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Although some studies are well controlled and show positive results, the efficacy of the GFCF diet is still questioned because most of the published research had methodological flaws such as lack of a control group, administration of medications and supplements in conjunction with the dietary intervention, Diversity of diagnoses of participants (individuals with ASD and Rett syndrome), limited number of participants, wide age range of participants, male and female participants in the same group, heterogeneous nutritional interventions and the effectiveness of the diet in most studies was assessed by psychological tests and behavioral observations directed at teachers, therapists and relatives of individuals with ASD [148,149]
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