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C-class rated low importance article on a controversial medical/dietary theory.
This article needs attention on:
-- Jeremy ( Blah blah...) 01:27, 24 June 2008 (UTC)
This article makes fairly impressive claims, but doesn't mention the scientific studies done to test them. I suppose they might be in some of the external links, but I haven't looked at all of them. The entire "Reported effects" section could definitely use some actual reports. A few other statements of note:
Who are these children who often show remarkable improvement? Which of the "many" families? How can the menu options possibly increase after adopting a restriction?
Who is questioning it within the medical community? It matters a lot whether the answer is "most of it" or "a few cranks who protest everything." And if the response is better after seeing the results "first-hand," what kind of success rate does this seem to have? For instance, if only 20% of autistics greatly improve after taking the diet, it's possible that some of them would have bloomed anyway.
Well, of course they can affect behavior, but how?
Don't get me wrong; it's entirely possible that this diet is the real thing, but even if studies have not been completed, surely some sourced speculation and rumination from scientists could be found. SnowFire 20:16, 28 July 2006 (UTC)
The section "Practical implementation" says citation is needed for "Gluten is found in all products containing wheat, rye, and barley and may sometimes contaminate oats grown nearby or processed on the same equipment as gluten-containing cereals" Does the following suffice?
Gluten Contamination of Commercial Oats in the United States Thompson T. NEJM. 2004;351:2021-2022 (Nov. 4, 2004, Number 19) http://www.celiac.com/st_prod.html?p_prodid=1054 Mike carton 16:30, 21 June 2007 (UTC)
This is a reasonably weasely article, filled with lots of non-statements like "many parents report that..." and "the vast majority of professionals...". It also swings back and forth between paragraphs suggesting that the casein/glutein->opiate theory is fact and paragraphs noting that little research supports its efficacy.
The truth of the matter is that the GFCF diet is advocate-driven science with little solid research working in its favor. That being said, the medical community is not "opposed" to the GFCF diet. The professionals who work with my autistic children have told us the same thing repeatedly: "go ahead and try it - it can't hurt. We don't expect it will make a difference, though."
If I have time I will try to digest the "advocate" piece and the "no research support" piece and come up with something NPOV. Irene Ringworm 23:28, 1 March 2007 (UTC)
This article says that gluten is found in rice, however the article on gluten says that there is no gluten in rice. One or the other should be changed by someone who knows. 24.7.254.33 14:11, 6 March 2007 (UTC)
Gastrointestinal problems are a common comorbid disorder with Autistic Spectrum Disorders and some people see this as proof for the "leaky gut" theory as a cause of Autism, while others see the gluten and casein-free diet as treating symptoms, not causes, of Autistic Spectrum Disorders. The molecular structure of the partially undigested proteins, known as peptides, resemble opiates and are claimed to have damaging effects on the developing brain and also affects behavior, just as any narcotic would.
The "leaky gut" theory remains controversial with no rigorous scientific studies done as yet. A recent study of the role of diets in Autism Spectrum Disorders noted that significant design flaws in all the current studies make it difficult to rely on an conclusions reached (Christianson & Ivany 2006).
Diet alone is not the cure for austistic children, The only way you can cure the intolerances is to reduce the gut infection and floral imblance seen in children with autism spectrum discorders. Current research points to the fact that many austistic children definently have a Enterocolitis like illness, which means that have an inflammatory like disease in their guts. recommend you read gut and mental illness —Preceding unsigned comment added by 211.30.235.237 ( talk) 00:58, 18 September 2007 (UTC)
23:32, 19 September 2007 (UTC)
I wouldn't say GF/CF necessarily is a sub-topic from the Autism Cure Movement, some Autism Rights Movement people use the diet as well.
I suggest someone take away that Autism Cure Movement box. It might even contribute to further polarization in the autism debate. —Preceding unsigned comment added by 85.166.146.68 ( talk) 15:37, 12 January 2008 (UTC)
Decided to do the change.
