An unwanted effect caused by the ingestion of food or drugs. Onset may be sudden or develop over time.
Amino acids: Amino acids are the smallest units of protein, often called the “building blocks” and are necessary for the growth, repair and maintenance of all body tissues.
Amino acid-based formula:
An amino acid-based formula is based on synthetic amino acids and is indicated for medical conditions where an infant or child has adverse reactions to whole or even hydrolyzed food proteins. These formulas provide protein in the smallest, simplest form that is easily digested and absorbed, relieving the adverse reactions seen with typical foods and formulas. An amino acid-based formula may be beneficial for a child following a special diet where high value proteins, such as gluten, casein and soy, are restricted from the diet.
Autism Spectrum Disorder:
According to the Centers for Disease Control, “Autism spectrum disorders (ASDs) are a group of developmental disabilities defined by significant impairments in social interaction and communication and the presence of unusual behaviors and interests.” This includes Autistic Disorder, Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS), and Asperger Syndrome. Features associated with ASD include unusual eating habits, gastrointestinal symptoms such as chronic diarrhea and/or constipation, hyperactivity, compulsivity, aggressiveness, self-injury, odd sleeping habits and unusual reactions to sensory input.
Body Ecology Diet:
This diet is sometimes used to treat fungal gut dysbiosis in children with ASD and involves eating fermented or cultured foods to establish a healthy immune and digestive system. Oftentimes, this diet is used in conjunction with the Gluten-Free, Casein-Free (GFCF) diet. In addition to eliminating gluten and casein, the combined diet would also eliminate sugar and certain fats. Neocate Junior unflavored or Neocate One+ would be appropriate for a child on this diet.
These macronutrients are essential elements of living cells and a main source of energy for the body's metabolic processes.
Casein is a food protein found in milk and dairy products. This protein is the predominant protein found in cow’s milk, making up approximately 80% of the protein content and accounting for roughly 3% by weight.
Casein-Free indicates that a food or product is completely free of any ingredient, including additives, that contains casein (see “casein” above). “Lactose-free” does not indicate that a product is casein-free, as lactose refers to a sugar found in dairy and not the protein component.
A Casein-Free Diet eliminates all sources or derivatives of casein from the diet. This diet is most common among individuals with milk allergies or intolerances, where the body produces an immune response to the protein component of milk and dairy products.
Caseomorphines are peptides resulting from the inadequate digestion of casein, a protein found in milk and dairy products. According to the Opiate Theory, these peptides react with opioid receptors in the brain and cause changes in neurological function.
Cow milk allergy:
Cow milk allergy (CMA) is a reaction to cow milk that results from a hypersensitive immune response to one or more milk proteins. This is the most common food allergy in infants and young children. Symptoms may include gastrointestinal (GI) issues, skin symptoms and breathing difficulties.
Dietary Reference Intake (DRI):
DRI refers to nutrient-based reference values (such as RDA, AI, UL, EAR), used in the United States to define recommended dietary intake levels for individual nutrients. The DRIs are determined by expert panels appointed by the Food and Nutrition Board of the Institute of Medicine.
An elemental formula describes a complete liquid diet which contains nutrients that are broken down into their smallest, purest form and therefore easy for the body to digest and absorb. Other terms used to describe an elemental formula include “predigested formula” or “amino acid-based formula”.
An elimination diet is a way to identify which foods are the sources of food intolerance. This process involves completely eliminating any suspect foods from your child’s diet until the symptoms go away. Then you begin to reintroduce the foods, one at a time, which allows you to pinpoint which foods cause symptoms. Always consult with a Healthcare professional before beginning an elimination diet to be sure your child receives adequate nutrition. Nutritionally complete, hypoallergenic formulas, such as Neocate products, allow you to implement an elimination diet safely.
Eosinophilic Esophagitis (EE):
EE is characterized by the infiltration of a large number of eosinophils, a type of white blood cell, in the esophagus. Eosinophils travel to different structures of the body, primarily the digestive tract, and function to help fight different types of infections, such as parasites. However, eosinophils are not normally found in the esophagus. When they are present, this is an indication of inflammation, which may be due to food allergens (e.g. milk, wheat, soy, eggs) or environmental allergens (aero-allergens).
Also known as “atopic dermatitis,” this term describes a particular kind of skin inflammation characterized by reddening, itching and the appearance of blisters with consequent hardening of the skin and scaling.
Failure to thrive (FTT):
Failure to thrive is a description given to children whose current weight or rate of weight gain is significantly below that of other children of similar age and sex.
This diet, also known as the Low Salicylate Diet, requires the elimination of artificial colors, artificial flavors, artificial sweeteners, certain synthetic preservatives and certain salicylates from your child’s diet. The aim of this diet is to reduce hyperactivity and it has been used to treat individuals with ADHD, ASD and anxiety.
A food allergy is an adverse immune response to a food protein which results in an allergic reaction. Symptoms of a food allergy include eczema, asthma, GI symptoms and in severe cases, anaphylaxis.
