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The Effect of a Combined Gluten- and Casein-Free Diet on Children and Adolescents with Autism Spectrum Disorders: A Systematic Review and Meta-Analysis.
Keller, Amélie; Rimestad, Marie Louise; Friis Rohde, Jeanett; Holm Petersen, Birgitte; Bruun Korfitsen, Christoffer; Tarp, Simon; Briciet Lauritsen, Marlene; Händel, Mina Nicole.
Afiliação
  • Keller A; Section of Epidemiology, Department of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark.
  • Rimestad ML; Institute of Psychology, Aarhus University, 8000 Aarhus, Denmark.
  • Friis Rohde J; The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2000 Frederiksberg, Denmark.
  • Holm Petersen B; The Danish Health Authority, 2300 Copenhagen, Denmark.
  • Bruun Korfitsen C; The Danish Health Authority, 2300 Copenhagen, Denmark.
  • Tarp S; The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2000 Frederiksberg, Denmark.
  • Briciet Lauritsen M; The Danish Health Authority, 2300 Copenhagen, Denmark.
  • Händel MN; The Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, 2000 Frederiksberg, Denmark.
Nutrients ; 13(2)2021 Jan 30.
Article em En | MEDLINE | ID: mdl-33573238
There has been a growing interest in the gastrointestinal system and its significance for autism spectrum disorder (ASD), including the significance of adopting a gluten-free and casein-free (GFCF) diet. The objective was to investigate beneficial and safety of a GFCF diet among children with a diagnosis of ASD. We performed a systematic literature search in Medline, Embase, Cinahl, and the Cochrane Library up to January 2020 for existing systematic reviews and individual randomized controlled trials (RCTs). Studies were included if they investigated a GFCF diet compared to a regular diet in children aged 3 to 17 years diagnosed with ASD, with or without comorbidities. The quality of the identified existing reviews was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR). The risk of bias in RCTs was assessed using the Cochrane Risk of Bias Tool, and overall quality of evidence was evaluated using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). We identified six relevant RCTs, which included 143 participants. The results from a random effect model showed no effect of a GFCF diet on clinician-reported autism core symptoms (standardized mean difference (SMD) -0.31 (95% Cl. -0.89, 0.27)), parent-reported functional level (mean difference (MD) 0.61 (95% Cl -5.92, 7.14)) or behavioral difficulties (MD 0.80 (95% Cl -6.56, 10.16)). On the contrary, a GFCF diet might trigger gastrointestinal adverse effects (relative risk (RR) 2.33 (95% Cl 0.69, 7.90)). The quality of evidence ranged from low to very low due to serious risk of bias, serious risk of inconsistency, and serious risk of imprecision. Clinical implications of the present findings may be careful consideration of introducing a GFCF diet to children with ASD. However, the limitations of the current literature hinder the possibility of drawing any solid conclusion, and more high-quality RCTs are needed. The protocol is registered at the Danish Health Authority website.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Caseínas / Dieta com Restrição de Proteínas / Dieta Livre de Glúten / Transtorno do Espectro Autista Tipo de estudo: Clinical_trials / Etiology_studies / Guideline / Prognostic_studies / Systematic_reviews Limite: Adolescent / Child / Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Caseínas / Dieta com Restrição de Proteínas / Dieta Livre de Glúten / Transtorno do Espectro Autista Tipo de estudo: Clinical_trials / Etiology_studies / Guideline / Prognostic_studies / Systematic_reviews Limite: Adolescent / Child / Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article