While I am personally sceptical of the GF/CF diet, I doubt that this sentence is warranted:
"Adequately designed, controlled studies and clinical trials show the GFCF diet is ineffective.[2] "
Indeed, one well-designed study has found no stastical differences between the group on the diet and the controls. This sentence however, could appear to generalize this in a way that its citation, from what I've read of it, has not. IvarTJ ( talk) 09:56, 10 June 2009 (UTC)
I believe these studies might be of interest to the background section:
http://www.ncbi.nlm.nih.gov/pubmed/17520243
http://www.ncbi.nlm.nih.gov/pubmed/12578238
http://www.ncbi.nlm.nih.gov/pubmed/18337276
I believe these studies might be of interest to the background section:
http://www.ncbi.nlm.nih.gov/pubmed/17520243
http://www.ncbi.nlm.nih.gov/pubmed/12578238
http://www.ncbi.nlm.nih.gov/pubmed/18337276 IvarTJ ( talk) 03:38, 4 September 2009 (UTC)
Elder JH, Shankar M, Shuster J, Theriaque D, Burns S, Sherrill L. College of Nursing, University of Florida, Gainesville, 32610, USA. elderjh@nursing.ufl.edu
This study tested the efficacy of a gluten-free and casein-free (GFCF) diet in treating autism using a randomized, double blind repeated measures crossover design. The sample included 15 children aged 2-16 years with autism spectrum disorder. Data on autistic symptoms and urinary peptide levels were collected in the subjects' homes over the 12 weeks that they were on the diet. Group data indicated no statistically significant findings even though several parents reported improvement in their children. Although preliminary, this study demonstrates how a controlled clinical trial of the GFCF diet can be conducted, and suggests directions for future research.
Ferriter M, Calver S, Connell-Jones G.
BACKGROUND:
It has been suggested that peptides from gluten and casein may have a role in the origins of autism and that the physiology and psychology of autism might be explained by excessive opioid activity linked to these peptides. Research has reported abnormal levels of peptides in the urine and cerebrospinal fluid of people with autism.
OBJECTIVES:
To determine the efficacy of gluten and/or casein free diets as an intervention to improve behaviour, cognitive and social functioning in individuals with autism. SEARCH STRATEGY: The following electronic databases were searched: CENTRAL(The Cochrane Library Issue 2, 2007), MEDLINE (1966 to April 2007), PsycINFO (1971 to April 2007), EMBASE (1974 to April 2007), CINAHL (1982 to April 2007), ERIC (1965 to 2007), LILACS (1982 to April 2007), and the National Research register 2007 (Issue1). Review bibliographies were also examined to identify potential trials.
SELECTION CRITERIA:
All randomised controlled trials (RCT) involving programmes which eliminated gluten, casein or both gluten and casein from the diets of individuals diagnosed with an autistic spectrum disorder.
DATA COLLECTION AND ANALYSIS:
Abstracts of studies identified in searches of electronic databases were assessed to determine inclusion by two independent authors The included trials did not share common outcome measures and therefore no meta-analysis was possible. Data are presented in narrative form.
MAIN RESULTS:
Two small RCTs were identified (n = 35). No meta-analysis was possible. There were only three significant treatment effects in favour of the diet intervention: overall autistic traits, mean difference (MD) = -5.60 (95% CI -9.02 to -2.18), z = 3.21, p=0.001 (Knivsberg 2002) ; social isolation, MD = -3.20 (95% CI -5.20 to 1.20), z = 3.14, p = 0.002) and overall ability to communicate and interact, MD = 1.70 (95% CI 0.50 to 2.90), z = 2.77, p = 0.006) (Knivsberg 2003). In addition three outcomes showed no significant difference between the treatment and control group and we were unable to calculate mean differences for ten outcomes because the data were skewed. No outcomes were reported for disbenefits including harms.
AUTHORS' CONCLUSIONS:
Research has shown of high rates of use of complementary and alternative therapies (CAM) for children with autism including gluten and/or casein exclusion diets. Current evidence for efficacy of these diets is poor. Large scale, good quality randomised controlled trials are needed.
