Pediatricians Deny Link Between Food and Autism
Filed under: Medical Conditions, Development/Milestones: Babies, In The News, Special Needs, Nutrition: Toddlers & Preschoolers, Nutrition: Big Kids, Nutrition: Tweens, Nutrition: Teens

Doctors are finding no link between autism and food allergies. Credit: Corbis
Jenny McCarthy is wrong, according to researchers at the Mayo Clinic.
Diet does not contribute to autism.
The autism activist who started her career as a model and Playboy playmate has made a crusade out of her belief that food allergies and childhood vaccines are major contributors to the rising number of children diagnosed with the neurological disorder.
However, Mayo Clinic researchers tracked 124 kids with autism for more than 18 years and compared them with "typical" children. Dr. Nancy Snyderman, NBC News' senior medical editor, was emphatic in reporting the researchers' conclusions.
"These findings are very conclusive," she said on the "Today" show following the release of the study Monday in the journal Pediatrics. "There is no link between illnesses of the gut and the signs and symptoms we see in children with autism."
This is good news for parents, she told viewers. "Because its means if you're putting your child on a restricted diet, or if you're doing colonics (which is a type of enema), if you're using extra vitamins and nutrients, and you're spending a lot of money and putting your child through that, there is no reason to," she said.
Children should only be put on wheat- or dairy-free diets after undergoing diagnostic tests, Dr. Samar H. Ibrahim told The New York Times. She is a pediatric fellow in gastroenterology and an instructor in pediatrics at the Mayo Clinic, as well as one of the principal authors of the report.
"There is actual no trial that has proven that a gluten-free and casein-free diet improves autism," she said. "The diets are not easy to follow and sometimes cause nutritional deficiencies."
Physicians listed with the advocacy organization Defeat Autism Now stick to their belief in the link between food and autism.
Dr. Rochelle Neally, a chiropractor at the Long Beach Autism Center in California questions large-scale medical studies. They are often backed by the big money of monolithic pharmaceutical companies," she said.
"What they call 'scientific' are these expensive double-blind tests," she said. "I tend to believe what I see in my office and what I've seen at the autism conferences I've attended for the past 10 years."
What she sees, she said, are often dramatic improvements in children's behavior when they are placed on a special diet. "The proof is in the pudding," she added.
The gluten-free pudding, that is.
However, she said parents with autistic children are increasingly unsatisfied with science that comes without answers. "Parents are rebelling against traditional medicine," Neally said.
Dr. Eileen Comia, M.D., in Bloomfield, Conn., is another physician allied with Defeat Autism Now. She said smaller-scale studies are needed. "Any doctor who says there's no link between diet and autism hasn't read a single article on the subject," she said.
Actually, believers in the link between mind and tummy have read too many articles -- inaccurate ones, Dr. Patricia Manning Courtney, medical director of the Kelly O'Leary Center for Autism Spectrum Disorders at Cincinnati Children's Hospital Medical Center, told US News and World Report.
"A couple of highly publicized cases of autism and loose stools in the 1990s led to an impression that children with autism had a higher rate of GI [gastrointestinal] dysfunction," she said. "It wasn't well characterized, but that got the story onto the national scene."
There is a link between diet and autism, Ibrahim said The New York Times, but not the one McCarthy and Defeat Autism Now physicians believe. Children with autism are often picky eaters. With limited diets, they often have more cases of constipation.
Restricting their diet choices even more than they do themselves only makes the problem worse, she told the paper.
"We did find that two specific problems -- constipation and feeding issues -- were more common in children with autism," Ibrahim told WebMD Health News.











ReaderComments (Page 1 of 7)
7-29-2009 @ 4:32PM
Jane said...Pretty silly to reach any conclusions from this study.
