Eficácia da dieta sem glúten e caseína na melhoria dos sintomas comportamentais e gastrointestinais em crianças com transtornos do espectro autista
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Publicado
Jun 6, 2025
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Resumo
Objetivo: Avaliar a eficácia da dieta sem glúten e caseína (GFCF) na redução de sintomas comportamentais e gastrointestinais em crianças com Transtorno do Espectro Autista (TEA). Métodos: Realizou-se uma revisão integrativa da literatura, por meio das bases PubMed, BVS e SciELO, com estudos publicados entre 2015 e 2025, nos idiomas português, inglês e espanhol. Utilizou-se a estratégia PICO para definição da pergunta norteadora. Foram incluídos 17 estudos, entre ensaios clínicos, revisões sistemáticas, estudos observacionais e metanálises. Resultados: A maioria dos estudos (76%) identificou melhorias comportamentais, como maior interação social e menor irritabilidade, e 47% apontaram benefícios gastrointestinais, como redução de dor abdominal e constipação. Os efeitos foram mais consistentes em subgrupos com alterações entéricas prévias. Entretanto, a heterogeneidade dos métodos e amostras limita a força das evidências. Considerações Finais: A dieta GFCF apresenta efeitos positivos em crianças com TEA, especialmente na presença de sintomas gastrointestinais prévios, mas requer aplicação individualizada e mais estudos com rigor metodológico.
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Como Citar
SousaA. L. P. de, & OneG. de M. da C. (2025). Eficácia da dieta sem glúten e caseína na melhoria dos sintomas comportamentais e gastrointestinais em crianças com transtornos do espectro autista. Revista Eletrônica Acervo Científico, 25, e20684. https://doi.org/10.25248/reac.e20684.2025
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Referências
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2. AKHTER M, et al. A narrative review on manifestations of gluten free casein free diet in autism and autism spectrum disorders. JPMA. The Journal of the Pakistan Medical Association, 2022; 72(10): 2054–2060.
3. ALAMRI ES. Efficacy of gluten- and casein-free diets on autism spectrum disorders in children. Saudi Medical Journal, 2020; 41(10): 1041–1046.
4. ALESSANDRIA C, et al. HLA-DQ genotyping, duodenal histology, and response to exclusion diet in autistic children with gastrointestinal symptoms. Journal of Pediatric Gastroenterology and Nutrition, 2019; 69(1): 39–44.
5. BASPINAR B, YARDIMCI H. Gluten-Free Casein-Free Diet for Autism Spectrum Disorders: Can It Be Effective in Solving Behavioural and Gastrointestinal Problems? The Eurasian Journal of Medicine, 2020; 52(3): 292–297.
6. BATARSEH H, et al. Gluten-free and casein-free diet for children with autism spectrum disorder: a systematic review. Advances in Neurodevelopmental Disorders, 2022; 6(3): 280–289.
7. CROALL ID, et al. Gluten and Autism Spectrum Disorder. Nutrients, 2021;13(2):572.
8. DÍAZ D, LEONARIO-RODRÍGUEZ M. Effectiveness of nutritional interventions on behavioral symptomatology of autism spectrum disorder: a systematic review. Nutrición Hospitalaria, 2022;39(6):1378–1388.
9. EL-RASHIDY O, et al. Ketogenic diet versus gluten free casein free diet in autistic children: a case-control study. Metabolic Brain Disease, 2017; 32: 1935–1941.
10. GHALICHI F, et al. Effect of gluten free diet on gastrointestinal and behavioral indices for children with autism spectrum disorders: a randomized clinical trial. World Journal of Pediatrics, 2016; 12(4): 436–442.
11. GOGOU M, KOLIOS G. Are therapeutic diets an emerging additional choice in autism spectrum disorder management? World Journal of Pediatrics, 2018; 14: 215–223.
12. GONZÁLEZ-DOMENECH PJ, et al. Influence of a Combined Gluten-Free and Casein-Free Diet on Behavior Disorders in Children and Adolescents Diagnosed with Autism Spectrum Disorder: A 12-Month Follow-Up Clinical Trial. Journal of Autism and Developmental Disorders, 2020;50:935–948.
13. HIROTA T, KING BH. Autism spectrum disorder: a review. Jama, 2023; 329(2): 157–168.
14. KARIMI P, et al. The Effects of a Gluten-Free/Casein-Free Diet on Behavioral Indices in Children with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. Iranian Journal of Pediatrics, 2024.
15. KELLER A, et al. The Effect of a Combined Gluten- and Casein-Free Diet on Children and Adolescents with Autism Spectrum Disorders: A Systematic Review and Meta-Analysis. Nutrients, 2021;13(2):470.
