Efectividad de la dieta libre de caseína y gluten en el tratamiento de niños con trastornos del espectro autista: revisión sistemática

Abstract

Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by impairments in social communication and repetitive behavioral patterns, frequently associated with gastrointestinal symptoms. Previous studies indicate that some children with ASD exhibit enzymatic deficiencies that hinder the digestion of proteins such as gluten and casein, which may lead to the formation of bioactive peptides that can alter intestinal function and behavior. Objective: To determine the effectiveness of gluten- and casein-free diets in the treatment of children with autism spectrum disorders. Methods: A descriptive systematic review was conducted following the PRISMA 2020 guidelines. Studies published between 2013 and 2025 were retrieved from academic databases. Case-control studies, cohort studies, and observational studies analyzing the relationship between the consumption or elimination of gluten and casein and the clinical progression of children diagnosed with ASD were included. Results: Fifteen studies were included, reporting a high prevalence of gastrointestinal symptoms, food selectivity, and nutritional deficiencies. Most studies did not assess direct clinical changes following dietary intervention; however, one study that applied a gluten- and casein-free diet for one year demonstrated significant improvements in behavioral indicators, while others reported partial benefits. Conclusions: Evidence suggests that a gluten- and casein-free diet may reduce gastrointestinal symptoms and, in some cases, improve behavioral aspects in children with ASD. Nevertheless, its effectiveness is variable and requires professional supervision. Keywords: effectiveness, gluten, casein, gastrointestinal disorders, ASD