Food intolerance is a reproducible adverse reaction to the ingestion of food or to any of its components, such as proteins, carbohydrates, fats and additives. Unlike with food protein allergy, the immune system is not involved. In certain cases, food intolerance can occur when the body is missing certain enzymes that help in digestion of food. Consequently, the digestive tract can not properly break down or digest a certain food. These reactions can be more delayed than a typical food protein allergy, with signs and symptoms occurring more than 24 hours after the ingestion of the problem food.
Symptoms of food intolerance include:
Gas, cramps or bloating;
Irritability or nervousness.
Gastroesophageal Reflux Disease (GERD):
Excessive reflux where the frequency and severity lead to disease symptoms: failure to thrive, sleeping and feeding problems, esophagitis, wheezing, cough, vomiting and regurgitation. It can be divided into Primary GERD, with motility disorder causing transient relaxations of the lower esophageal sphincter, and Secondary GERD, where some factor (e.g. food intolerance/allergy) indirectly gives rise to the above disorder.
Gastrointestinal tract (GI tract):
The GI tract describes the part of our body going from the mouth to the anus, in which muscle movement and hormone and enzyme release allow food digestion. Also called alimentary canal or digestive tract, it is formed by mouth, esophagus, stomach, duodenum, small intestine, large intestine, rectum and anus.
Gastrointestinal tract impairment (GI tract impairment):
GI tract impairment prevents foods from being broken down appropriately, and therefore interferes with the body’s ability to extract and use nutrients and energy from foods. Amino acid-based products, such as Neocate products, are beneficial for patients with GI tract impairment because the nutrients and energy in these formulas are already in the smallest form and available for use in the body.
Gluteomorphine is a peptide resulting from the inadequate digestion of gluten, a food protein found predominantly in wheat, rye, barley and oats. According to the Opiate Theory, these peptides react with opioid receptors in the brain and cause changes in neurological function.
Gluten is a food protein found in wheat, barley, rye, triticale, spelt, kamut and sometimes oats.
Gluten-Free indicates that a food or product is completely free of any ingredient that is derived from foods that contain gluten (see “Gluten” above). This includes any gluten derived additives that are used as food thickeners, stabilizers or enhancers.
The gluten-free diet eliminates all sources and derivatives of gluten-containing foods (see “Gluten” above). This diet is most common among individuals with celiac’s disease, an autoimmune disorder of the small intestine where the body produces an inflammatory response to gluten. The gluten-free diet is also indicated for individuals with wheat allergies or conditions of gluten intolerance.
Gluten-Free, Casein-Free Diet (GFCF):
The GFCF Diet is the most commonly used special diet for kids with Autism Spectrum Disorder. Children following this diet often are placed on amino acid-based formulas. These formulas are beneficial because they provide an easily absorbable, non-inflammatory protein to children with problematic reactions to most whole food proteins, such as gluten, casein or soy.
A hydrolyzed formula contains cow's milk proteins that have been broken down so that they are less allergenic than the whole proteins in regular formula. Although this lowers the likelihood of an allergic response, infants and children with severe food allergies or intolerances will continue to react adversely to a hydrolyzed formula, and may require an amino acid-based formula, such as Neocate, instead.
In order for a product to be classified as hypoallergenic, clinical study must prove that at least 95 percent of children experience no allergic reaction to it.
Impaired Intestinal Permeability aka “Leaky Gut”:
This term refers to the compromised integrity of the mucosal wall lining the gastrointestinal tract. When the mucosal lining is impaired, harmful macromolecules, such as toxins, allergens or food peptides, are able to pass into the circulatory system and cause overreaction of the immune system.
Low Oxalate Diet:
This describes a diet low in oxalates, which is sometimes used for GI treatment in children with ASD. Some theorize that children with ASD have high levels of oxylates which causes inflammation of the gut. Oxylates are food components found in many foods, especially in nuts, seeds, plants and fruits.
Macronutrients describe the three main components of food: proteins, fats and carbohydrates, which the body requires in relatively large amounts. Water is sometimes classified as a macronutrient as well. Macronutrients are required for energy, normal growth and development.
Malnutrition occurs when a person's body is not getting enough nutrients. It may result from an inadequate or unbalanced diet, digestive problems, malabsorption or other medical conditions.
A condition in which our body is not able to absorb all or part of the substances taken with food.
According to the Food and Drug Administration and as defined in section 5(b) of the Orphan Drug Act (21 U.S.C. 360ee (b)(3)), “a medical food is a food which is formulated to be consumed or administered enterally under the supervision of a physician and which is intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation.”
A food is subject to this exemption if:
It is a specially formulated and processed product (as opposed to a naturally occurring foodstuff used in its natural state) for the partial or exclusive feeding of a patient by means of oral intake or enteral feeding by tube;
It is intended for the dietary management of a patient who, because of therapeutic or chronic medical needs, has limited or impaired capacity to ingest, digest, absorb, or metabolize ordinary foodstuffs or certain nutrients, or who has other special medically determined nutrient requirements, the dietary management of which cannot be achieved by the modification of the normal diet alone;
It provides nutritional support specifically modified for the management of the unique nutrient needs that result from the specific disease or condition, as determined by medical evaluation;
It is intended to be used under medical supervision; and
It is intended only for a patient receiving active and ongoing medical supervision wherein the patient requires medical care on a recurring basis for, among other things, instructions on the use of the medical food.