PMID: 18425890 [PubMed - indexed for MEDLINE]
Blake32509 ( talk) 18:51, 6 September 2009 (UTC)blake32509
References
The theory was recently debunked by a well done study that no one is citing. The glutein and casein peptides happen to be the same size as some opiate-like peptides but they are NOT the same molecules. We should add this ref to the article.
Cass H, Gringras P, March J, McKendrick I, O'Hare AE, Owen L, Pollin C. Absence of urinary opioid peptides in children with autism. Arch Dis Child. 2008 Sep;93(9):745-50. Epub 2008 Mar 12. —Preceding unsigned comment added by 148.177.0.100 ( talk) 13:49, 15 September 2009 (UTC)
An interesting article:
The article itself isn't a WP:MEDRS source, but it is a RS and may contain links or or mentions of MEDRS. -- Brangifer ( talk) 03:34, 10 February 2010 (UTC)
In the opening paragraph: "gluten (found naturally in wheat, barley, rye, and several other grains)". Presumably this is a reference to oats and the nebulous triticale — but it's misleading, so I've changed it to: "gluten (found in wheat, barley, rye, and commercially available oats)". Let's keep this discussion space open for these other grains and their gluten status, please add to the list: Njál ( talk) 13:31, 12 September 2010 (UTC)
Pure oats have uncertain gluten status. Commercial oats tend to be grown in rotation with wheat/barley/rye, which means gluten-containing cereals grow up around them and get harvested with them. They're all also usually processed on the same equipment. Njál ( talk) 13:31, 12 September 2010 (UTC)
A wheat-rye hybrid, contains gluten. Njál ( talk) 13:31, 12 September 2010 (UTC)
A species of wheat, contains gluten. Njál ( talk) 13:31, 12 September 2010 (UTC)
A variety or cultivar of wheat, contains gluten. Njál ( talk) 13:31, 12 September 2010 (UTC)
This article discusses autisim and other issues prevalantly while giving little to the person who was looking for information on the named diet. Perhaps the article should be renamed to better describe its focus and another page should be created which gives more comprehensive information on the diet itself, and no the hype surrounding it.
Spiralamok ( talk) 20:47, 18 November 2010 (UTC)
"Among studies reporting negative results, none were longer than 6 weeks, with two out of four studying effects of the diet for 4 days and 9 days" Science does not progress with mere cursory efforts at examination. I do not find the length of a 9 day study, especially on matters of dietary alterations to be notable in regards to validity in disapproval. In regards to chelation studies, the necessary data points must be in regards to metals excreted via a Spectrometer analysis of the bodily wastes. 30 days for a human study would be sufficient, 9 would not. Were we studying animals to later be dissected on a part-by-part basis, a few days would be acceptable, though biopsy of a living human for mere dietary changes would not. I give higher validity to the longer studies not merely because I favor or disfavor the results. 75.134.100.125 ( talk) 04:49, 7 March 2012 (UTC) Gridlock
The problem is there are no double-blind studies reporting positive affects of the diet, so as the paper concludes-
4.5. Summary and implications for practice Based on the results of this review, it would appear that evidence in support of Opioid-Excess Theory and the resulting treatment of ASD with the GFCF diet is limited and weak. Adverse consequences potentially associated with GFCF diets (e.g., stigmatization, diversion of treatment resources, reduced bone cortical thickness) further the argument against the diet’s therapeutic use. Controversy and conflicting research findings concerning the Opioid-Excess Theory renders other explanations for observed benefits plausible (e.g., biological motivating operations influence behavior). [ [3]]
Even if the negative results are discounted, there is no scientific evidence that the diet is useful for autism Bhny ( talk) 21:10, 7 March 2012 (UTC)
The article seems to entirely revolve around autism and associated skepticism, as if there were no other reason to quit wheat and milk. Vitaken02 ( talk) 22:34, 5 April 2012 (UTC)
I think the diet was invented by Kalle Reichelt to possibly ease symptoms of autism (not that this was proven to help). Is there any other published reason for this combined GFCF diet? Bhny ( talk) 22:55, 5 April 2012 (UTC)
This is the
talk page for discussing improvements to the
Gluten-free, casein-free diet article. This is not a forum for general discussion of the article's subject. |
Article policies
|
Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL |
This article is rated Start-class on Wikipedia's
content assessment scale. It is of interest to multiple WikiProjects. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
C-class rated low importance article on a controversial medical/dietary theory.
