Posts tagged ‘gluten-free diet’

Should Your Child Eat A Gluten-Free Diet

By Christine Payne, MD

Should your child eat a gluten-free diet, check the facts before making the decision

When we shop for groceries, most of us check the nutritional facts for calories, protein, preservatives, etc. trying to provide the healthiest choices for our families. Should we also be looking for a gluten-free label as well?  In the last several years, gluten has come under attack as a culprit in many diseases. Currently, it has been scientifically proven to cause celiac disease and as one component in wheat allergy.  Many people are also convinced it can be a factor in other medical disorders as well.  Searching gluten sensitivity or intolerance on the Internet brings up numerous websites and blogs, their authors passionate about linking gluten to many illnesses. Testimonials abound proclaiming resolution of conditions such as irritable bowel disease and migraines to improvement in developmental disorders like autism and ADHD. Much of this informationin the media is currently unproven, and should be examined with caution.  The jury is still out whether the gluten-free diet is an extraordinary cure, or just snake oil.

Gluten is a protein found in wheat, barley and rye.  Celiac disease occurs when this protein causes an immune-mediated reaction ingenetically predisposed people.  This reaction destroys the lining of the intestine, resulting in the malabsorption of nutrients.  Affecting 1% of the population of the United States, it is one of the most common chronic disorders in children.  Issues range from the gastrointestinal symptoms of diarrhea, poor weight gain and abdominal pain, to other findings such as short stature, delayed puberty and arthritis.  Reliable screening tests are available for celiac disease involving blood tests for endomysial antibody and tissue transglutaminase.  Intestinal biopsy often accompanies the evaluation.  Children with chronic gastrointestinal symptoms, poor growth, or evidence of malnutrition should be tested.  Likewise, children with certain associated diseases should also be checked.  Treatment for positive individuals includes mandatory, complete removal of all gluten from the diet. This results in symptom improvement often in a matter of weeks. Referrals to a nutritionist and gastroenterologist are also important.

Intolerance or sensitivity to gluten is something else altogether.  It is a basket term linking gluten ingestion to a multitude of medical problemsin people with negative celiac disease tests. Many of these individuals still report improvement of many symptoms when going to a gluten free diet. In an effort to treat frustrating conditions like autism and hyperactivity, many parents place their children on diets free of gluten as well.  This is not advisable unless instructed by a medical doctor.  Altering a child’s diet in this way can lead to both inadequate calories and vitamin D and B12 deficiencies among other problems.  Although research is underway, currently the gluten-free diet as a treatment in children who do not have celiac disease is unproven and possibly harmful.

On a practical note, gluten-free diets are extremely difficult. Gluten is found not only in bread, baked goods and pasta, but is used in many foods as a thickener or filler.   Occasionally, a few products catering to this diet can be found in major grocery stores; but most of these items need to be purchased at specialty shops.  Determining what contains gluten on a restaurant menu is also next to impossible, making dining out troublesome. Understandably the foods taste strange to kids new to the diet.  My daughter described gluten free brownies as bitter and chewy, not to mention the mix was three times the cost of the regular Betty Crocker variety.

In conclusion, unless advised by your pediatrician or gastrointestinal specialist, a gluten-free diet should not be placed upon your child. If done inappropriately, it can be unhealthy not to mention extremely difficult for your child’s palate.  We have learned much about celiac disease in the last few decades.  Hopefully further research will shed light onto other gluten-associated disorders. Until then, following the good ole food pyramid with lots of fruits and vegetables is usually the best option.

May 9, 2012 at 7:54 pm 1 comment