The Gluten-Casein-Free Diet in Children with Autism: A Clinical Results of the Ophthalmic and Behavioral Manifestations

Abstract

Aim: To evaluate the ophthalmic and behavioral effects of a gluten-free casein-free diet (GCFD) in autism spectrum disorder (ASD). Method: The study was conducted from November 2020 to January 2023. We designed an 8-week clinical trial of GCFD on corneal reflex, pupil size, body mass index (BMI), weight, Autistic Disorder Index, Communication, Social interaction, and Stereotype Behavior. Results: A total of thirty participants completed the trial. GCFD reduced BMI [%95 CI -4.8895 to -2.1305 (P < 0.0001)], weight [%95 CI -8.5153 to -0.0647 (P = 0.0467)], Autistic Disorder Index [%95 CI -28.0359 to -16.2841 (P < 0.0001)], Communication [%95 CI -3.3325 to -1.6675 (P < 0.0001)], Social Interaction [%95 CI -4.3190 to -2.4010 (P < 0.0001)], and Stereotype Behavior [%95 CI -2.3939 to -0.2461 (P =0.01)] significantly. GCFD also reduced left [%95 CI -2.2421 to -1.6779 (P <0.0001)] and right pupil size [%95 CI -2.2999 to -1.7201 (P <0.0001)] significantly. Conversely, corneal reflex was significantly increased [95% CI 0.2159 to 2.1241 (P = 0.01)]. No differences were observed for IPD. Conclusion: This study suggested that the GCFD can effectively control ASD behaviors as well as regulate autonomic functions related to ophthalmic markers such as pupil size and corneal reflex, but more research is needed.

Keywords

• Autism spectrum disorders
• cognitive functions
• corneal reflex
• gluten-free casein-free diet
• plusoptix a09
• pupil size

Otizmli Çocuklarda Glutensiz Kazeinsiz Diyet: Oftalmik ve Davranışsal Belirtilerin Klinik Sonuçları

Abstract

Amaç: Otizm spektrum bozukluğunda (ASD) glutensiz kazeinsiz diyetin (GCFD) oftalmik ve davranışsal etkilerini değerlendirmektir. Yöntem: Çalışma Kasım 2020'den Ocak 2023'e kadar gerçekleştirildi. Kornea refleksi, gözbebeği büyüklüğü, vücut kitle indeksi (BMI), ağırlık, Otistik Bozukluk İndeksi, İletişim, Sosyal Etkileşim ve Stereotip Davranış üzerinde GCFD'nin 8 haftalık bir klinik çalışması yapıldı. Bulgular: Çalışmaya toplamda 30 çocuk dahil edildi. GCFD, BKİ'yi [%95 CI 4,8895 ile -2,1305 (P < 0,0001)], ağırlığı [%95 CI -8,5153 ila -0,0647 (P = 0,0467)], Otistik Bozukluk İndeksini [%95 CI -28.0359 to -16.2841 (P < 0.0001)], İletişim [%95 CI 3,3325 ila -1,6675 (P < 0,0001)], Sosyal etkileşim [%95 CI -4,3190 ila -2,4010 (P < 0,0001)] ve Stereotip Davranışı [%95 CI -2,3939 ila -0,2461 (P =0,01)] önemli ölçüde azalttı. GCFD ayrıca soldaki [%95 CI -2,2421 ila -1,6779 (P <0,0001)] ve sağ gözbebeği boyutunu [%95 CI -2,2999 ila -1,7201 (P <0,0001)] önemli ölçüde azalttı. Tersine, kornea refleksi önemli ölçüde arttı (%95 CI 0,2159 - 2,1241 (P = 0,01)). IPD için hiçbir fark gözlenmedi. Sonuç: Bu çalışma, GCFD'nin OSB davranışlarını etkili bir şekilde kontrol edebileceğini ve ayrıca gözbebeği boyutu ve kornea refleksi gibi oftalmik belirteçlerle ilgili otonomik işlevleri düzenleyebileceğini göstermiştir ancak daha fazla araştırmaya ihtiyaç vardır.

Keywords

• Otizm spektrum bozuklukları
• bilişsel fonksiyonlar
• kornea refleksi
• glutensiz kazeinsiz diyet
• plusoptix a09
• pupil çapı

Supporting Institution

Üsküdar University and Dünya Bursa Göz Hospital

Ethical Statement

Üsküdar University The Human Ethics Committee approved the protocol (number:61351342/2021-526, date: 26.11.2020). Informed consent was obtained from all participants and their parents. This study was conducted within the framework of the World Medical Association ethical rules.

Thanks

The authors thankful for the financial support to Üsküdar University and Dünya Bursa Göz Hospital

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