• Casein-free and gluten-free (CF/GF) diets
  
• Anti-Candida diets
  
• Feingold diet
  
• Elimination/reintroduction diet for food allergies
  
• Rotation diet for food allergies
  
• The ketogenic diet
  
• Blood-type diet
  
• The "caveman" diet
  
• Immune-boosting diets
  

If this is the case for you or your child, a nutritionist with expertise in addressing GI tract problems via dietary changes will be able to help. Effective medical treatments are also available.

Casein-free and gluten-free (CF/GF) diets

Casein is the easier protein to avoid. It is present only in milk and milk byproducts, so you must rule out milk, cream, buttermilk, butter, sour cream, yogurt, and cheese. You also have to watch out for milk derivatives, which are hiding in many places. For example, check the ingredients label on that soy cheese: almost all varieties are made with casein or caseinate. Ditto for most margarines, which may contain casein, lactose (milk sugar), whey, dry nonfat milk, yogurt, or buttermilk. Cookies, soups, breads, potato chips, and many other supermarket foods may contain milk byproducts.

If you aren't allergic to soy products, there are many excellent substitutes available for casein-containing foods. Soy milk fortified with calcium and vitamins is widely available now, and there are also casein-free soy cheeses and soy yogurts. Tofu substitutes nicely when you want the creaminess of cheese or sour cream in a recipe, and a couple of manufacturers produce dairy-free sour cream, cream cheese, and frozen desserts. Check out vegetarian or vegan (no animal products, including dairy) cookbooks for some ideas on cooking without casein, and keep an eye out for packaged foods that are labeled "vegan."

Gluten is a bit harder to avoid. It is the protein found in wheat, spelt, oats, rye, triticale, and barley. Bread is the staff of life, so how can you avoid gluten? Choose other grains instead. Nonglutenous grains include corn, rice, wild rice, buckwheat, millet, quinoa, teff, and more. As with casein, gluten can be hiding in common supermarket items. Look out for malt, grain starches, textured vegetable protein (TVP), hydrolyzed vegetable protein (HVP), and vinegar, among other items. Sometimes TVP and HVP are made from soybeans, but not always.

here are some commercial gluten-free products on the market, including baking mixes, rice flour, cornmeal, baked goods, frozen waffles, breakfast cereals, and more.

Parents report that children who do respond to a CF and/or GF diet tend to exhibit clingy, whiny, irritable behavior when just starting out. Some may go on a hunger strike, refusing to eat at all. This stage will pass. More positive results that you may see are a newfound ability to be toilet trained, willingness to try a wider variety of foods, and more normal bowel movements. Some parents also report that long-standing skin problems have cleared up on the diet, and that children who wandered aimlessly or even made escape attempts reduce these behaviors.

One of the great questions about CF/GF diets is how long you need to stay on them. The usual recommendation for a trial of the diet is three months to a year, after which it can be safely abandoned if no positive benefits have been seen. If it does seem to be working, one school of thought says that once the gut is healed (assuming that casein and gluten peptides are only escaping into the bloodstream due to GI tract damage), these foods can return to the diet in moderation. Others say it should be a lifelong project, as the sensitivities will not go away. Your best guideline is the results you get. If going casein- and/or gluten-free seems to help, and if regression or behavior problems occur when these proteins are added back to the diet, stick with the strict diet. Some people may want to use urine tests to determine whether the peptides have disappeared.

Lisa Lewis, the parent of a child with PDD-NOS, has written an excellent book on the topic of CF/GF diets and PDD called Special Diets for Special Kids (Future Horizons, 1998). She also maintains two Web sites (http://members.aol.com/lisas156/index.htm and http://www.autismNDI.com/). There is more information about CF/GF diets in books written for people with celiac disease. These individuals must also avoid gluten, and many eschew dairy foods as well. Two other sites of interest are maintained by Don Wiss: the Gluten-Free Page and the No Milk Page.

Anti-Candida diets

Fermented or moldy foods, yeasty foods, and sugars are the main items to be avoided. Fermented or moldy foods include cheese, alcohol, brine pickles, tempeh, soy sauce, vinegar, dried fruits, nut butters, honey, and others. Yeasty foods include all glutenous grains and all yeasty products, including yeast-containing baked goods, brewer's yeast ("nutritional yeast"), and beer.

It's also suggested that citrus and acid fruits, such as grapefruit, oranges, lemons, limes, pineapple, and tomatoes, be avoided for the first month of an anti-Candida diet. In fact, many such diet plans are completely free of fruit. All of them are as sugar-free as possible. Finally, anti-Candida diets should contain plenty of roughage for fiber.

Most books on Candida overgrowth suggest starting with an allergy elimination/reintroduction diet, and then following a rotation diet. They often suggest paying attention to environmental sources of mold as well, such as damp basements, carpets, and old furnace filters.

Anti-Candida diets are gluten-free, and many people avoid dairy foods as well. For more information, see the many books available on Candida albicans or this Candida Web site.

Feingold diet

The Feingold Association is a group formed to support families using the diet plan. Its useful Pure Facts newsletter lists commercial foods that meet (or do not meet) the restrictions. The Feingold Association also supports "The IA-USA Extended Feingold Program for Autism/PDD and Milk & Wheat Allergies," which combines the original plan with CF/GF restrictions. There is a membership charge to join this group, which can provide meal plans, food lists, information about doctors and nutritionists who support the diet, and contacts with other parents using the diet.

Clinical testing has not proven Dr. Feingold's claims true, but some parents have reported improvements. Generally speaking, the original Feingold diet did not carry any health risks. The autism/PDD diet plan was not available for free inspection at press time. If you want to know more about the Feingold diets, see the Feingold Association Web site.

Elimination/reintroduction diet for food allergies

Next comes the reintroduction process: Reintroduce one previously eliminated food at a time. Eat it at every meal. If you suffer no ill effects, you aren't allergic to that food and it can be added back to the regular diet.

If you do seem to have an allergic reaction to a food, eliminate it again for several weeks and then reintroduce it once more. You may need to follow this last step several times to make sure you know which food is causing the possible allergic reaction or intolerance problem.

Rotation diet for food allergies

The ketogenic diet

Obviously, this is not a healthy, balanced diet. It is used as a last-ditch effort to manage seizures that cannot be controlled with medication. Under no circumstances should this diet be tried on your own, without medical supervision. Not only is it potentially dangerous, it's pretty hard to make it appetizing. A medical center that specializes in epilepsy treatment should be able to provide guidance and expert nutritional advice if this option is recommended for you or your child.

Blood-type diet

The "caveman" diet

By necessity this diet is casein- and gluten-free. It's probably a reasonably healthy choice, although many physicians counsel their patients to eat less meat these days. If the meat is lean and not treated with preservatives, and if you like it, why not, unless otherwise indicated? Potential benefits for people with PDDs would presumably be similar to those of the GF/CF option.

Immune-boosting diets