurological conditions like epilepsy in children, it is not well studied for its efficacy in ameliorating symptoms and severity of Autism.
Nevertheless, a recent case-control study examining a Ketogenic Diet versus a Gluten-Free Casein-Free diet in children with autism found that a modified ketogenic diet and gluten-free casein-free diet may safely and effectively improve symptoms and severity of Autism in children. However, the two diets did not result in the same benefits, and the Ketogenic Diet appeared to ameliorate more of the core symptoms of ASD.
Ketogenic Diet vs Gluten Free Casein Free Diet in Autism study
Study: “Ketogenic diet versus gluten free casein free diet in autistic children: a case-control study.” [Link]
Autism spectrum disorder (ASD) is a complex neurodevelopmental syndrome; it begins before three years of age and is characterized by pervasive deficits in social interaction, impairment in communication, and stereotyped patterns of interests and activities. To date, no known causes have been identified that fully explain the occurrence of ASD, which can be attributed to complex behavioral phenotypes as well as the involvement of various genetic and environmental factors in the etiology of ASD.
All patients were given a neurological examination, the Childhood Autism Rating Scale (CARS) rating, and Autism Treatment Evaluation Test (ATEC) scales assessment before and 6 months after starting the diet they were randomized for. In short, both the ketogenic diet and GFCF groups showed significant improvement in both ATEC and CARS scores in comparison to the control group.
ATEC scores in Modified Ketogenic Diet Group
ATEC scores (p = 0.003) (S-value = 8.38), and overall ATEC score improvement for modified Keto Diet were significantly decreased, (P-value = 0.0001)( S-value= 13.29) indicating a decrease in the severity of ASD symptoms. In other words, the data is more surprising than getting all heads on 13 fair coin tosses.
Further, in the ATEC subgroups there was a statistically significant improvement in speech (p = 0.004) (S-value = 7.97), sociability (p = 0.034) (S-value = 4.88) and cognitive awareness (p = 0.0001 (S-value: 13.29).
For an enhanced understanding of the significance of these findings, Convert P-values to S-Values
CARS scores in Modified Ketogenic Diet Group
The group randomized to the modified ketogenic diet showed significant improvements in CARS scores (p = 0.001) (S-value = 9.97). Before the start of the modified ketogenic diet, no mild cases of autism were found compared to 4 after end of the diet. Before start of the diet, 6 cases were classified as moderate compared to only 2 after the end of the diet. And the CARS score was severe in 9 patients before diet start of the diet, compared to only 4 patients after the end.
ATEC scores in Gluten-Free Casein-Free Group
Patients who received the GFCF diet showed significant improvement in autism symptoms before and after receiving the diet as evidenced by CARS and ATEC autism scores. Like the modified ketogenic diet, the total ATEC scores were also significantly decreased, (P-value = 0.0001)( S-value: 13.29) indicating a decrease in the severity of ASD symptom as well. In other words, the data is more surprising than getting all heads on 13 fair coin tosses.
In the ATEC subgroups there was a statistically significant improvement in speech (p = 0.011) (s = 6.51) and behavior (p = 0.011) (s = 6.51). However, unlike the modified ketogenic diet, no significant changes to sociability and cognitive awareness occurred.
CARS scores in Gluten-Free Casein-Free Group
Before the start of the gluten-free casein-free diet, no patients were classified as mild grade before the start of the diet in comparison to the 2 patients after the end of the diet. CARS scores were moderate in 3 patients before the start of the diet, compared to 10 patients after the diet. CARS scores were severe in 12 patients before the GFCG diet, compared to only 3 patients after diet.
From these results, the authors concluded that a modified ketogenic diet and gluten free casein free diet may safely improve autistic symptoms and severity, and could be recommended for children with ASD. However, more research is necessary to determine the ketogenic diet’s efficacy and long-term safety.
Although treatments for children with autism spectrum disorders are still in development, the results from this study are promising, as are the results from other similar studies involving children with ASD. Further, available medical treatments are limited in their ability to address core symptoms of ASD. However, while the ketogenic diet has shown to be effective in addressing some of those core symptoms and deserves further attention from the medical community that oversees the care of ASD patients to avoid potential adverse effects of the ketogenic diet.
Ketogenic Diet and Autism Studies
- Ketogenic Diet versus gluten free casein free diet in autistic children: a case-control study.
- Potential Therapeutic Use of the Ketogenic Diet in Autism Spectrum Disorders
- Autism and Dietary Therapy: Case Report and Review of the Literature
- A Modified Ketogenic Gluten-Free Diet with MCT Improves Behavior in Children with Autism Spectrum Disorder
Learn more with our comprehensive list of current Ketogenic Diet Research and Reviews.