a2 Milk for Autism and Attention-deficit Hyperactivity Disorder (ADHD)

NCT ID: NCT02911194

Last Updated: 2018-09-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-09-30

Study Completion Date

2018-09-30

Brief Summary

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Under double-blind, placebo-controlled, cross-over conditions, the short-term effects of use of A1 beta casein free milk (a2 milk) and milk containing A1 beta casein will be compared in a sample of pre-pubescent boys diagnosed with an autism spectrum disorder (ASD) with concurrent features of attention-deficit hyperactivity disorder (ADHD).

Detailed Description

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Previous preliminary research studies have suggested that a diet devoid of milk and dairy products might be useful for some people on the autism spectrum in reducing certain types of behaviours or other symptoms that can affect quality of life. Aggravation of some of the symptoms of autism has been suggested to be linked to some of the constituents of milk, in particular a natural breakdown product of the milk protein called beta-casomorphin 1-7 (BC 1-7 or BCM-7) found in the majority of mammalian dairy products. A dairy-free diet (casein-free diet) can however be a difficult diet to follow and may increase the risk that certain nutrients are missing from the diet.

Anecdotal evidence suggests that different types of milk from different breeds of cattle (cows) may not carry the same biological effects for some on the autism spectrum. Milk typically found in supermarkets naturally contains BC1-7 as a function of the type of cows producing the milk and the protein it contains (A1 variant of the beta casein protein).

The investigators are aiming to test whether a particular type of milk (A1 beta casein free milk also called a2 Milk™) might be able to replace a casein-free diet for children on the autism spectrum also presenting with attention-deficit hyperactivity disorder (ADHD) type symptoms. The investigators will be looking at the potential effects of A1 beta casein free milk on behaviour and various biological processes going on in the body. The source of A1 beta casein free milk will be commercially available a2 Milk™ branded milk that is directly comparable to regular supermarket bought milk with the exception of the beta casein component and is already available to buy.

In this double-blind, randomised, placebo-controlled trial, the effects of milk free of A1 beta casein (a branded milk called a2 milk™) and milk containing A1 beta casein will be compared in a sample of pre-pubescent children diagnosed with an autism spectrum disorder with concurrent features of attention-deficit hyperactivity disorder (ADHD). Forty children based in North East England will be initially recruited; all possessing communicative speech and language. A baseline assessment will be conducted to include behavioural, psychometric and health-related parameters. Following random allocation, participants will be assigned to group A or group B and given A1 milk or a2 Milk™ initially for a period of 4 weeks. At this point, baseline assessment measures will be repeated. Milk types will be crossed for groups for a further 4 weeks. At study endpoint, baseline assessment measures will be repeated again. Data derived from the study will be analysed and outcomes reported in peer-review format. During the course of the study, all other forms of dairy product consumption (cheese, yogurts, etc) will be excluded from the diet of all participants irrespective of their treatment allocation.

Data from supervised baseline, midpoint and endpoint psychometric and behavioural assessments will be made and stored via a secure survey website accessed via tablets supplied to all participants.

Conditions

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Autism Attention Deficit Hyperactivity Disorder Autism Spectrum Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Treatment

a2 milk intervention period

Group Type EXPERIMENTAL

a2 milk

Intervention Type DIETARY_SUPPLEMENT

replace all milk with a2 milk

Control

a1 containing milk (normal) intervention period

Group Type PLACEBO_COMPARATOR

a1 containing milk

Intervention Type DIETARY_SUPPLEMENT

use a1 containing milk

Interventions

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a2 milk

replace all milk with a2 milk

Intervention Type DIETARY_SUPPLEMENT

a1 containing milk

use a1 containing milk

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of autism spectrum disorder (autism, Asperger syndrome, Autism Spectrum Disorder)
* Diagnosis or fulfilling the diagnostic criteria for / presenting with the symptoms of attention-deficit hyperactivity disorder (ADHD)
* Regular milk drinker
* Functional use of spoken language (for ability to self-report)
* Access to internet connection (WiFi)

Exclusion Criteria

* Undergoing current medical treatment (and an inpatient at a state hospital)
* Current or past 3 month use of a gluten- and/or casein-free diet
* Co-morbid diagnoses of Fragile-X syndrome, epilepsy or tuberous sclerosis
* Indications or diagnosis of cows milk protein allergy (IgE)
Minimum Eligible Age

5 Years

Maximum Eligible Age

10 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

Yes

Sponsors

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ESPA Research

UNKNOWN

Sponsor Role collaborator

a2 Milk Company Ltd.

