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CompletedNCT02911194A2MTUpdated Sep 5, 2018

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

An interventional study of a2 milk and a1 containing milk in Autism, Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder, sponsored by Northumbria University. Completed at 1 site in United Kingdom. Open to male participants aged 5 Years to 10 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2018-09-05.

Sponsored by Northumbria University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
40
Allocation
Randomized
Ages
5 Years to 10 Years
Sex
Male
01

Study summary

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).

Read the detailed description

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.

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Conditions studied

  • Autism
  • Attention Deficit Hyperactivity Disorder
  • Autism Spectrum Disorder
03

In context

Hyperkinesis

729 studies on the registry are indexed under Hyperkinesis; 25 are open to participants now.

This study's enrollment of 40 is below the median of 80 across 583 interventional studies indexed under Hyperkinesis.

Browse Hyperkinesis studies →

Lead sponsor

Northumbria University is the lead sponsor of 156 studies on the registry; 22 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
5 Years to 10 Years
Sexes eligible
Male
Accepts healthy volunteers
Yes

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

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)
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
40 participants (actual)

Study arms

  • Experimental
    Treatment

    a2 milk intervention period

    Dietary Supplement: a2 milk

  • Placebo comparator
    Control

    a1 containing milk (normal) intervention period

    Dietary Supplement: a1 containing milk

Interventions

  • Dietary supplementa2 milk

    replace all milk with a2 milk

  • Dietary supplementa1 containing milk

    use a1 containing milk

06

What researchers measure

Primary outcomes

  1. Change in Childhood Autism Rating Scale (CARS2-HF) Value during intervention

    Difference in CARS raw scores and severity group between baseline and 4 weeks and 8 weeks.

    Time frame: Baseline to Week 4 to Week 8

  2. Change in Conners' Rating Scale - Revised (L) value during intervention.

    Difference in Conners' raw scores and totalled scores between baseline and 4 weeks and 8 weeks

    Time frame: Baseline to Week 4 to Week 8

Secondary outcomes

  1. Amino acid analysis of urine samples by mass spectroscopy.

    Analysis of urine samples via non-targeted and targeted liquid chromatography mass spectrometry analysis. The targeted compounds to be measured include urinary metabolites of intestinal bacterial species (specifically related to the aromatic amino acids, tryptophan, tyrosine and phenylalanine) and urinary concentrations of compounds related to the methionine cycle (including methionine, homocysteine, cystathione and cysteine).

    Time frame: Baseline to Week 4 to Week 8

  2. Metabolomic analysis of blood spot samples by mass spectroscopy.

    Where blood spot samples are/can be provided by participants, non-targeted and targeted liquid chromatography mass spectrometry analysis will be undertaken. The targeted compounds to be measured include various amino acids including the aromatic amino acids and the branched chain amino acids. Blood spot concentrations of compounds related to the methionine cycle (including methionine, homocysteine, cystathione and cysteine) will also be examined.

    Time frame: Baseline to Week 4 to Week 8

  3. Changes to the gut microbiome profile.

    Gene sequencing of stool samples to characterise the gut microbiome measured by operational taxonomic units (OTUs) of individual bacterial species.

    Time frame: Baseline to Week 4 to Week 8

  4. Changes to stool appearance measured using the Bristol Stool Chart.

    At time of stool sample collection, the presentation of the stool will be recorded using the Bristol Stool Chart.

    Time frame: Baseline to Week 4 to Week 8

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Study locations

1 site
  • ESPA Research
    Sunderland, Tyne And Wear, United Kingdom
08

References and documents

Publications

  • 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. PubMed 25311313 ↗
  • 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. PubMed 24075141 ↗
  • 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. PubMed 23316152 ↗
  • 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. PubMed 20406576 ↗
  • 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. Erratum In: Nutr J. 2016 Apr 29;15(1):45. doi: 10.1186/s12937-016-0164-y. PubMed 27039383 ↗
  • 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. PubMed 24986816 ↗
  • 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. PubMed 25018147 ↗

Individual participant data

Plan to share: Yes — Group data will be available upon request

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 5, 2018, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02911194
Lead sponsor
Northumbria University
Collaborators
ESPA Research, a2 Milk Company Ltd.
Responsible party
John Lodge (Doctor, Northumbria University) — Principal investigator
First posted
Sep 22, 2016
Start date
Sep 2016
Primary completion
Sep 2018
Completion
Sep 2018
Last update
Sep 5, 2018

Study contacts

John K Lodge, PhD
principal investigator · Northumbria University

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Sep 2018. You cannot join it, but the record below documents what was studied.

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