First, it is retrospective which means that it relies on how well the physicians record the symptoms (even if the access to records is great). It has been shown in reviews of other studies in autism comparing retrospective to prospective designs, that many physicians simply ignore the GI symptoms in children with autism. There may be many reasons for this, including that they don’t believe that their GI symptoms are relevant to the presenting complaint, there is difficulty getting a history from a non-verbal child (i.e. the kids may not complain), the symptoms present differently from other kids (they don’t describe heartburn for reflex; or the stools are only mushy, not watery so they don’t consider it “diarrhea”; or their stools are infrequent and hard to pass but they come out loose so they don’t consider this constipation; or they don’t look at or measure the abdomen and since the kids don’t complain, they don’t record abdominal bloating). When studies have been done that look prospectively at GI symptoms in autism with specific targeted questionnaires, they have always shown a difference between kids with autism and controls.
Second and more importantly, they measure a cumulative incidence. That means that if any of the kids had diarrhea recorded in their chart, even if only once, it would be counted. That is why they have such high incidence in both kids with autism and normal kids. It is very common to have one or two bouts with constipation or diarrhea over your entire childhood. The important difference is how chronic it is, not if you’ve ever had it. So having a viral illness with diarrhea that last for a week or two was counted the same as children who may have had chronic loose stools every day of their life. They do not distinguish these issues in their study data.
Third, they did find differences in constipation and food selectivity but they interpret this as a behavior consequence not a physiological problem. That is their opinion. There is nothing in their study design that would show if that is true or not true.
Fourth, they mentioned that very few of the autistic children had documented Crohn’s disease, Celiac disease, or enzyme deficiency. But they don’t mention how many of the kids were worked up for these things. If you don’t look, you won’t find it. Why not report the number of scopes, biopsies or celiac panels? My guess is that it is because very few of these kids were actually worked up appropriately.
Fifth, assessing the prevalence of some of the GI symptoms in autism is very challenging without a further workup because many of the symptoms are subjective and require patient cooperation to get at the diagnosis. For example, abdominal pain. If a child cannot tell you that they are having abdominal pain, how are you going to identify it or record it. Especially when many of the potential manifestations of abdominal pain in autism (irritability, aggressiveness, self-injurious behaviors, etc) are often and easily explained away as typical “autism” behavior and a pain etiology is not further explored. How does a child with autism who is having reflux describe that to a doctor. Unless it is severe enough to be causing vomiting, asthma, etc., it will be missed. Yet, neurotypical kids can describe heartburn or epigastric discomfort and are more likely to have it diagnosed. So mild cases will be diagnosed in neurotypical kids and only severe cases in autistic children. This will change the prevalence numbers between the cases and controls and it all comes down to how easy it is to obtain the history, not the true prevalence. I suspect that if you took all of those children, both neurotypical and controls, and scoped them, that the level of pathology would be much, much higher in autism.
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7-29-2009 @ 1:33PM
SKL said...I find it disappointing that the only "scientific" research that has been reported on autism in recent memory has been studies to debunk ideas to help or protect these kids. So-called "science" is coming up with no positive developments or advice for proactive parents.
Every child's behavior is affected by diet. Some perhaps more than others, but there is no question about that basic fact. The closer you get to nature, the fewer substances in the food are likely to disagree with your child physically and/or mentally, and the more calm and clear-headed your child will be. If you have a child who is mellow by nature, then maybe you don't have to bother about this, but if your child has difficulties of any kind, the first places you should look are the basics - diet, sleep, fresh air and sunshine, discipline, etc. An honest scientific study would prove each and every one of these as fact. But there's no money / security in that for people who make their living off of "conventional" autism treatment. I continue to sense a huge amount of bias in all of these studies. Aside from the fact that they are completely unhelpful. How can it possibly harm a child to put him on a basic and healthful diet that takes into account his unique allergies and sensitivities? With this kind of attitude in the "science" community, it's no wonder parents go searching for other sources of ideas.
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7-31-2009 @ 9:00AM
Matt's Papa said...You're right on with your analysis. Open discussions and studies are needed not constant negatives. Find an answer not an excuse!