16. LANGE KW, et al. Gluten-free and casein-free diets in the therapy of autism. Current Opinion in Clinical Nutrition and Metabolic Care, 2015; 18(6): 572–575.
17. LEADER G, et al. Gastrointestinal symptoms in autism spectrum disorder: a systematic review. Nutrients, 2022; 14(7): 1471.
18. LEE RWY, et al. A modified ketogenic gluten-free diet with MCT improves behavior in children with autism spectrum disorder. Physiology & Behavior, 2018; 188: 205–211.
19. MONTEIRO MA, et al. Autism spectrum disorder: a systematic review about nutritional interventions. Revista Paulista de Pediatria, 2020; 38: e2018262.
20. NOGAY NH, NAHIKIAN-NELMS M. Effects of nutritional interventions in children and adolescents with autism spectrum disorder: an overview based on a literature review. International Journal of Developmental Disabilities, 2022; 69: 811–824.
21. NURUL HAKIM RY, et al. Effect of gluten free casein free diet on maladaptive behavior in autistic children: meta-analysis. Indonesian Journal of Medicine, 2023.
22. PAGE MJ, et al. A declaração PRISMA 2020: diretriz atualizada para relatar revisões sistemáticas. Revista Panamericana de Salud Pública, 2023; 46: e112.
23. PHAN J, et al. Precision synbiotics increase gut microbiome diversity and improve gastrointestinal symptoms in a pilot open-label study for autism spectrum disorder. mSystems, 2024; 9.
24. PIWOWARCZYK A, et al. Gluten-and casein-free diet and autism spectrum disorders in children: a systematic review. European Journal of Nutrition, 2018; 57: 433–440.
25. PIWOWARCZYK A, et al. Gluten-Free Diet in Children with Autism Spectrum Disorders: A Randomized, Controlled, Single-Blinded Trial. Journal of Autism and Developmental Disorders, 2020;50(2):482–490.
26. REISSMANN A. Gluten-free and casein-free diets in the management of autism spectrum disorder: a systematic literature review. 2020.
27. SAAD K, et al. Gluten-Free, Casein-Free Diet for Children with Autism Spectrum Disorder: A Case-Controlled Study. Journal of Pharmacy & Bioallied Sciences, 2024; 16: S905–S908.
28. SATHE N, et al. Nutritional and dietary interventions for autism spectrum disorder: a systematic review. Pediatrics, 2017; 139(6): e20170346.
29. SAUSMIKAT J, SMOLLICH M. Ernährungstherapie bei Autismus-Spektrum-Störungen im Kindes- und Jugendalter: wie ist die Evidenz? Klinische Pädiatrie, 2016; 228: 62–68.
30. SOUSA MNA, et al. Trilhando o caminho do conhecimento: o método de revisão integrativa para análise e síntese da literatura científica. Revista Observatorio de la Economia Latinoamericana, 2023; 21(10): 18448–18483.
31. TARNOWSKA K, et al. The opioid excess theory in autism spectrum disorders – is it worth investigating further? Critical Reviews in Food Science and Nutrition, 2021; 63: 3980–3993.
32. ZAFIROVSKI K, et al. Impact of Gluten-Free and Casein-Free Diet on Behavioural Outcomes and Quality of Life of Autistic Children and Adolescents: A Scoping Review. Children, 2024; 11.
2. AKHTER M, et al. A narrative review on manifestations of gluten free casein free diet in autism and autism spectrum disorders. JPMA. The Journal of the Pakistan Medical Association, 2022; 72(10): 2054–2060.
3. ALAMRI ES. Efficacy of gluten- and casein-free diets on autism spectrum disorders in children. Saudi Medical Journal, 2020; 41(10): 1041–1046.
4. ALESSANDRIA C, et al. HLA-DQ genotyping, duodenal histology, and response to exclusion diet in autistic children with gastrointestinal symptoms. Journal of Pediatric Gastroenterology and Nutrition, 2019; 69(1): 39–44.
5. BASPINAR B, YARDIMCI H. Gluten-Free Casein-Free Diet for Autism Spectrum Disorders: Can It Be Effective in Solving Behavioural and Gastrointestinal Problems? The Eurasian Journal of Medicine, 2020; 52(3): 292–297.
6. BATARSEH H, et al. Gluten-free and casein-free diet for children with autism spectrum disorder: a systematic review. Advances in Neurodevelopmental Disorders, 2022; 6(3): 280–289.
7. CROALL ID, et al. Gluten and Autism Spectrum Disorder. Nutrients, 2021;13(2):572.
8. DÍAZ D, LEONARIO-RODRÍGUEZ M. Effectiveness of nutritional interventions on behavioral symptomatology of autism spectrum disorder: a systematic review. Nutrición Hospitalaria, 2022;39(6):1378–1388.
