The Autism Society Event and Education Recordings Archive

Gluten, casein and other protein intolerances are common to those on the autism spectrum. Dietary restrictions, such as the gluten-free casein-free diet (GFCF), often bring relief but are also expensive, lifestyle changing, and require months before benefits are observed. Dietary enzymes may provide a superior alternative to the GFCF diet. The session will strive to educate the lay person as to what dietary enzymes are, their history of use in the food industry and how they work, safety, and the scientific evidence for their benefits in helping gluten, casein, soy and other protein intolerances.

In the process of normal digestion, certain food proteins, such as gluten and casein, are broken down via a specific sequence of stomach and pancreatic protease enzymes. The net result of this breakdown process is to produce small peptides that have the capacity to interact with opiate receptors found in the gut. These opiate peptides, known as exorphins, have little effect on most persons, other than a feeling of contentment and sedation. However, those with autism often appear to have quite different reactions to these exorphins: aggression, hyperactivity, loss of contact with others, lack of response to stimuli, etc. The basis of this reaction is not clearly known, but a body of evidence indicates that it may be mediated through opiate receptor mechanisms. Restriction of dietary sources of gluten and casein often produce notable improvements in digestion and behavior, and as such, the gluten-free casein-free diet is often recommended to those parents dealing with autism.

However, the GFCF diet is often quite difficult to install within a family. The foods are often expensive, difficult to find, require more preparation time, and often must involve the entire family in order to obtain compliance. Most agree that the diet must be maintained for up to one year before any evidence of benefit is observed.

Dietary enzyme supplements from plant sources are well-characterized as to their ability to break down proteins, carbohydrates, and triglycerides found in foods. Plant-based enzymes have an advantage over pancreatic enzymes in that they are acid-stable and so work in the fed stomach environment. It is this characteristic that provides the key benefit for protein intolerances. Proteins and peptides are not absorbed in the stomach, so any gluten or casein ingested may be worked on by the enzymes during that time. Peptides are absorbed in the small intestine, so it is vital that appropriate protease enzymes are allowed ample opportunity to work on food proteins while still in the stomach.

The use of protease enzymes on gluten, casein and other potentially intolerant proteins provides a two-pronged approach. One, the additional protease enzymes result in proteins being broken down in different sequences and more thoroughly as well. Two, the addition of a specific peptidase enzyme, dipeptidyl peptidase IV (DPP IV), provides a direct means of removing exorphin peptides. The specific amino acid sequences of casomorphin and gluteomorphin are known. DPP IV is the only known enzyme able to break down exorphin peptides such that they no longer bind to the opiate receptor. Therefore, appropriately formulated enzyme products may disrupt the effects of gluten and casein by 1) more thorough breakdown of protein structure, and 2) specific breakdown of exorphin peptides that may still be present, or produced from endogenous sources, such as hemoglobin.

Also addressed is a discussion of the applications of diet based on known receptor-ligand binding mechanisms, again presented on a level understood by the lay person.

Information as to understanding dosing and customization of enzyme supplementation based on individual dietary intake will also be presented.

Content Area: Medicine and Research