The increasing popularity of a gluten-free diet is important for children. Parents are the gatekeepers of what children eat and many who have selected a gluten-free eating style adopt this for their children as well. They believe it may relieve GI symptoms, it may prevent celiac disease, or it is a healthy alternative. This dietary change is often made without consulting their pediatrician or without testing for celiac disease. Is this wise?
Surveys show that 0.5% of Americans adhere to a strict gluten-free diet, but a far greater number of people regularly buy gluten-free foods. Approximately 1% of the population has celiac disease and another 0.4% has a wheat allergy. Yet, a Gallup poll in 2015 showed that one in five people include gluten-free foods in their meals and 17% say they try to avoid gluten. Clearly, most people who buy gluten-free food have done it for reasons other than a diagnosis of celiac disease.
Norelle R. Reilly, MD from the Division of Pediatric Gastroenterology at Columbia University Medical Center attempted to understand and discuss the facts and myths that surround gluten-free eating to provide parents with accurate information regarding what to feed their children. Dr. Reilly doesn’t think health care providers can end the gluten-free diet fad but they can play a role in educating parents to make the right decisions for their children. Research scientists and physicians, Antonio Di Sabatino and Gino Roberto Corazza are also concerned that gluten-free eating is becoming a social health problem rather than a medical health problem and worry that too many people are self-prescribing a gluten-free diet.
Myth: Gluten is a toxic substance for everyone. There is no evidence to support this idea. Gluten, found in wheat, barley and rye provides the elasticity needed to support dough when it bakes. Theories that celiac disease is being driven by modern wheat that has been bred to contain more gluten cannot be supported by research. Only those with diagnosed celiac disease suffer GI symptoms and damage from eating foods with gluten.
Myth: Gluten-free foods are healthier. For otherwise healthy kids, this is untrue. Many gluten-free foods have more fat and sugar than gluten-containing alternatives. Some studies have shown that children on a gluten-free diet tend to gain more weight and may have more insulin resistance. As most grain foods in the US are fortified with folic acid, B vitamins and iron, there may be a nutrient shortfall when these foods are eliminated. Recently, there has been concern about arsenic in rice because rice is very efficient at taking up arsenic from soil. Many gluten-free foods rely on rice flour as a substitute for wheat.
Fact: There are multiple reasons to eat gluten-free. Gluten needs to be excluded, lifelong, for anyone with a diagnosis of celiac disease. Those with nonceliac gluten or wheat sensitivity also benefit from gluten-free foods as do those who have a wheat allergy.
Myth: It is okay to self-diagnose gluten sensitivity. In a study completed in Italy less than 7% of those who believed they were gluten sensitive experienced symptoms when gluten-containing foods were reintroduced to their diet. Other serious conditions such as irritable bowel syndrome, small bowel bacterial overgrowth, and fructose and lactose intolerance may be overlooked by those who self-diagnose.
Myth: Children of parents with celiac disease are at risk. In fact, less than 8% of children with a parent with celiac disease are at risk. By eliminating gluten from a child’s diet before they are tested makes a diagnosis very difficult because without the presence of gluten it is impossible to detect antibodies that point to or rule out celiac disease. A child with true celiac disease needs to be monitored for anemia, bone disease, and other autoimmune diseases.
Bottom line: Dr. Reilly concluded that there was not role for a gluten-free diet for healthy children outside the treatment for diagnosed celiac disease or wheat allergy. Following a gluten-free diet in childhood may carry more risk than benefit. The only exception to this recommendation may be for children with autism. The research for use of a gluten-free diet in cases of autism is limited, but as long as the autistic child is monitored and followed by a registered dietitian, gluten-free can be tried when no other diet option has proven useful.
© NRH Nutrition Consultants, Inc.
Jo-Ann Heslin, MA, RD, CDN is a registered dietitian and the author of 30 books. Available as eBooks from iTunes and Kindle/Amazon:
Healthy Wholefoods Counter
Complete Food Counter
Fat and Cholesterol Counter
Available in print from Gallery Books:
Most Complete Food Counter, 3rd Ed.
Your Complete Food Counter App: http://itunes.apple.com/us/app/your-complete-food-counter/id444558777?mt=8
For more information on Jo-Ann and her books, go to: www.TheNutritionExperts.com.