Gluten and Casein Allergies
Definition
Gluten is the protein in wheat, barley, rye, oats and their derivatives: malt, grain starches, hydrolysed vegetable/plant proteins, textured vegetable proteins, grain vinegar, grain alcohol, malt, modified food starch, caramel, maltodextrin, soy sauce, flavourings and the binders found in medication. Since the texture of gluten is elastic it also appears in many processed foods as well as in the gum substance on envelopes.
Casein is the protein found in dairy products. It is present in small quantities in bread, processed cereals, instant soups, instant potatoes, margarine, salad dressings, sweets and mixes for cakes. Casein is also found in some medication, including the pill or stomach tablets.
A reaction to some proteins
It is believed that individuals who are allergic to gluten react to the toxicity of one group of proteins called the gliadins. The immune system mistakenly believes that the proteins in milk or gluten are a threat to the body. In its attempt to protect the body, it creates specific IgA, IgG and IgE antibodies in large amounts which provoke an inflammatory reaction that can be immediate or delayed by weeks or months.
Symptoms
Common symptoms include: a pale complexion, diarrhoea, bloating, fatigue or hyperactivity, breathlessness, weight loss or vomiting.
Consequences
There is a high risk that individuals who are hypersensitive to gluten will eventually suffer from Coeliac disease. In both types of allergy the immune system will be depleted and individuals will be prone to colds and infections. Casein allergy also increases mucous secretions.
Diagnosis
Serological tests run by laboratories can detect allergies. In the case of gluten and casein allergies IgA, IgE and IgG antibodies are tested, if the results show elevated levels this means that there is an allergy. However these tests will not prove useful if done during a gluten or casein free diet. (A list of specialised laboratories is indicated at the end of the fact sheet).
Gluten and casein free diet
Gluten-free food: the list below may vary according to Coeliac organisations
Red and white meat (not bacon)
Fish
Shellfish
Vegetables
Dried, canned or fresh fruits
Juices (with no other ingredients)
Fresh coffee
Tea
Eggs
Soya
Rice
Potato
Corn
Buckwheat
Chickpeas
Lentils
Millet
Peas
Beans
Quinoa
Tapioca
Lentils
Sago
Yam
Potatoes
Rice
Flour (made from the above)
Rice Krispies
Plain Crisps
Nuts
Oil (olive, walnut, sesame, soya, sunflower, peanut, rapeseed, maize, cornflower)
Pure spices
Herbs
Maize
Sugar
Honey
Jams or marmalade
Yeast
Almond
A comprehensive list of foods to avoid may be viewed on the internet at: http://www.fastlane.net/homepages/thodge/GFDIET.txt
Casein free food:
Rice, soya (although some soya products also contain gluten!) or potato milk.
Food containing no gluten and no casein may be difficult to find, for instance some brands of tuna fish contain hydrolysed caseinate which is not good for a casein free diet, some milk substitutes sometimes have added ingredients that contain gluten products.
A report in the Journal of Allergy and Clinical Immunology (May 2000, 105:1031-1034)) revealed that mare's milk can be tolerated by most children as it is more similar to human milk than cow's milk.
Looking for gluten free (GF) products may not prove an easy task, it is recommended to read labels carefully. It is also advised to contact the manufacturers as gluten may represent such a tiny percentage that it may not appear on their ingredient list. Manufacturers also change the ingredients in their products from time to time.
Traces of gluten remain in the body for at least eight months after stopping taking gluten, it is therefore necessary to follow a strict diet for several months in order to see any improvement. This implies that the list of foods absorbed must be carefully checked as even a minute amount of gluten or casein may be enough to counteract any progress. Some people may find the diet difficult to cope with at first, as gluten and casein are reported to be addictive, and it often means a drastic change of life.
When starting a gluten and casein free diet the first step is to eliminate any processed food and cook only fresh food, after a while gluten substitutes can be added. Nowadays it is easy to find these substitutes, there is a large variety of products and it is even possible to find substances such as xanthan gum or guar which can be used to bind food to make dishes similar to processed food.
Gluten and casein substitutes are widely available from health stores, supermarkets, chemists or mail order companies. For those diagnosed with Coeliac disease a list of products is available on prescription.
If you intend to start a gluten and casein free diet, we strongly recommend that you seek advice from nutritional experts.
