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Treatment Ratings for Autism claims that basically any special diet is an effective treatment of autism. Is this true?

From the study,

The following data have been collected from the more than 27,000 parents who have completed our questionnaires designed to collect such information. For the purposes of the present table, the parents responses on a six-point scale have been combined into three categories: “made worse” (ratings 1 and 2), “no effect” (ratings 3 and 4), and “made better” (ratings 5 and 6). The “Better:Worse” column gives the number of children who “Got Better” for each one who “Got Worse.”

The study presents results such as this one:

Removed Chocolate:

Got worse: 2%
No Effect: 46%
Got Better: 52%

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    Is there any information on how the survey was conducted? Were these diets the only thing that was done? For how long? And what about the controls?
    – Laurel
    May 3, 2019 at 17:47
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    Laurel: As far as I've understood, the data is based on a questionnaire sent to parents of children with autism. Don't know if the questionnaire contained questions apart from self-rating of different treaments.
    – Buhb
    May 3, 2019 at 17:54
  • To the answerers. I've removed two answers not up to our standards: please DO NOT answer based on your judgment, or in general; ALWAYS link evidence which is specific to the question. This question is about autism and diets, any evidence you present must be relevant to these two. We don't care if you find the claim plausible or not or whether if you find the research in the question plausible or not. The question is whether it is supported by medical evidence or not.
    – Sklivvz
    May 5, 2019 at 7:49

1 Answer 1

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According to Sathe N, Andrews JC, McPheeters ML, et al. Nutritional and Dietary Interventions for Autism Spectrum Disorder: A Systematic Review. Pediatrics. 2017;139(6):e20170346:

People do use try to use diet as part of treatment

... many families, if not a majority of families, pursue dietary and nutritional approaches as components of treatment. (Footnotes 1–11)

However, there is little evidence to support its effectiveness - the Strength-of-Evidence (SOE) is generally rated as insufficient:

RESULTS: Nineteen randomized controlled trials (RCTs), 4 with a low risk of bias, evaluated supplements or variations of the gluten/casein-free diet and other dietary approaches. Populations, interventions, and outcomes varied. Ω-3 supplementation did not affect challenging behaviors and was associated with minimal harms (low SOE). Two RCTs of different digestive enzymes reported mixed effects on symptom severity (insufficient SOE). Studies of other supplements (methyl B12, levocarnitine) reported some improvements in symptom severity (insufficient SOE). Studies evaluating gluten/casein-free diets reported some parent-rated improvements in communication and challenging behaviors; however, data were inadequate to make conclusions about the body of evidence (insufficient SOE).

(Emphasis added above.)

In conclusion:

Despite their widespread reported use, little evidence supports the effectiveness of nutritional supplements or the GFCF diet for improving ASD symptoms. Harms reported in studies were generally considered mild, but the long-term effects of these therapies are not well understood.

[...]

Even without a clear evidence base documenting safety and efficacy, many families of children with ASD use diet and nutritional approaches.

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    -1 Your first bolded "yes" seems misleading. You are using "treatment" as "things people do", but the claim is about "things that make things better". Answering "yes" to a different claim is likely to confuse casual readers. Your "maybe" also seems like a generous reading of the text, seeing that the conclusion of the study is: "There is little evidence to support the use of nutritional supplements or dietary therapies for children with ASD".
    – tim ♦
    May 5, 2019 at 9:12
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    The answer to the question "Is any special diet a treatment of autism?" is not "yes" according to your report: it is "some parents think it is" which is not "yes" but, in effect, a restatement of the question. The objective evidence is what we need; the reason why the question is important is that parental opinion is a very poor guide to what is actually true.
    – matt_black
    May 5, 2019 at 19:23
  • @matt_black While I appreciate your point, I would suggest not bolding the yes, because while it does technically answer the question as asked it doesn't answer the question likely intended. People scanning your answer looking for a quick answer without reading the specifics may walk away thinking you said there was evidence a diet was effective. I'd either remove the bold on the yes or replace it with a sentence saying the diet is utilized, but diet effectiveness is inconclusive, all bolded.
    – dsollen
    May 6, 2019 at 16:35
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    Enormous downvote for me, because the first article cited, which is used to support a bolded "yes", clearly states as its conclusion: "There is little evidence to support the use of nutritional supplements or dietary therapies for children with ASD". This is also the only source cited. Basically this answer is complete garbage.
    – Zibbobz
    May 14, 2019 at 2:50
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    Editted to have the summaries more closely reflect the evidence.
    – Oddthinking ♦
    May 14, 2019 at 3:35

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