7-31-2009 @ 10:01AM
Ashlyn said...Yes it is! Ive been reading up on all kinds of things lately. The doctors are not going to say it because they cant! This is a crazy system we live in! If they tell us how simple it really is, they would loose money for meds. So they have to say shes wrong. But shes totally right!
7-31-2009 @ 10:23AM
Bree said...I agree with you..it is sad..its like they cant seem to find the time to help this situation for families like mine..instead they just find more ways to debunk data or to make parents feel that they can't do a thing to help their kids or are actually hurting their children..very little of these studies is done within the same autism gene pools..I don't believe that diet and vaccines effects ALL children..however, I KNOW it DID effect mine!!..all three of mine have different forms of autism..and with each child I learned something new and restricted more foods and vaccines..and funny enough my last child..who has NOT had vaccines, actually talks! and laughs! and can eat foods his siblings cant! They were raised by the same parents in the same environment with the same help..but the one without vaccines has done not just a little better..but leaps ahead of the other two..we will never have another child..but if we did..THOSE are the children that should be followed and tested..because they seem to be predisposed to this "condition"..studying children with no history of autism in the family is not helping anyone but the pharmaceutical companies continue to make more money.. My children have been studied briefly..but not about vaccines..about every days tasks they can and can not do..the research consists of questions answered by surveys...I was not happy with the way this research is done..there are lots of questionnaires and things for parents to fill out..and I'm not exaggerating when I say that some studies are written to question 5-18 year olds..so the data is skewed..they were asking me things like can your child take himself to the Dr. or can he use public transit alone..um he was 5 at the time!!! The sheet left no room for this information and I had to answer NO to over half the questions..so I'm telling you right now a typical 5 year old cant do these things..so don't set us up as parents to make our children look either better off or worse than they are..it makes us all look like fools and continues to skirt the real issues here! They also "debunked" the idea that children with autism are picky eaters (latest Parents magazine article reports)..it explains that "When asked about their children's diets research shows that autistic children were no more particular about the types of foods they ate when compared to that of a typically developing child." "It seems the parents are just more focused on their autistic child's food and diet and therefore may be the ones who see them as picky".
I was so furious with this "data"!!! being familiar with the way "research' is done for this type of thing, I KNOW there is lots of room for error EXAMPLE:..when I was asked about my children's diets during another “written research survey” they asked things like “Does your child eat eggs”..and my answer was “yes”..but if there was a place to write I would have EXPLAINED: “But only on Tuesdays if its written on his picture schedule and only if I add red food coloring (since his trigger color is red) and only if it is scrambled and he cant see any parts where the whites separated from the yellow..and it has to be on his Telltubbies plate..otherwise he will just sit and stare at it..not get mad..not refuse to eat..but just sit and stare at it and then eventually wander away without eating!!" so yah..he may F'n eat eggs, but it's certainly NOT like other children!!..I would have done anything to help my children develop typically or eat normally! Children like mine take lots of trial and error to get them to learn, eat, and even sleep! research in this area is so poorly done and I'm sad that I don't believe there will be help for my children in their lifetime..I'm so tired of all the posted information on the Internet and in magazines that give "definitive" proof that there is nothing wrong with these children..or that its the parents fault..cause not only does it send the wrong message to society about children and families like mine..but it also leaves no room to find the TRUTH! lets not forget Agent Orange ppl!!!
7-31-2009 @ 11:04AM
hylabrookb said...I wish these physicians would stop saying what it isn't and put their efforts into finding out what it is that is causing all these neurological problems in children. In the 70's you hardly ever heard of a kid with autism now it is 1 in 150. They need to start doing the proper studies that need to be done and not worry that they and the pharmaceutical companies are going to be sued. There is "something" out there that is causing this that wasn't around 40 years ago. They need to find out what it is and stop saying what it isn't.