Resources
Suppliers
Trufree Foods
PO Box 99
Trowbridge
Wiltshire BA14 0YN
Tel: 01225 711 801
http://www.trufree.co.uk
Nutricia Dietary Care
Newmarket Avenue
White Horse Business Park
Trowbridge
Wiltshire BA14 0XQ
Tel: 01225 711801
http://www.glutafin.co.uk/
SHS International
100 Wavertree Boulevard
Liverpool L7 9PT
Tel: 0151 228 1992
http://www.shsweb.co.uk
Distributed in Ireland by Nutricia Ireland.
Lifestyle Healthcare Ltd.
Centenary Business Park
Henley on Thames
Oxfordshire. RG9 1DS
Tel 01491 570000
For further information contact the following organisations:
Action against Allergy
PO Box 278
Twickenham TW1 4QQ
Tel: 020 8892 2711
(Offers information to allergy sufferers, information about diagnosis and treatment within the NHS)
British Society for Allergy Environmental & Nutritional Medicine BSAENM
PO Box 7
Knighton
Powys LD8 2WF
Tel: 01547 550 380
http://www.bsaenm.org.uk
Provides information on practitioners, organises scientific conferences
British Dietetic Association
5th floor, Charles House
14819 Great Charles Street
Queensway
Birmingham B3 3HT
Tel: 0121 616 4900
http://www.bda.uk.com
National Society for Research into Allergies
PO Box 45
Hinckley
Leicestershire LE10 1JY
Tel: 01455 250 715
Offers practical advice to affected individuals, diet sheets
St John's Allergy Clinic
27 Browning Avenue
Boscombe Manor
Bournemouth BH5 1NS
Tel: 01202 399 446
Coeliac Society
PO Box 220
High Wycombe
Buckinghamshire HP11 2HY
Tel: 01494 437278
http://www.coeliac.co.uk
Laboratories (mail order service available)
Biolab
The Stonehouse
9 Weymouth Street
London W1W 6DB
Tel: 020 7636 5959
http://www.biolab.co.uk
Antigliadin antibodies test (£28)
Allergy Diagnostic Centre
Grays Farm Production Village
Grays Farm Road
Orpington
Kent BR5 3BD
Tel/Fax: 020 8308 1363
http://www.pathlynx.co.uk/adc/
Allergy Diagnostic Laboratory
68 Milton Park Estate
Abingdon
Oxfordshire OX14 4RX
Tel: 01235 862757
Genesis Diagnostics Ltd
Eden Research Park
Henry Crabb Road
Littleport
Cambridgeshire CB6 1SE
Tel: 01353 862220
http://www.genini.co.uk/biopages/co/genesis/genesis.html
Gliadin IgG & gliadin IgA tests.
Health Interlink Ltd.
Interlink House
Unit B, Asfordby Business Park
Welby
Melton Mowbray
Leicestershire LE14 3JL
Tel: 01664 810011
The laboratory offers a casein antibodies IgG and IgA test (£52), a gliadin antibodies test (£50), gluten sensitivity evaluation (£87)
Publications
These are some of the references that have been passed to us; the list is not exhaustive. We have not necessarily read the books, and cannot say how easy it will be to get them.
- Carper, S No milk today: How to live with lactose intolerance. Steve Simon & Schuster, Inc., 1986 ISBN 0-671-60301-0).
- Gioannini M. The complete food allergy cookbook. The foods youve always loved without the ingredients you cant have. ISBN 0-7615-0051-01
- Greer R. Diets to help gluten and wheat allergy. Thornsons
- Greer R. Gluten free cooking ISBN 0-7225-0831
- Hagman, B. (1990) The Gluten-Free Gourmet. Henry Holt & Co. ISBN 0-8050-1210-9 - Kisslinger, J. (1987) The Joy of Gluten-Free Cooking, Kisslinger Publications ISBN 0-921019-03-3
- Lowell, J. P.(1995) Against the Grain, Henry Holt & Co. ISBN 0-8050-3624-5
- Rawcliffe, P.and Ruth R. (1985) The Gluten-Free Diet Book, Arco Publishing, ISBN 0-668-05973-7
- Redjou, P. (1990) The "No-Gluten" Solution, ISBN 0-9626052-0-4
- Thompson P. (1995) The Gluten-free Cookery, The Complete Guide for Gluten-free or Wheat-free Diets, Headway Hodder Headline, Oxon, UK, ISBN 0-340-62098-6
- Wood, M. N. (1982) Coping With the Gluten-Free Diet, Charles C. Thomas ISBN 0-398-04718-9
Websites
-http://www.geocities.com/EnchantedForest/Glade/2715/allergies.html
-http://www.adelaide.net.au/
-http://www.ourworld.compuserve.com/homepages/stevecarper/qaindex.htm
-http://www.inside-story.com/
-http://www.wwwebguides.com/nutrition/diets/glutenfree/
Gluten/casein allergies and autism
It is believed that there may be a link between gluten and casein allergies and autism. Individuals who have a gluten or casein allergy are not able to fully metabolise food containing gluten or casein proteins and so small units called peptides remain undigested. According to William Shaw, at the Great Plains Laboratory, "One of the reasons for the incomplete digestion may be a deficiency of enzymes that breakdown these small peptides." The undigested harmful peptides are said to leak into the bloodstream and are able to cross the blood brain barrier which protects the nervous system. The consequences can be quite hazardous as some of these peptides are casomorphine and gliadinomorphine peptides (they contain high levels of opioids, a drug like heroin and morphine); which are believed to mimic neurotransmitters and therefore can cause chaos in the sensory system. These peptides react with areas of the brain such as the temporal lobes which are involved in speech and auditory integration.