This article needs attention on:
-- Jeremy ( Blah blah...) 01:27, 24 June 2008 (UTC)
This article makes fairly impressive claims, but doesn't mention the scientific studies done to test them. I suppose they might be in some of the external links, but I haven't looked at all of them. The entire "Reported effects" section could definitely use some actual reports. A few other statements of note:
Who are these children who often show remarkable improvement? Which of the "many" families? How can the menu options possibly increase after adopting a restriction?
Who is questioning it within the medical community? It matters a lot whether the answer is "most of it" or "a few cranks who protest everything." And if the response is better after seeing the results "first-hand," what kind of success rate does this seem to have? For instance, if only 20% of autistics greatly improve after taking the diet, it's possible that some of them would have bloomed anyway.
Well, of course they can affect behavior, but how?
Don't get me wrong; it's entirely possible that this diet is the real thing, but even if studies have not been completed, surely some sourced speculation and rumination from scientists could be found. SnowFire 20:16, 28 July 2006 (UTC)
The section "Practical implementation" says citation is needed for "Gluten is found in all products containing wheat, rye, and barley and may sometimes contaminate oats grown nearby or processed on the same equipment as gluten-containing cereals" Does the following suffice?
Gluten Contamination of Commercial Oats in the United States Thompson T. NEJM. 2004;351:2021-2022 (Nov. 4, 2004, Number 19) http://www.celiac.com/st_prod.html?p_prodid=1054 Mike carton 16:30, 21 June 2007 (UTC)
This is a reasonably weasely article, filled with lots of non-statements like "many parents report that..." and "the vast majority of professionals...". It also swings back and forth between paragraphs suggesting that the casein/glutein->opiate theory is fact and paragraphs noting that little research supports its efficacy.
The truth of the matter is that the GFCF diet is advocate-driven science with little solid research working in its favor. That being said, the medical community is not "opposed" to the GFCF diet. The professionals who work with my autistic children have told us the same thing repeatedly: "go ahead and try it - it can't hurt. We don't expect it will make a difference, though."
If I have time I will try to digest the "advocate" piece and the "no research support" piece and come up with something NPOV. Irene Ringworm 23:28, 1 March 2007 (UTC)
This article says that gluten is found in rice, however the article on gluten says that there is no gluten in rice. One or the other should be changed by someone who knows. 24.7.254.33 14:11, 6 March 2007 (UTC)
Gastrointestinal problems are a common comorbid disorder with Autistic Spectrum Disorders and some people see this as proof for the "leaky gut" theory as a cause of Autism, while others see the gluten and casein-free diet as treating symptoms, not causes, of Autistic Spectrum Disorders. The molecular structure of the partially undigested proteins, known as peptides, resemble opiates and are claimed to have damaging effects on the developing brain and also affects behavior, just as any narcotic would.
The "leaky gut" theory remains controversial with no rigorous scientific studies done as yet. A recent study of the role of diets in Autism Spectrum Disorders noted that significant design flaws in all the current studies make it difficult to rely on an conclusions reached (Christianson & Ivany 2006).
Diet alone is not the cure for austistic children, The only way you can cure the intolerances is to reduce the gut infection and floral imblance seen in children with autism spectrum discorders. Current research points to the fact that many austistic children definently have a Enterocolitis like illness, which means that have an inflammatory like disease in their guts. recommend you read gut and mental illness —Preceding unsigned comment added by 211.30.235.237 ( talk) 00:58, 18 September 2007 (UTC)
23:32, 19 September 2007 (UTC)
I wouldn't say GF/CF necessarily is a sub-topic from the Autism Cure Movement, some Autism Rights Movement people use the diet as well.
I suggest someone take away that Autism Cure Movement box. It might even contribute to further polarization in the autism debate. —Preceding unsigned comment added by 85.166.146.68 ( talk) 15:37, 12 January 2008 (UTC)
Decided to do the change.
