A wide range of behavioural issues, mood changes and psychiatric symptoms can be the first presentation of gluten sensitivity and its association with behaviour. These symptoms can be seen as early as in toddler years. That is when we wean them with gluten-containing foods. Gluten sensitivity is relatively a new term. It is different from celiac disease; as its initial symptoms are mainly are extraintestinal. Children with neurological conditions like ADHD, autism may have underlying gluten sensitivity as the main cause of their unmanageable behaviour issues. Such children do not show improvement with standard treatment for their behavioural problems. Research by Carlo Catassi, Julio C. Bai have suggested a correlation between gluten sensitivity and behavioural problems. When such children are put on a gluten-free diet, they show improvement.
The Gut-Brain Connection
Your tiny little baby when was in your uterus, her gut and brain are created out of the same type of tissue. During early development, one part turns into the central nervous system while the other develops into her enteric nervous system. These two systems are connected by the vagus nerve, the tenth cranial nerve that runs from your brain stem down to your abdomen. So now, it makes sense why your gut health is related to mental health. The research by Goldstein et al explains this in detail.
There is another concept that is related to gut health and brain function, called Gut Homeostasis. A vast diversity of microorganisms colonises in the human gastrointestinal tract, called as intestinal microbiota. They are mainly symbiotic and important for human well-being. In healthy individuals the commensals are in harmony with human, this is called as Gut Homeostasis. When there is an alteration in commensal gut microbiota with an increase in pathogenic bacteria, homeostasis is lost and gut dysbiosis is developed. Dysbiosis in gluten intolerant children causes gut inflammation, diarrhoea, constipation, visceral hypersensitivity and abdominal pain. The gut dysbiosis also causes dysfunction in the gut-brain axis pathway through the vagus nerve. This dysfunctional communication between the enteric nervous system (ENS) of the intestine with the central nervous system (CNS) is known to affect brain functions including cognition, memory and emotions of the individual.
Gliadin – the Culprit?
Strong evidence is coming out in support of gluten sensitivity being the reason for behavioural problems like autistic spectrum disorders in children. Apart from the various behavioural difficulties demonstrated, it is also noticed that communicative ability and social and cognitive functioning are similarly affected.
According to Vojdani A., O’Brian T., et al and Volta U, Tovoli F, Caio G., et al medical researchers have analysed blood samples of autistic children, which have shown the presence of antibodies to gliadin.
In some medical trials, the effectiveness of a gluten-free diet was tested on children with autistic spectrum disorder and a significant improvement in behavioural symptoms was observed. In simple words, antibodies that a child has when they are gluten sensitive can be directly and uniquely toxic to the brain. The troublemaker here is gliadin. Gliadin is a component of gluten. In a gluten sensitive individual, the body develops an antibody to gliadin, which is called “anti-gliadin” antibody. This antigen-antibody reaction sets in inflammatory response causing the release of a chemical called as cytokines. These cytokines directly affect brain function.
How Brain Function is Impacted
Other proposed pathological process behind brain involvement is improper breaking down of gluten in gluten sensitive person. Inadequately metabolised proteins are then probably broken down into peptides that are absorbed across the gut mucosa into the body’s systems. These circulating peptides when coming in contact with opioid receptors they become bioactive. This causes the brain to read it as excessive opioid and not a peptide. The resulting excess of opioids is thought to lead to the behaviours noted in autistic spectrum disorders.
There is evidence suggestive of variation in behaviour of children with autism that can be linked with food sensitivity. It is proposed that the disruptive behaviour noticed in many children with autism is directly linked to particular foods, for example, wheat and dairy products. Dairy products contain casein. Some gluten-sensitive children may show overlapping sensitivity to casein as well.
Even though what causes it is under research, it is hypothesised that the peptides probably derived from gluten and casein have a negative pharmacological effect on attention, brain maturation, social interaction and learning. Hence, research proves that appropriate diets would facilitate learning, social behaviour, cognitive functioning and communicative skills in individuals with autism.
How to Identify if Your Child’s Behavior is Related to Gluten Sensitivity?
There is no test that can confirm gluten sensitivity. The only way to know, if your child is gluten sensitive is to start a gluten-free diet for 30 days and see if there is an improvement.
Observe the behaviour of your child at the end of the 30-day trial. If you notice a significant change in the behaviour of your child, with no complaints of abdominal pain, irritability then you should continue the gluten-free diet further. In between if there is even a little gluten consumption there can be a variety of symptoms, tantrums that may continue for days to weeks. So careful planning is required on your part to make it a success.
How to Manage Your Child’s Behavior?
Knowing the cause of your child’s behaviour solves the major problem. Following a 30-day gluten-free diet, will help you identify if your child is gluten sensitive. Therefore, the best method to manage your child’s behaviour is simply by eliminating gluten from the diet.
Starting a gluten-free diet may prompt you to visit the grocery shop for finding gluten-free products. Instead of this, start from what is already in your kitchen, that is gluten-free. Yoghurt smoothies with fresh fruits like banana, apple can be a good start for gluten-free breakfast it contains what you have at home.
The Internet is full of do’s and do not’s for going gluten-free. However, keeping your doctor and nutritionist in the team will definitely benefit the child by not losing at important nutrients while going gluten-free.
The use of complementary or alternative treatment approaches is becoming priority choices among parents of autistic children. However, the most popular of the list is gluten-free diet and sometimes-additional elimination of casein. This article may help parents of children with behavioural issues get help what may be wrong with their children and help them find out what can be done.
Written By:
Dr. Priti V. (M.B.B.S., Diploma In Child Health, India)
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