The best way to neutralise the effects of opioid peptides appears to be the complete removal of gluten and casein from the diet, even though this may prove a difficult task sometimes since opiates are addictive, which might be the reason why some autistic children eat a lot of bread and drink a lot of milk. "People with food allergies usually crave most of those foods that they should not have." says Lisa Lewis, the mother of two autistic children who has been actively campaigning in favour of a gluten casein free diet for autistic children. Lisa Lewis set up the Autism Network for Dietary Intervention (see details in the address section).
According to Paul Whiteley and Paul Shattock from the Autistic Research Unit, at the University of Sunderland, a few days after removing gluten and casein products there seems to be a period of regression with some of the following behaviours appearing: "anxiety, clinginess, and over-affectionate behaviours, crying, dizziness, increased urination, aching"; but soon an improvement in the condition of children can be noticed, they have better concentration, better sleep patterns, reduced aggression, improved communication and co-ordination. However, it is essential to follow a strict diet as even the smallest amounts of gluten or casein can have an effect on autistic children. It is also believed that once the diet has stopped the old patterns will reoccur within a couple of days. Once casein has been removed from the diet, urine tests show no trace of casein within days. For gluten it could take up to eight months to be eliminated from the system.
Gluten-free products are expensive, but some parents have reported that their doctor was willing to prescribe some of them, although they are more likely to do it for patients with Coeliac disease. Nutritionists believe that children on a gluten and casein free diet will lack certain nutrients and therefore recommend that supplements such as calcium or zinc should be added to the diet.
Research
Dr Karl Reichelt, in Norway, and Paul Shattock discovered that autistic patients have normal essential peptides but also high levels of non-essential harmful peptides in their urine samples, which originate from milk and gluten.
The role of these opiates on the nervous system and brain was highlighted by Jaak Panksepp in the early 1980's. He studied the behaviour of animals under the influence of opioid drugs such as morphine and noticed that their behaviour was similar to that of autistic children. He then deducted that they may have high levels of opiates in their central nervous system.
Dr Christopher Gillberg, a Swedish specialist in autism, also found elevated levels of endorphin-like substances in autistic children.
Dr. Alan Friedman, a physical chemist at Johnson and Johnson Medical, has isolated and identified peptides in urine. Dr. Friedman compared the samples of normal children with those of autistic children. Some of the particles found include casomorphine, A-gliadin, desmorphin, deltophin II and morphine modulating peptides. Desmorphin is only found in autistic children and on the backs of non-captive poison dart frogs.
Zhongjie Sun and Robert Cade, of the University of Florida, showed that concentrations of beta-casomorphin-7 (B-CM7) in blood, urine, and spinal fluid are higher in autistic and schizophrenic individuals than in normal individuals.
A list of research papers can be found at the end of this fact sheet.
For further information
Autism Network for Dietary Intervention (ANDI)
PO Box 77111
Rochester
NY
USA
http://www.AutismNDI.com
ANDI was created by parents Lisa Lewis and Karyn Seroussi
Autism Research Unit
School of Health Sciences
University of Sunderland
Sunderland SR2 7EE
Tel: 0191 510 8922 - 0191 515 2581
http://www.osiris.sunderland.ac.uk/autism
The ARU produces a leaflet entitled "Guidelines for the implementation of a gluten and/or casein free diet with people with autism or associated spectrum disorders."
Autism Independent UK (The Society For The Autistically Handicapped/SFTAH)
199-201 Blandford Ave.
