A Case of Changes in Emotional State and Cognitive Index Following Comprehensive Nutritional Intervention Including a Gluten- and Casein-Free Diet in a School-Aged Boy

Abstract

Background: Children with IgE-mediated (immediate-type) food allergies may develop emotional i nstability and behavioral difficulties possibly associated with intestinal hypersensitivity and increase d intestinal permeability, and dietary adjustment from a nutritional psychiatry perspective may be beneficial in selected cases.

Case: The patient was a school-aged boy with multiple food allergies since infancy, presenting wi th abdominal pain, anxiety, sensory hypersensitivity, restlessness, recurrent skin eruptions, and freq uent aphthous stomatitis. During a period of school closure, a natural reduction in wheat and dair y intake occurred, which was followed by resolution of abdominal pain within a few days and e motional stabilization within several weeks. Subsequently, a gluten- and casein-free diet, a high-pro tein diet, and stepwise nutritional interventions including vitamin D, zinc, B vitamins, glutamine, a nd probiotics were introduced. Serum zinc levels increased, and elevated urinary arabinose levels d etected on organic acid testing decreased over time. On the Wechsler Intelligence Scale for Childr en–Fourth Edition (WISC-IV), full-scale IQ increased, with marked improvements in verbal compre hension and perceptual reasoning.

Conclusion: Although this is a single case and causality cannot be determined, the clinical course suggests that dietary adjustment and appropriate nutritional intervention may be associated with im provements in emotional and behavioral difficulties as well as cognitive indices in children with al lergic predisposition and intestinal vulnerability.