7-31-2009 @ 11:25AM
Patti said...I don't think this article is telling parents that eating healthy does not help children. It does state that restrictive diets are not healthy and you've got to agree with that. A healthy diet (containing multiple choices from all food groups) is definately the way to go. Natural foods and not processed foods are also beneficial.
Autistic children are uber-specific about what they will try/eat and so restriction of the things they will eat, could be a bad thing. It's best just to try lots of things. Your child won't eat fruits? Try raisins or slice a banana and poke a pretzel stick into it...it could be a tactile issue of sticky stuff on their fingers.
Try lots of things and when you find something that works, keep a journal of the food & how it was prepared because sometimes it's all about the presentation. Example: My grandson would eat a certain food (like a sandwich) if it was cut in three equal pieces. If it was whole, he wouldn't touch it.
Other autistic children prefer a certain cup, plate or perhaps a bowl...sometimes the same eating utensil or a straw helps.
Don't make the mistake of thinking if the autistic child gets hungry enough, they will eat what is put on their plate - if someone put a slimy mound of ground glass on your plate would hunger tempt you into eating it? Textures of certain foods may seem as awful as what I have just described to a child on the spectrum.
Constipation is an issue with any picky eater and I find that fruity bran bars and apple juice seemed to help in my family.
It may be hard work to find nutritious meals your son or daughter likes but who told you parenting was easy?
7-31-2009 @ 11:28AM
William Foster said...Personally, I am grateful for the careful studies that refute the many inaccurate stories circulating in the autism community concerning the cause and cure of this disorder. Several comments have correctly pointed out that many of the studies show what DOESN'T work, and few if any talk about what DOES. The parents of autistic children feel utterly frustrated. The problem is ... autism is in much the same situation that cancer was in several decades back. Remember Laetrile? Shark cartilage? Chelation therapy? These treatments seemed to 'cure' supposedly incurable cancers, and desperate patients spent millions on them. Problem was, when these treatments were looked at carefully, they turned out to be ineffective. Autism has seen more than its share of miracle cures that seem to work ... for one of two patients. Megadose B-vitamins, IV Immunoglobulins, and Secretin are just a few examples. But ... when these treatments were tried on large numbers of patients and compared to a placebo treatment, they failed over and over again. Surely an effective treatment should work on more than a tiny percentage of patients. But, sadly, they DON'T. Their proponents exhibit the same sort of bias they claim to see in the "medical establishment". Full disclosure: I am a physician AND the father of an autistic son. Let me be very clear. Many researchers are busting their butts working on autism, and if there was a clear answer to the problem, the person who came up with that answer would be a very wealthy Nobel Prize winner.
7-31-2009 @ 4:05PM
David said...Science can debunk scam artists who sell worthless or harmful nostrums to worried patients. There are endless things that we know no way to help. Predators who use these situations to cheat victims need to be stopped, and science is the best way to prove or disprove whether our beliefs are the truth.
7-31-2009 @ 12:47PM
anon07 said...Debunking myths may not be as helpful as developing new treatments, but it is certainly of some use. It prevents parents from wasting money and time and hope on treatments that have no chance of working! It is ridiculous to chastise scientists for learning more about the disease.
As for you parents who "know" what caused your child's autism, I'm sorry, but there is no way that you could "know." You "think" and you "hope" that you have the answer based on anecdotal evidence but scientific conclusions are not based on coincidences, they are based on the double blind studies that scientists do. Even then, few scientists would ever say that the "know" what the cause is. They would say that there is evidence to suggest a certain causal relationship.
By being so stubborn in your "beliefs" you are hurting the scientific process and causing people to not vaccinate their kids based on no scientific evidence. Even though measles was supposed to have been eradicated in the US in 2002, there have been outbreaks in recent years because kids are not being vaccinated. Those kids then can pass on the disease to infants too young to be vaccinated. This should not be happening. We have the means to keep people from getting measles!