INDUSTRY

Sponsor Role collaborator

Northumbria University

OTHER

Sponsor Role lead

Responsible Party

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John Lodge

Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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John K Lodge, PhD

Role: PRINCIPAL_INVESTIGATOR

Northumbria University

Locations

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ESPA Research

Sunderland, Tyne and Wear, United Kingdom

Site Status

Countries

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United Kingdom

References

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Whiteley P. Nutritional management of (some) autism: a case for gluten- and casein-free diets? Proc Nutr Soc. 2015 Aug;74(3):202-7. doi: 10.1017/S0029665114001475. Epub 2014 Oct 14.

Reference Type BACKGROUND
PMID: 25311313 (View on PubMed)

Pedersen L, Parlar S, Kvist K, Whiteley P, Shattock P. Data mining the ScanBrit study of a gluten- and casein-free dietary intervention for children with autism spectrum disorders: behavioural and psychometric measures of dietary response. Nutr Neurosci. 2014 Sep;17(5):207-13. doi: 10.1179/1476830513Y.0000000082. Epub 2013 Nov 26.

Reference Type BACKGROUND
PMID: 24075141 (View on PubMed)

Whiteley P, Shattock P, Knivsberg AM, Seim A, Reichelt KL, Todd L, Carr K, Hooper M. Gluten- and casein-free dietary intervention for autism spectrum conditions. Front Hum Neurosci. 2013 Jan 4;6:344. doi: 10.3389/fnhum.2012.00344. eCollection 2012.

Reference Type BACKGROUND
PMID: 23316152 (View on PubMed)

Whiteley P, Haracopos D, Knivsberg AM, Reichelt KL, Parlar S, Jacobsen J, Seim A, Pedersen L, Schondel M, Shattock P. The ScanBrit randomised, controlled, single-blind study of a gluten- and casein-free dietary intervention for children with autism spectrum disorders. Nutr Neurosci. 2010 Apr;13(2):87-100. doi: 10.1179/147683010X12611460763922.

Reference Type BACKGROUND
PMID: 20406576 (View on PubMed)

Jianqin S, Leiming X, Lu X, Yelland GW, Ni J, Clarke AJ. Effects of milk containing only A2 beta casein versus milk containing both A1 and A2 beta casein proteins on gastrointestinal physiology, symptoms of discomfort, and cognitive behavior of people with self-reported intolerance to traditional cows' milk. Nutr J. 2016 Apr 2;15:35. doi: 10.1186/s12937-016-0147-z.

Reference Type BACKGROUND
PMID: 27039383 (View on PubMed)

Ho S, Woodford K, Kukuljan S, Pal S. Comparative effects of A1 versus A2 beta-casein on gastrointestinal measures: a blinded randomised cross-over pilot study. Eur J Clin Nutr. 2014 Sep;68(9):994-1000. doi: 10.1038/ejcn.2014.127. Epub 2014 Jul 2.

Reference Type BACKGROUND
PMID: 24986816 (View on PubMed)

Trivedi MS, Shah JS, Al-Mughairy S, Hodgson NW, Simms B, Trooskens GA, Van Criekinge W, Deth RC. Food-derived opioid peptides inhibit cysteine uptake with redox and epigenetic consequences. J Nutr Biochem. 2014 Oct;25(10):1011-8. doi: 10.1016/j.jnutbio.2014.05.004. Epub 2014 Jun 6.

Reference Type BACKGROUND
PMID: 25018147 (View on PubMed)

Related Links

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http://www.espa-research.org.uk

ESPA Research website

Other Identifiers

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SUB017_Lodge_031115

Identifier Type: -

Identifier Source: org_study_id

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