While I am personally sceptical of the GF/CF diet, I doubt that this sentence is warranted:
"Adequately designed, controlled studies and clinical trials show the GFCF diet is ineffective.[2] "
Indeed, one well-designed study has found no stastical differences between the group on the diet and the controls. This sentence however, could appear to generalize this in a way that its citation, from what I've read of it, has not. IvarTJ ( talk) 09:56, 10 June 2009 (UTC)
I believe these studies might be of interest to the background section:
http://www.ncbi.nlm.nih.gov/pubmed/17520243
http://www.ncbi.nlm.nih.gov/pubmed/12578238
http://www.ncbi.nlm.nih.gov/pubmed/18337276
I believe these studies might be of interest to the background section:
http://www.ncbi.nlm.nih.gov/pubmed/17520243
http://www.ncbi.nlm.nih.gov/pubmed/12578238
http://www.ncbi.nlm.nih.gov/pubmed/18337276 IvarTJ ( talk) 03:38, 4 September 2009 (UTC)
Elder JH, Shankar M, Shuster J, Theriaque D, Burns S, Sherrill L. College of Nursing, University of Florida, Gainesville, 32610, USA. elderjh@nursing.ufl.edu
This study tested the efficacy of a gluten-free and casein-free (GFCF) diet in treating autism using a randomized, double blind repeated measures crossover design. The sample included 15 children aged 2-16 years with autism spectrum disorder. Data on autistic symptoms and urinary peptide levels were collected in the subjects' homes over the 12 weeks that they were on the diet. Group data indicated no statistically significant findings even though several parents reported improvement in their children. Although preliminary, this study demonstrates how a controlled clinical trial of the GFCF diet can be conducted, and suggests directions for future research.
Ferriter M, Calver S, Connell-Jones G.
BACKGROUND:
It has been suggested that peptides from gluten and casein may have a role in the origins of autism and that the physiology and psychology of autism might be explained by excessive opioid activity linked to these peptides. Research has reported abnormal levels of peptides in the urine and cerebrospinal fluid of people with autism.
OBJECTIVES:
To determine the efficacy of gluten and/or casein free diets as an intervention to improve behaviour, cognitive and social functioning in individuals with autism. SEARCH STRATEGY: The following electronic databases were searched: CENTRAL(The Cochrane Library Issue 2, 2007), MEDLINE (1966 to April 2007), PsycINFO (1971 to April 2007), EMBASE (1974 to April 2007), CINAHL (1982 to April 2007), ERIC (1965 to 2007), LILACS (1982 to April 2007), and the National Research register 2007 (Issue1). Review bibliographies were also examined to identify potential trials.
SELECTION CRITERIA:
All randomised controlled trials (RCT) involving programmes which eliminated gluten, casein or both gluten and casein from the diets of individuals diagnosed with an autistic spectrum disorder.
DATA COLLECTION AND ANALYSIS:
Abstracts of studies identified in searches of electronic databases were assessed to determine inclusion by two independent authors The included trials did not share common outcome measures and therefore no meta-analysis was possible. Data are presented in narrative form.
MAIN RESULTS:
Two small RCTs were identified (n = 35). No meta-analysis was possible. There were only three significant treatment effects in favour of the diet intervention: overall autistic traits, mean difference (MD) = -5.60 (95% CI -9.02 to -2.18), z = 3.21, p=0.001 (Knivsberg 2002) ; social isolation, MD = -3.20 (95% CI -5.20 to 1.20), z = 3.14, p = 0.002) and overall ability to communicate and interact, MD = 1.70 (95% CI 0.50 to 2.90), z = 2.77, p = 0.006) (Knivsberg 2003). In addition three outcomes showed no significant difference between the treatment and control group and we were unable to calculate mean differences for ten outcomes because the data were skewed. No outcomes were reported for disbenefits including harms.
AUTHORS' CONCLUSIONS:
Research has shown of high rates of use of complementary and alternative therapies (CAM) for children with autism including gluten and/or casein exclusion diets. Current evidence for efficacy of these diets is poor. Large scale, good quality randomised controlled trials are needed.