7-31-2009 @ 12:18PM
Irene said...It's amazing to me how women, and yes I am one, always neglect to consider how their entire behavioral history has an effect on our ovaries; thus having a profound adverse reaction on our offspring.
As women we are born with all of the eggs (ovaries) we'll ever need, and then some. Everything we put in our bodies from food, nutrients, elements in the environment, prescribed and illegal drugs, alcohol etc directly expose our future children (via the eggs) from our first breath.
How is it that when there is a defect in our children we can't explain, did all the right things during pregnancy, we immediately want to put the blame on something. Why is it that many women don't look at themselves what may have caused the problem? Do they think that just because they cleaned up their lives just prior to or as soon as they found out they were pregnant that all is okay?
NO...WAKE UP AND SMELL THE COFFEE...IT MAY BE YOUR FAULT!!!
We need to educate our daughters from an early age that the drive to avoid excessive medications, drugs and alcohol has more to do with self preservation and the health of our unborn children.
It's true that sometimes it's not our fault but we really need to look within.
7-31-2009 @ 12:41PM
Arianna said...I agree with Irene's comments but I also want to add that many women are having babies later in life. All of the studies in the world clearly share that the older our eggs get the higher the incidence of any given defect.
It is widely known that when a pregnancy terminates (natural causes) it is the body's way of ending a non-viable pregnancy. For many couples they will go to any length to have a child and sometimes this yields a child that nature would have naturally terminated but with medical interventions it comes to term with problems.
Sometimes our age and our interference with nature and God's plan comes back to bite us.
We should be careful what we ask for in life. It all come with a price.
7-31-2009 @ 1:25PM
Todd Conway said...It never ceases to amaze me how prideful and arrogant MD's are when it comes to nutrition and its effects on our health. I am a MD that has spent the last 20 years working in the Emergency Medicine field. I finally reached a point where I could no longer stand the insanity and had to do something different. I can almost guarantee that Dr Ibrahim has had minimal training in nutrition as have most MD’s-I certainly know how much nutrition training I received in medical school. They are always wanting to play the "there aren't any double-blind, placebo controlled studies" card and don't seem intelligent enough to understand that we are as human beings incredibly unique and complex, both genetically and biochemically. We’ll never be able to sort it out with enough randomized controlled trials. No one who understands autism will ever say that it's always related to gluten and/or dairy. There are undoubtedly a number of potential causes and contributing factors-we just haven't been smart enough to figure it out yet. How dare you tell the literally thousands of autistic children (and their parents), who have been helped, that there is no correlation. What do we know? In 1901, the United States was ranked #1 in a list of the top of 100 healthiest nations in the world. In 1970, we had dropped into the 40s. Today we are dead last. Not only have we become one of the unhealthiest nations in the world, we spend $2.5 trillion (and soon to be more) on this "sick-care" system. It’s more than any other industrialized nation in the world. Nearly 3/4 of the $2.5 trillion price tag is for managing chronic disease. What’s really interesting is that our decline in health perfectly correlates with the amount of money we spend on fast food, as well as the amount of sugar we consume as Americans. Hmmm. I don't need any randomized controlled trial to prove to me that our skyrocketing rates of cancer, heart disease, type 2 diabetes, obesity, hypertension, etc. are undoubtedly linked to our diets and our lack of exercise. Why is it that we choose to neglect common-sense and instead try to portray the notion that a handful of pills is really all we need to gain our health back. Isn’t it time we stopped this insanity?
T. Conway, MD
7-31-2009 @ 1:49PM
Max Spencer said...The argument that there's no money / security in so-called food cures for people who make their living off of "conventional" autism treatment is bogus. Actually there would be vastly more money if a definite cure could be found. Cures are worth billions. I sympathize with the skepticism that medicine or science has not found a cure, but despite anecdotal optimism, no one else has either. Parents have tried the Jenny McCarthy diet with little or no results. Whether that anecdotal evidence convinces anyone is an open question depending on the person's wish to rely on optimism, magic or voodoo, call it what you wish.
