17

PETA (People for Ethical Treatment of Animals) suggest the existence of a link between milk consumption and autism spectrum disorder (ASD) (see here on the PETA website).

More research is needed, but scientific studies have shown that many autistic kids improve dramatically when put on a diet free of dairy “products”. One study of 20 children found a major reduction in autistic behavior in kids who were put on a casein-free diet (casein is a component of cow’s milk). And another study done by researchers at the University of Rome showed a “marked improvement” in the behavior of autistic children who were taken off dairy products.

The two studies they link to are Knivsberg et al. (2002) and Lucarelli et al. (1995).

Quickly looking at these two studies, Knivsberg et al. (2002) has sample size of 10 children (very low for an effect that, if is real, would likely be small) and Lucarelli et al. (1995) does not really seem to be specific to milk consumption. Neither of these studies mention the funding agencies or make any declarations of potential conflict of interest.

PETA give potential reasons and an anecdote from an anonymous mother supporting their claim that milk consumption increases ASD behaviours.

Do autistic kids tend to improve symptoms when put on a diet free of dairy products?

Laurel
  • 30,040
  • 9
  • 132
  • 118
Remi.b
  • 2,001
  • 1
  • 17
  • 29
  • I'm recalling claims from about 30 years ago that a [ketogenic diet helps ASD](http://www.jlr.org/content/55/11/2211.long). If there is an effect it could be related. – Daniel R Hicks Jun 02 '18 at 18:55
  • 2
    Something to keep in mind here: They have found in some cases at least a link between digestive tract bacteria and autism. I could easily see someone having a sensitivity to some component of cow's milk that showed up that way. Note that this would **not** mean it applied generally and would not support PETA's position. – Loren Pechtel Jun 03 '18 at 04:47
  • 2
    If valid, it could be something where dairy doesn't, per se, *cause* autism, but some other disorder or abnormality causes the body to react poorly to something in dairy, with tragic results. Kind of like how phenylalanine is a necessary amino acid, but can cause toxic reactions in people who inherit PKU. – PoloHoleSet Jun 04 '18 at 20:12

1 Answers1

14

There is little evidence to support the effectiveness of nutritional supplements or the GFCF diet for improving ASD symptoms.

A dairy-free, gluten-free diet for autistic kids is called GFCF (Gluten-Free, Casein-Free). Parents do often report improvements in behavior after diet change. Currently, there are several reviews that suggest that these improvements are not scientifically measurable, but one metastudy recommends GFCF based solely on parent reporting, and a brand new study (as of 2018) suggests that the GFCF diet can cause significant, measurable improvement for some forms of autism.

"Current nutritional approaches in managing autism spectrum disorder: A review" Nutritional Neuroscience, 8/2017

It is reported that in individuals with ASD, while the gluten-free casein-free and KDs, camel milk, curcumin, probiotics, and fermentable foods can play a role in alleviating ASD symptoms, the consumption of sugar, additives, pesticides, genetically modified organisms, inorganic processed foods, and difficult-to-digest starches may aggravate symptoms.

"Nutritional and Dietary Interventions for Autism Spectrum Disorder: A Systematic Review" Pediatrics 5/2017

One RCT (high risk of bias) reported significant parent-rated improvements in communication, resistance to communication, social isolation, repetitive or challenging behavior, and overall impairment in children on a GFCF diet compared with those on a usual diet (P values ≤ .007). Children on the GFCF diet also improved significantly on tests of cognitive skills, motor skills, verbal and social communication, anxiety, and reaction to changes in environment and routine compared with control children (P values < .05). Another high risk of bias RCT with 24-month follow-up of participants reported few differences in behavioral measures between children on a GFCF diet and those with no dietary restrictions; ASD symptoms improved significantly in participants in the GFCF diet group versus the no diet group at 12 months, but were not different on any measure in a subset of participants followed for 24 months.

Conclusion: Despite their widespread reported use, little evidence supports the effectiveness of nutritional supplements or the GFCF diet for improving ASD symptoms. Harms reported in studies were generally considered mild, but the long-term effects of these therapies are not well understood. Although the conduct of studies generally improved from those reported in our 2011 review, evidence remains insufficient for most interventions given the small sample sizes, lack of longer term follow-up, and heterogeneous agents and populations.

"Gluten- and casein-free diet and autism spectrum disorders in children: a systematic review" European Journal of Nutrition 3/2018

With few exceptions, there were no statistically significant differences in autism spectrum disorder core symptoms between groups, as measured by standardized scales. One trial found that compared with the control group, in the GFCF diet group there were significant improvements in the scores for the ‘communication’ subdomain of the Autism Diagnostic Observation Schedule and for the ‘social interaction’ subdomain of the Gilliam Autism Rating Scale. Another trial found significant differences between groups in the post-intervention scores for the ‘autistic traits’, ‘communication’, and ‘social contact’ subdomains of a standardized Danish scheme. The remaining differences, if present, referred to parent-based assessment tools or other developmental/ASD-related features. No adverse events associated with a GFCF diet were reported. Conclusion: Overall, there is little evidence that a GFCF diet is beneficial for the symptoms of ASD in children.