9. EL-RASHIDY O, et al. Ketogenic diet versus gluten free casein free diet in autistic children: a case-control study. Metabolic Brain Disease, 2017; 32: 1935–1941.
10. GHALICHI F, et al. Effect of gluten free diet on gastrointestinal and behavioral indices for children with autism spectrum disorders: a randomized clinical trial. World Journal of Pediatrics, 2016; 12(4): 436–442.
11. GOGOU M, KOLIOS G. Are therapeutic diets an emerging additional choice in autism spectrum disorder management? World Journal of Pediatrics, 2018; 14: 215–223.
12. GONZÁLEZ-DOMENECH PJ, et al. Influence of a Combined Gluten-Free and Casein-Free Diet on Behavior Disorders in Children and Adolescents Diagnosed with Autism Spectrum Disorder: A 12-Month Follow-Up Clinical Trial. Journal of Autism and Developmental Disorders, 2020;50:935–948.
13. HIROTA T, KING BH. Autism spectrum disorder: a review. Jama, 2023; 329(2): 157–168.
14. KARIMI P, et al. The Effects of a Gluten-Free/Casein-Free Diet on Behavioral Indices in Children with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. Iranian Journal of Pediatrics, 2024.
15. KELLER A, et al. The Effect of a Combined Gluten- and Casein-Free Diet on Children and Adolescents with Autism Spectrum Disorders: A Systematic Review and Meta-Analysis. Nutrients, 2021;13(2):470.
16. LANGE KW, et al. Gluten-free and casein-free diets in the therapy of autism. Current Opinion in Clinical Nutrition and Metabolic Care, 2015; 18(6): 572–575.
17. LEADER G, et al. Gastrointestinal symptoms in autism spectrum disorder: a systematic review. Nutrients, 2022; 14(7): 1471.
18. LEE RWY, et al. A modified ketogenic gluten-free diet with MCT improves behavior in children with autism spectrum disorder. Physiology & Behavior, 2018; 188: 205–211.
19. MONTEIRO MA, et al. Autism spectrum disorder: a systematic review about nutritional interventions. Revista Paulista de Pediatria, 2020; 38: e2018262.
20. NOGAY NH, NAHIKIAN-NELMS M. Effects of nutritional interventions in children and adolescents with autism spectrum disorder: an overview based on a literature review. International Journal of Developmental Disabilities, 2022; 69: 811–824.
21. NURUL HAKIM RY, et al. Effect of gluten free casein free diet on maladaptive behavior in autistic children: meta-analysis. Indonesian Journal of Medicine, 2023.
22. PAGE MJ, et al. A declaração PRISMA 2020: diretriz atualizada para relatar revisões sistemáticas. Revista Panamericana de Salud Pública, 2023; 46: e112.
23. PHAN J, et al. Precision synbiotics increase gut microbiome diversity and improve gastrointestinal symptoms in a pilot open-label study for autism spectrum disorder. mSystems, 2024; 9.
24. PIWOWARCZYK A, et al. Gluten-and casein-free diet and autism spectrum disorders in children: a systematic review. European Journal of Nutrition, 2018; 57: 433–440.
25. PIWOWARCZYK A, et al. Gluten-Free Diet in Children with Autism Spectrum Disorders: A Randomized, Controlled, Single-Blinded Trial. Journal of Autism and Developmental Disorders, 2020;50(2):482–490.
26. REISSMANN A. Gluten-free and casein-free diets in the management of autism spectrum disorder: a systematic literature review. 2020.
27. SAAD K, et al. Gluten-Free, Casein-Free Diet for Children with Autism Spectrum Disorder: A Case-Controlled Study. Journal of Pharmacy & Bioallied Sciences, 2024; 16: S905–S908.
28. SATHE N, et al. Nutritional and dietary interventions for autism spectrum disorder: a systematic review. Pediatrics, 2017; 139(6): e20170346.
29. SAUSMIKAT J, SMOLLICH M. Ernährungstherapie bei Autismus-Spektrum-Störungen im Kindes- und Jugendalter: wie ist die Evidenz? Klinische Pädiatrie, 2016; 228: 62–68.
30. SOUSA MNA, et al. Trilhando o caminho do conhecimento: o método de revisão integrativa para análise e síntese da literatura científica. Revista Observatorio de la Economia Latinoamericana, 2023; 21(10): 18448–18483.
31. TARNOWSKA K, et al. The opioid excess theory in autism spectrum disorders – is it worth investigating further? Critical Reviews in Food Science and Nutrition, 2021; 63: 3980–3993.
32. ZAFIROVSKI K, et al. Impact of Gluten-Free and Casein-Free Diet on Behavioural Outcomes and Quality of Life of Autistic Children and Adolescents: A Scoping Review. Children, 2024; 11.