8-03-2009 @ 9:23PM
Yahzi said..."I find it disappointing that the only "scientific" research that has been reported on autism in recent memory has been studies to debunk ideas"
I find disappointing that so many people understand so little about how science works.
Negative results are just as valid and useful as positive results. Debunking bad ideas is necessary and valuable. You can't just pick out the successful avenues of research in advance - if you could, there'd be no reason to do any research!
Please, people, get a basic understanding on how science works before you start complaining about how it is practiced.
7-31-2009 @ 6:36AM
jennifer said...I think Jenny needs to stay doing what she does best. That is being Pretty. My son who is physically 16, is Autistic. But the ironic thing , he NEVER ate By Mouth a day in his life. He has a feeding tube in. He gets fed Nutren 1.0. So he gets everything in a can. proper nutrition wise, Tell me Jenny, why is he still Autistic? He is a Great kid, would have him again if God said to !!!!
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7-31-2009 @ 9:02AM
Faith said...Good for you Jennifer!!! I have a 5 year old son with Autism - all we've found out is that he's lactosse intolerant, made the appropriate changes - still has autism. A friend of mine's son has autism and has celiac's disease...changed his diet - still has autism. Another friend - doing it all: casein free, gluten free, vitamin B shots, melatonin - everything - son still has Autism and is more severely affected than all of our kids put together! Ya know what else kills me - these parents who give their kids gluten free pucks that are supposed to be cookies and all the other "free" food that not only looks, but tastes like crap - there they are sitting right next to them eating a bag of Keebler cookies or having a burger and fries!!!
7-31-2009 @ 9:44AM
Michelle Reich said...Proper nutrition by whose standards? That's the point, people are not understanding what proper nutrition really is and furthermore it is different for every person. I am sure what your son eats would be considered proper nutrition - for someone who didn't have his problems. There is quite possibly ingredients in that can that are not tolerable to your son. But, I suppose since he is fed via tube, you have limited options in what you can feed him. You seem to be doing the very best for your son, but don't discount nutrition. Also, I don't think anyone is saying that diet restrictions will "cure" a chile with autism, but I have friends who have followed these ideas and HAVE without a doubt seen much improvement. They also use this diet for many other problems and it is curing their family. There is a LINK! I am on the diet myself for Lupus, Fibromyalgia, migraines and it is amazing - it truly works - I am proof. My diet is more extreme than Gluten-casein free. I follow the SCD diet. Your son is lucky to have a mom who loves him so much, continue to do your best for him, God blesses that!!
7-31-2009 @ 10:50AM
Melody said...Jenny McCarthy does not claim that a proper diet works towards "curing" autism, but rather that it makes it possible to "recover", much like one would recover from a traumatic injury. Please read this article: http://www.cnn.com/2008/US/04/02/mccarthy.autsimtreatment/index.html
I am sorry to hear that your son has autism, but I am glad that he has still delighted your life. I'd also like to say that I believe it is counter-productive for you to fight against someone who is advocating for those with autism. Shouldn't you be supporting someone like that? What I mean is, regardless of whether Jenny's "method" is correct or not, you might want to consider putting forth as much effort as she has to fight the political battle involved with keeping the public in a pasture like sheep.
7-31-2009 @ 11:01AM
abaemeehan said...I am totally with you sister...my daughter has an Austism Spectrum Disorder and she had GI reflux as a baby. She was on a total restrictive diet, only drinking prescription formula! She didn't speak until she was 3, so is Jenny really going to tell me that her diet caused her to be Autistic? And since she never had the regression of develpment, particularly speech, we didn't even have her diagnosed until she was 13 (she's 15 now). Even though she was pretty difficult as a younger child, I wouldn't trade her in for "typical" child for all the tea in China! She's such a joy and makes me a better person every day.
Amy Meehan