A micronutrient is a nutrient required by the body in small amounts and includes vitamins, minerals and trace elements.
Minerals are elements that originate in the earth and cannot be made by living organisms. Plants obtain minerals from the soil and humans obtain minerals directly from plants, indirectly from animal sources or from the water we drink.
Multiple Food Protein Intolerance:
Multiple food protein intolerance describes the condition where infants and children are allergic/intolerant to a wide variety of food proteins, such as milk, soy, egg, wheat, peanut, fish, meats and rice.
Nutrients are substances found in foods and are required for normal body function and structure. Nutrients can be divided into macronutrients and micronutrients.
Medical foods can be designated as nutritionally complete or incomplete. A nutritionally complete product can serve as the sole source of nutrition for a person. This means a prescribed dose provides the required daily value of calories, proteins, carbohydrates, fats, vitamins, minerals and trace elements.
Nutritional deficiency occurs when one’s nutrient intake consistently falls below the level needed for proper bodily function. It can result in a variety of health problems.
This theory is based on the concept that inadequate digestion of certain proteins can result in the presence of food peptides with excitotoxin capabilities or “dietary opiates” in the central nervous system. Specific peptides derived from gluten (a protein found predominantly in wheat, barley, rye and oats) and casein (a protein found in dairy products) can bind to opioid-receptors in the brain and affect neurological function.
A chain of amino acids linked together by a "peptide bond". A protein is made up of one or more peptides.
Recommended Daily Allowance (RDA):
This term, established by the Food and Nutrition Board of the Institute of Medicine, describes the average daily dietary intake of a nutrient sufficient to meet the requirements of nearly all healthy individuals in a specific age and gender group.
The term “safe food” refers to any food that is compliant with a particular special diet or medical condition. For example, for a child following the Gluten-Free, Casein-Free Diet, safe foods would include fruits, vegetables, rice, meat, corn or any GFCF alternative foods (assuming that no other food allergies or intolerances are present).
Small Bowel Syndrome (SBS):
SBS is a condition caused by the loss of part of the small bowel, either from disease or surgical removal. A person with short bowel syndrome is likely to be deficient in various important nutrients because their intestine cannot absorb enough nutrients from food. Infants and children with short bowel syndrome will require specialized infant formulas and medical foods, medical procedures and medications to help their body adapt to the reduced length of the small bowel and to obtain all the nutrients and fluids they need for optimal growth.
Soy protein is a protein found in soy beans and soy-based products. Soy is a high value protein source and is commonly used by vegans and vegetarians as an alternative to animal proteins. Like milk and wheat, soy is one of the top 8 food allergens in children. Often, soy will be eliminated along with a Gluten-Free, Casein-Free Diet, because soy has a protein structure that is similar in structure to gluten and casein.
A special diet describes a dietary intervention that is implemented to treat a medical condition. Examples of special diets include the low protein diet for people with metabolic disorders such as PKU, the gluten-free diet for individuals with Celiac’s Disease, the Ketogenic Diet for children with intractable seizures, and the Gluten-free, Casein-free Diet, which is used for nutritional therapy and GI treatment in children with autism, for example.
Specific Carbohydrate Diet (SCD):
This diet limits complex carbohydrates, which includes disaccharides and polysaccharides, and refined sugars. The aim of this diet is to starve out harmful bacteria, enabling a healthy balance of gut flora with improved digestion and reduced inflammation. Children with Autism Spectrum Disorder may follow this diet to improve gut dysbiosis and yeast overgrowth. The Neocate line of products would not be appropriate while following the SCD diet because they contain carbohydrates which are not allowed on this particular diet.
Trace elements are chemical elements that our bodies require in very small amounts in order to maintain health. Examples of trace elements include copper, selenium, and iodine.
Vitamins are natural substances that our bodies require to grow and develop properly. For humans, there are 13 vitamins which must be obtained through our diets. Consistent lack of vitamins can provoke various diseases, such as Vitamin Deficiency Anemia, caused by a deficiency in iron, Vitamin C, folate, and/or Vitamin B12. Other well known conditions of vitamin deficiency include Rickets, which is caused by a deficiency in calcium and/or Vitamin D, along with Scurvy, which is caused by a deficiency in Vitamin C.
Adams, James B. “Summary of Biomedical Treatments for Autism”.
Autism Spectrum Disorders: Pervasive Developmental Disorders. The National Institute of Mental Health. January 2007.
Converse, Judy. “Medical Nutrition Therapy for Pediatric Autism: Strategies for Assessment and Monitoring”.
Food Allergy: An Overview. The National Institute of Allergy and Infectious Diseases. US Department of Health and Human Services: The National Institute of Health. NIH Publication Number 07-5518. July 2007. www.NIAID.NIH.gov
National Center on Birth Defects and Developmental Disabilities 2007.
Orphan Drug Act (21 U.S.C. 360ee (b)(3)). The Food and Drug Administration. Office of the Federal Register, National Archives and Records Administration.
(National Center on Birth Defects and Developmental Disabilities 2007).