Kettering
Northants NN16 9AT
Tel: 01536 523274
http://www.autismuk.com
The National Autistic Society (NAS)
393 City Road
London EC1V 1NG
Tel: 020 7833 2299
http://www.oneworld.org/autism_uk/
Allergy Induced Autism (AIA)
11 Larklands
Longthorpe
Peterborough PE3 6LL
Tel: 01733 331 771
www.kessick.demon.co.uk/aia.htm
The Autism File
PO Box 144
Hampton TW12 2FF
Tel: 020 8979 2525
www.autismfile.com
Quarterly magazine created by Mrs and Mrs Tommey, parents of an autistic child. Investigates therapies and gives updates on treatment.
The Great Plains Laboratory
Dr William Shaw
11813 West 77th
Lenexa
KS66214
USA
Tel: (001) 913 341 8949
http://www.greatplainslaboratory.com
Nutrition Clinic Biopterin
Consultative firm for research and rehabilitation of autistic patients
Teuvo Rantala
Gummeruksenkatu 13
Jyväskylä
40100 Finland
http://www.sci.fi/~biopteri/
A private consultative firm specialising in nutritional rehabilitation of autistic patients and research. As well as a gfcf diet, the Biopterin method recommends the implementation of a special diet and supplements.
Publications
- Shattock P. & Savery D. (1996) Urinary profiles of people with autism. Possible implications and relevance to research. Autism Research Unit.
- Shattock P. & Whiteley P. (1998) Guidelines for the implementation of a gluten and/or casein free diet with people with autism or associated spectrum disorders. The Autism Research Unit.
- Shattock P., Whiteley P., Rodgers J., Savery D. &. (1999) A gluten-free diet as an intervention for children with autism and associated spectrum disorders: preliminary findings. Autism 3.
- Shattock P., Kennedy A., Rowell F. & Berney, T. (1990) Role of Neuropeptides in Autism and their relationship with Classical Neurotransmitters Brain Dysfunction 3: 328- 345
- Williams K., Shattock P. & Berney T. (1991) Proteins, Peptides and Autism: Part 1. Urinary Protein Patterns in Autism as revealed by Sodium Dodecyl Sulphate-Polyacrylamide Gel Electrophoresis and Silver Staining. Brain Dysfunction 4:320-322
- Shattock P. & Lowdon G. (1991) Proteins, Peptides and Autism: Part 2. Implications for the Education and Care of People with Autism. Brain Dysfunction 4:323-334
- Whiteley P., Rodgers J. & Shattock P. (1998) Clinical features associated with autism: Observations of symptoms outside the diagnostic boundaries of autistic spectrum disorders. Autism 2: 415-422
- Gillberg C. (1988) "The role of endogenous opioids in autism and possible relationships to clinical features" in Wing L. Aspects of autism: biological research. Gaskell London.
- Panksepp J. (1979) A neurochemical theory in autism. Trends in neuroscience Vol. 2 P. 174-177
- Reichelt K.L. et al. (1981) Biologically active peptide containing fractions in schizophrenia and childhood autism.
- Reichelt K.L., Knivsberg A.M., Nodland M., Lind G. (1994) Nature and consequences of hyperpeptiduria and bovine casomorphins found in autistic syndromes. Developmental brain dysfunction. Vol 7 P. 71-85
- Baker S.M (1997) Detoxification and healing: The key to optimal health. Keats publishing. New Canaan, CT.
- Paroli E: (1988) Opioid peptides from food (the Exorphins) World Review of Nutrition and Dietetetics. Vol. 55 P. 58-97
- Fukudome S., Yoshikawa M. (1992) Opioid peptides derived from wheat gluten: their isolation and characterization. Federation of European Biochemical Societies (FEBS) Vol. 296 P.107-111.
- Lewis L. (1998) Special diets for special kids. "Understanding and Implementing Special Diets in the treatment of Autism and Related Developmental Disorders" Future Horizons Inc. ISBN 1-885477-44-9.
- Sun Z., Cade R. Fregly M.J., Privette R.M. (1999). B-casomorphin induces fos-like immunoreactivity in discrete brain regions relevant to schizophrenia and autism. Autism Vol. 3. No. 1. P.67-83
- Shaw William (1998). Biological treatments for Autism and PDD.
- Rapp Doris. Is this your child? William Morrow & Co; ISBN: 0688119077
- Le Breton Marilyn (2001) Diet Intervention and Autism, Jessica Kingsley Publishers; ISBN: 1853029351
Websites
- www.fastlane.net/homepages/thodge/AUTGFFAQ.txt . Frequently Asked Questions about gluten and casein free diet by Karyn A.Serioussi.
- www.gfcfdiet.com
- www.insidetheweb.com/mbs.cgi/mb668990 . Webforum
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