PMID: 18425890 [PubMed - indexed for MEDLINE]
Blake32509 ( talk) 18:51, 6 September 2009 (UTC)blake32509
References
The theory was recently debunked by a well done study that no one is citing. The glutein and casein peptides happen to be the same size as some opiate-like peptides but they are NOT the same molecules. We should add this ref to the article.
Cass H, Gringras P, March J, McKendrick I, O'Hare AE, Owen L, Pollin C. Absence of urinary opioid peptides in children with autism. Arch Dis Child. 2008 Sep;93(9):745-50. Epub 2008 Mar 12. —Preceding unsigned comment added by 148.177.0.100 ( talk) 13:49, 15 September 2009 (UTC)
An interesting article:
The article itself isn't a WP:MEDRS source, but it is a RS and may contain links or or mentions of MEDRS. -- Brangifer ( talk) 03:34, 10 February 2010 (UTC)
In the opening paragraph: "gluten (found naturally in wheat, barley, rye, and several other grains)". Presumably this is a reference to oats and the nebulous triticale — but it's misleading, so I've changed it to: "gluten (found in wheat, barley, rye, and commercially available oats)". Let's keep this discussion space open for these other grains and their gluten status, please add to the list: Njál ( talk) 13:31, 12 September 2010 (UTC)
Pure oats have uncertain gluten status. Commercial oats tend to be grown in rotation with wheat/barley/rye, which means gluten-containing cereals grow up around them and get harvested with them. They're all also usually processed on the same equipment. Njál ( talk) 13:31, 12 September 2010 (UTC)
A wheat-rye hybrid, contains gluten. Njál ( talk) 13:31, 12 September 2010 (UTC)
A species of wheat, contains gluten. Njál ( talk) 13:31, 12 September 2010 (UTC)
A variety or cultivar of wheat, contains gluten. Njál ( talk) 13:31, 12 September 2010 (UTC)
This article discusses autisim and other issues prevalantly while giving little to the person who was looking for information on the named diet. Perhaps the article should be renamed to better describe its focus and another page should be created which gives more comprehensive information on the diet itself, and no the hype surrounding it.
Spiralamok ( talk) 20:47, 18 November 2010 (UTC)
"Among studies reporting negative results, none were longer than 6 weeks, with two out of four studying effects of the diet for 4 days and 9 days" Science does not progress with mere cursory efforts at examination. I do not find the length of a 9 day study, especially on matters of dietary alterations to be notable in regards to validity in disapproval. In regards to chelation studies, the necessary data points must be in regards to metals excreted via a Spectrometer analysis of the bodily wastes. 30 days for a human study would be sufficient, 9 would not. Were we studying animals to later be dissected on a part-by-part basis, a few days would be acceptable, though biopsy of a living human for mere dietary changes would not. I give higher validity to the longer studies not merely because I favor or disfavor the results. 75.134.100.125 ( talk) 04:49, 7 March 2012 (UTC) Gridlock
The problem is there are no double-blind studies reporting positive affects of the diet, so as the paper concludes-
4.5. Summary and implications for practice Based on the results of this review, it would appear that evidence in support of Opioid-Excess Theory and the resulting treatment of ASD with the GFCF diet is limited and weak. Adverse consequences potentially associated with GFCF diets (e.g., stigmatization, diversion of treatment resources, reduced bone cortical thickness) further the argument against the diet’s therapeutic use. Controversy and conflicting research findings concerning the Opioid-Excess Theory renders other explanations for observed benefits plausible (e.g., biological motivating operations influence behavior). [ [3]]
Even if the negative results are discounted, there is no scientific evidence that the diet is useful for autism Bhny ( talk) 21:10, 7 March 2012 (UTC)
The article seems to entirely revolve around autism and associated skepticism, as if there were no other reason to quit wheat and milk. Vitaken02 ( talk) 22:34, 5 April 2012 (UTC)
I think the diet was invented by Kalle Reichelt to possibly ease symptoms of autism (not that this was proven to help). Is there any other published reason for this combined GFCF diet? Bhny ( talk) 22:55, 5 April 2012 (UTC)