Department of Paediatrics with Clinical Decisions Unit, The Medical University of Warsaw, Żwirki i Wigury 63a, 02-091, Warsaw, Poland.
Department of Paediatrics, The Medical University of Warsaw, Żwirki i Wigury 63a, 02-091, Warsaw, Poland.
Eur J Nutr. 2018 Mar;57(2):433-440. doi: 10.1007/s00394-017-1483-2. Epub 2017 Jun 13.
Effective treatments for core symptoms of autism spectrum disorders (ASD) are lacking. We systematically updated evidence on the effectiveness of a gluten-free and casein-free (GFCF) diet as a treatment for ASD in children.
The Cochrane Library, MEDLINE, and EMBASE databases were searched up until August 2016, for randomized controlled trials (RCTs); additional references were obtained from reviewed articles.
Six RCTs (214 participants) were included. 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.
Overall, there is little evidence that a GFCF diet is beneficial for the symptoms of ASD in children.
自闭症谱系障碍（ASD）的核心症状缺乏有效治疗方法。我们系统地更新了无麸质和无酪蛋白（GFCF）饮食作为儿童 ASD 治疗方法的有效性证据。
截至 2016 年 8 月，我们在 Cochrane 图书馆、MEDLINE 和 EMBASE 数据库中搜索了随机对照试验（RCT）；从已审查的文章中获得了其他参考文献。
纳入了 6 项 RCT（214 名参与者）。除了少数例外，在使用标准化量表衡量时，各组之间的自闭症谱系障碍核心症状没有统计学上的显著差异。一项试验发现，与对照组相比，在 GFCF 饮食组中，自闭症诊断观察量表的“沟通”子域和 Gilliam 自闭症评定量表的“社会互动”子域的评分有显著改善。另一项试验发现，在标准化丹麦方案的“自闭症特征”、“沟通”和“社会接触”子域的干预后评分中，组间存在显著差异。如果存在其他差异，则涉及基于父母的评估工具或其他发育/ASD 相关特征。未报告与 GFCF 饮食相关的不良事件。
总体而言，几乎没有证据表明 GFCF 饮食对儿童 ASD 症状有益。
