Nutrition Therapy

Gluten-Free, Casein-Free and Soy-Free Diet

Gluten, found in wheat and other grains, casein, found in dairy, and soy are all inflammatory proteins. The proteins are hard to digest, and when not properly broken down can form opiate compounds. Opiates (just like morphine) can slow the motility of the gut causing constipation and further digestive discomfort, and cause inflammation. Constipation is very common with dairy intolerance – one study of children with constipation revealed that 80% of the patients had a cow’s milk allergy.3  A gluten-free, casein-free and soy-free diet is a great diet to start with when chronic digestive issues are present

Grain-Free Diets

Grains are hard to digest, as they require large amounts of carbohydrate digesting enzymes. And we know that people with autism are often low in the correct enzymes.4 The starch in grains also feed pathogens and small intestine bacterial overgrowth (SIBO), resulting in irritation and damage to the gut, causing diarrhea, constipation, pain, and distress. There are several grain-free diets that can be helpful with digestive problems:
·  Specific Carbohydrate Diet (SCD)
·  GAPS Diet
·  Paleo Diet
·  Autoimmune Paleo

Body Ecology Diet

Salicylates occur in plant foods, including berries, grapes, tomatoes, almonds, herbs, and spices. But salicylates are also present in honey. In addition to behavioral symptoms, salicylates can cause digestive symptoms such as diarrhea, and can increase digestive pain when consuming FODMAPs. Low salicylate diets include:
·  Feingold diet
·  FAILSAFE diet

Low Oxalate Diet

Oxalates are inflammatory molecules that are found in certain foods, including: Nuts, spinach, Swiss chard, chocolate, and beans. Oxalates can kill good bacteria and perpetuate yeast and gut microbiome imbalance. And create inflammation in the gut.


FODMAPS is an acronym for various fermentable carbohydrates including oligosaccharides found in the onion family and polyols found in prunes. Fermentable carbohydrates feed bacteria, but when there is an imbalance such as small intestine bacterial overgrowth (SIBO) it can cause gas, bloating, pain, diarrhea and constipation. Studies have shown a Low FODMAPS diet can be helpful for IBD.

Body Ecology Diet

The Body Ecology diet avoids sugar and foods that feed and perpetuate candida overgrowth, and includes foods that are healthy – while supplying good bacteria through fermented foods. It’s often used to address candida overgrowth and other “inner ecology” imbalances.

Low Histamine Diet

There are a variety of low amine and histamine approaches. As the name implies, histamine is one type of amine. You find amines in: bone broth, sauerkraut, fermented foods, wine, beer, chocolate, and cheese. Histamine and other amines can cause intestinal and systemic inflammation, diarrhea, and abdominal cramps.

Low Glutamate Diet

Glutamate is an excitatory neurotransmitter – think the opposite of calm! Glutamate is often present in food. Glutamate often occurs in similar foods to histamine ike: sauerkraut, fermented food, bone broth – and occurs in high amounts  in soy sauce and parmesan cheese, and additives like monosodium glutamate (MSG) and autolyzed yeast extract. Glutamate can affect the nervous system and can cause reactions such as inflammation systemically. Glutamate can also cause diarrhea, constipation, and gut issues.

Ketogenic Diet

The Ketogenic diet is a very low carbohydrate diet that uses ketones/fat for energy instead of glucose/sugar. Though very restrictive, keto can help with balancing the microbiome and supply the proper energy for the gut to heal for the right individual. Remember, this diet is very strict and high fat diets can often lack the beneficial fiber for the microbiome –  so more studies are needed to find out when this diet supports or imbalances the microbiome.

Underlying Considerations for Choosing a Special Diet

Now that you know a little about the diets, let’s tackle four considerations that arise with gut health, including their potential implications, and possible dietary choices for these gastrointestinal issues.

Inflammation affects the gut by aggravating the gut wall, causing leaky gut, leading to food sensitivities, and often contributing to chronic disease or autoimmunity, affecting every system. Symptoms can include diarrhea, constipation, gas, bloating, and pain. Dietary considerations: Food allergies and sensitivities, oxalates, salicylates, amines, histamine, FODMAPs, and grains.

Mitochondrial dysfunction
Mitochondria are the powerhouses of the cell responsible for making energy, and if they aren’t  functioning well, it can lead to constipation, but also fatigue, pain, and disease in any organ or system of the body. Dietary considerations: oxalates, a ketogenic diet, or adequate carbohydrates.

Poor sulfation
Sulfation is a set of biochemical processes that use sulfate, and it’s a necessary process for intestinal barrier integrity (to avoid leaky gut) and aid digestion. An imbalanced gut microbiome can contribute to poor sulfation. Poor sulfation can cause reactions to phenols, salicylates, and amines – many are present in foods traditionally considered “healthy” like berries, spices, almonds, fruits and vegetables. Additionally, when sulfate the building block for sulfation is low, problems with oxalates can result, Dietary considerations include salicylates, amines, and other phenols, plus oxalates.

Microbiome imbalance
Good bacteria is essential for good digestive health, while pathogens contribute to digestive issues and disease. Eating a diet that supports good bacteria while starving out the bad pathogens can be tricky to balance. For example, high fiber foods are good for beneficial bacteria but cause reactions for children with SIBO. Additionally, if there is an imbalanced microbiome  these reactions to foods that might otherwise be healthy can result in reactions to salicylates, amines or oxalates. Dietary considerations include: FODMAPS, salicylates, oxalates, and amines. The key is eating foods that support digestion and feed beneficial bacteria, while not causing another reaction. Determining which foods your child needs while avoiding those that cause or contribute to underlying problems is essential to helping them improve.

Beyond GFCF, you can see it gets a bit tricky. Complicating matters further, practitioners often recommend many healthy foods for “gut healing diets” – such as bone broth, sauerkraut, spinach, and almonds. Such foods contain natural food compounds that can cause or exacerbate the exact GI issue the practitioner is working to resolve! So do make sure you find someone that understands the big picture of diets and gut health for your child. Understanding the relationship between symptoms and foods will allow you to work with your healthcare practitioner to find the right healing, gut health diet. This process needn’t be overly complicated. Remember you can aid healing with the basics of a healthy gluten-free, casein-free, and soy-free diet, as well as digestive enzymes and probiotics.

Dr. Alain Sanua


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