Metabolic Brain Disease

, Volume 32, Issue 6, pp 1935–1941 | Cite as

Ketogenic diet versus gluten free casein free diet in autistic children: a case-control study

  • Omnia El-Rashidy
  • Farida El-Baz
  • Yasmin El-Gendy
  • Randa Khalaf
  • Dina Reda
  • Khaled SaadEmail author
Original Article


Many diet regimens were studied for patients with autism spectrum disorder (ASD) over the past few years. Ketogenic diet is gaining attention due to its proven effect on neurological conditions like epilepsy in children. Forty-five children aged 3–8 years diagnosed with ASD based on DSM-5 criteria were enrolled in this study. Patients were equally divided into 3 groups, first group received ketogenic diet as modified Atkins diet (MAD), second group received gluten free casein free (GFCF) diet and the third group received balanced nutrition and served as a control group. All patients were assessed in terms of neurological examination, anthropometric measures, as well as Childhood Autism Rating Scale (CARS), Autism Treatment Evaluation Test (ATEC) scales before and 6 months after starting diet. Both diet groups showed significant improvement in ATEC and CARS scores in comparison to control group, yet ketogenic scored better results in cognition and sociability compared to GFCF diet group. Depending on the parameters measured in our study, modified Atkins diet and gluten free casein free diet regimens may safely improve autistic manifestations and could be recommended for children with ASD. At this stage, this study is a single center study with a small number of patients and a great deal of additional wide-scale prospective studies are however needed to confirm these results. Trial registration number: UMIN-CTR Study Design: trial Number UMIN000021433


Autism Ketogenic diet Gluten free casein free 



The authors are grateful for the enrolled children and their caregivers; without their participation, this study would not have been accomplished.

Compliance with ethical standards

Competing interest

The author(s) declare that they have no competing interest.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of Pediatrics, Faculty of MedicineAin Shams UniversityCairoEgypt
  2. 2.Department of Pediatrics, Faculty of MedicineAssiut UniversityAssiutEgypt

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