"Comprehensive Nutritional and Dietary Intervention for Autism Spectrum Disorder—A Randomized, Controlled 12-Month Trial" Nutrients 3/2018

Modest improvements in CARS-2 and SAS-Pro suggest some reduction in autism symptoms, consistent with parent reports of improvements on the PDD-BI, ATEC, and SRS. Parent reports also suggest improvements in aberrant behaviors (ABC—Irritability, Lethargy/Social Withdrawal, Stereotypy, and Hyperactivity), sensory processing (SSP), and GI symptoms (6-GSI, PGI-2, ATEC), and Overall (PGI-2). ... Three unusual case reports, in which three very different long-term problems were greatly improved, shows the power of comprehensive nutritional interventions in addressing complex, puzzling medical conditions which may involve one or more nutritional deficiencies.

Community
  • 1
Avery
  • 44,313
  • 16
  • 183
  • 179
  • 14
    Just because there are some literature reports doesn't mean much. Biased studies and the over reporting of non-repeatable results in small trials are common, especially when the effects being reported are hard to measure consistently in the first place. – matt_black Jun 03 '18 at 16:03
  • 24
    I don't think there's any value in what the parents say. Parents of autistic children are often desperate to find something, anything, to blame for their child's condition. I feel they could easily fool themselves into believing they're an improvement out of wishful thinking. – ApproachingDarknessFish Jun 03 '18 at 18:43
  • 5
    No that's not how it works. Anecdotal evidence results in a biased picture of the world, because it is not something that can be duplicated and experienced by others. This is literally Skeptic 101 stuff you could learn in a couple minutes of googling. – Jacob Andrew Hollander Jun 04 '18 at 11:24
  • Let us [continue this discussion in chat](https://chat.stackexchange.com/rooms/78421/discussion-between-avery-and-jacob-andrew-hollander). – Avery Jun 04 '18 at 11:39
  • I'm not sure why you quoted the "One RCT (high risk of bias)" paragraph - it doesn't really agree with the conclusion you quoted, and the paragraph prior to it in the source talks about two RCTs with "moderate risk of bias" that show no significant differences. – Rob Watts Jun 05 '18 at 21:23
  • 4
    Regarding the last study you quoted ("Comprehensive Nutritional ...") - holy confounding factors Batman! "special vitamin/mineral supplement, and additional treatments were added sequentially, including essential fatty acids, Epsom salt baths, carnitine, digestive enzymes, and a healthy gluten-free, casein-free, soy-free (HGCSF) diet" - even if they had shown real improvement, there's no way to tell which treatment caused it. Also, being a "single-blinded study" I really wouldn't trust parent reports here, as parents *knew* if their child had received the treatment or not. – Rob Watts Jun 05 '18 at 21:52
  • `It is reported that in individuals with ASD, while the gluten-free casein-free and KDs, camel milk, curcumin, probiotics, and fermentable foods can play a role in alleviating ASD symptoms,` So some dairy improves it? –  Jun 06 '18 at 11:53
  • Autism is a spectrum of disorders, the mechanisms of which are poorly understood. I removed part of an edit that makes the fairly extraordinary claim that we *know* this treatment does not work for any ASD. I agree that there is "little evidence" that it works on a systematic basis. – Avery Sep 13 '18 at 23:01
  • @Avery I'm not sure why you removed "The claim is not supported by evidence". That's the scientific consensus, so why are we hiding it? – Sklivvz Sep 14 '18 at 07:15
  • @Sklivvz I think there is a big difference between "little evidence" and "no evidence". – Avery Sep 14 '18 at 10:03
  • " but one metastudy recommends GFCF based solely on parent reporting, and a brand new study (as of 2018) suggests that the GFCF diet can cause significant, measurable improvement". A metastudy based on subjective feedback and a sole study. Looks like a poor argument to me. Are there other metastudies that base its conclusions in more objective elements or more studies that get to a similar conclusion? – bradbury9 Sep 14 '18 at 12:00
  • 2
    @Avery if this were a medicine, it would not be possible to sell it. There is not sufficient evidence to say that there is a link. The burden of proof is on the claimant. The way it's now it reads more like "perhaps yes", which I feel is a misrepresentation. There is little evidence that cold fusion works, so if someone claimed that there is scientific evidence of cold fusion. they would be incorrect. – Sklivvz Sep 14 '18 at 13:32
  • It's not a medicine, though, and it's not cold fusion either. It's about how consumption of specific things normally found in the West diet affects a broad spectrum of disorders, which is necessarily a complex question. – Avery Sep 15 '18 at 02:35