Many autistic adolescents experience gastrointestinal problems and restricted food intake, which can be of great concern to families (Baspinar, 2020). Some of their gastrointestinal challenges may result from atypical sensory processing such as restricted food type preferences (Baspinar, 2020) and may be related to anxiety (Mazurek et al., 2013).
In general (despite inconsistent results), many studies have found that children on the autism spectrum have higher rates of intestinal permeability (leaky gut) than children with typical types. known (Tarnowska et al., 2021). Microbial taxonomic diversity (Yap et al., 2021).
Given that many families focus on eating and digestion because of the concerns above, many parents believe that eating is a hallmark of autism in their loved ones, or at least gut health and related immunity. I am naturally interested in whether it affects health (Rudzki and Szults, 2021). A gluten-free and casein-free diet is one of the most frequently tried and controversial dietary interventions (Tarnowska et al., 2021).
What is gluten?
According to Biesiekierski (2017), gluten is “a complex mixture of hundreds of related but distinct proteins, mainly gliadin and glutenin”. Gluten can be used as an additive in non-grain foods to help the food retain its shape and is found in thickeners, pharmaceuticals, meat, and many other foods. It depends on the gliadin to glutenin ratio (Biesiekierski, 2017).
For some individuals with specific genetic vulnerabilities, degradation of peptide sequences within the gliadin protein is associated with adverse immune responses that are part of celiac disease. suggests that for a subset of children with ‘increased immune reactivity to gluten’ is independent of celiac disease and may be related to other factors such as impaired intestinal permeability (Lau et al., 2013).
Gluten and ASD
In 1979 Panksepp suggested that there may be a link between opiate hyperactivity in children and features of autism, particularly those related to social-emotional mechanisms. This is called the opioid excess theory.
One of the mechanisms postulated to contribute to the overactivity of the opiate system in children is increased permeability of the intestinal epithelium (leaky gut), which allows gluten and pathogens to leak into the bloodstream. (Piwowarczyk et al., 2018). Peptides can reach the central nervous system after crossing the blood-brain barrier (Tarnowska et al., 2021).
Another hypothetical mechanism underlying the hyperactive opiate system is the atypical metabolism of gluten and casein (Piwowarkzyk et al., 2018)..
To test the opioid excess theory, researchers investigated whether concentrations of opioid peptides (components of opioid proteins) are elevated in the urine or plasma of children with autism.
A meta-analysis of studies concluded that there was not enough evidence to support the opioid excess theory. This was not the case (Piwowarkzyk, 2018).
However, the merits of different methods of urine and plasma analysis continue to be debated, and heterogeneity in autism makes it difficult to generalize findings, especially those with small sample sizes ( Tarnowska, 2021).
Tarnowska et al. (2021), his Tveiten et al. (2014) study, which used HPLC and tandem mass spectrometry to prevent peptide degradation, addressed concerns about testing concentrations of opioid peptides in urine at the time. I showed you what I was doing.
In a study of 335 participants by Tveiten et al. (2014), exogenous opioid peptide in urine samples from people with autism.
A similar study mentioned in the Tarnowska (2021) review is that of Sokolov et al. (2014), Opioid peptides in 10 children with autism. Tested by ELISA method.
Tarnowska et al. (2021) and many other authors (Basbinar et al., 202, Piwowarczyk et al., 2018, etc.) found that the quantity and quality of studies to date and that autism is sample may have limited generalizability.
Gluten-free and casein-free diets are widely practiced (Piwowarczyk, 2018) but are not generally recommended as the current evidence is considered insufficient. Gluten-free and casein-free Potential adverse dietary reactions in humans include decreased bone density, increased homocysteine levels, decreased serum folate and vitamin B, and increased risk of malnutrition in a population of individuals already affected by food choices. increase (Basbina, 2020).
On the other hand, gluten-free and casein-free diets are thought by many researchers to have some therapeutic benefits in children with autism, and participants’ responses to these diets range from beneficial to harmful. There are various research results. has the most benefit.
Further investigation of the various mechanisms underlying the opioid excess theory continues to be sought. For example, studies on the activity of peptide-degrading peptidases (enzymes) in various samples or intestinal permeabilities from children with autism and an increasing number of studies on their effectiveness. Interventions such as digestive enzyme therapy on different samples of children with autism (Tarnowska et al., 2021).
Parents considering a gluten-free diet are encouraged to talk to their doctor for support in managing the risks of an elimination diet, including monitoring their loved ones’ food intake and nutrient levels.