Creating a Healthy Gluten-Free Diet For Children
Maintaining a strict gluten-free diet (GFD) is necessary for anyone diagnosed with celiac disease or gluten intolerance. Not adhering to the lifestyle could lead to severe health consequences such as nutritional deficits. Obviously, in children, balancing the GFD with a diet that has adequate amount of energy and nutrients for growth and development is essential.
Gluten is a storage protein found in wheat, barley, rye and hybrids of these grains, such as kamut and triticale. Unfortunately, avoiding gluten isn’t as easy as just skipping the bread basket at dinner.
Wheat products are found everywhere, especially in processed foods. Some of the most common foods that contain gluten include bouillon cubes/broth, gravy, cold cuts, imitation fish, rice mixes, sauces, soups and seasoned snack foods (even if the grain used in the snack is gluten-free, such as in the case of corn tortilla chips).
Studies indicate that 20-38% of adults and children with celiac disease have nutritional complications, such as calorie/protein imbalance, lack of dietary fiber, mineral and vitamin deficiencies – especially iron, copper, folate, vitamin B12 and zinc. At diagnosis, this is usually due to nutrient malabsorption due to intestinal mucosa damage. The more pronounced the damage (the longer the time before an accurate diagnosis), the greater the nutritional deficiencies.
In addition, children on a gluten-free diet may be taking in too little carbohydrate and too much saturated fat.
Researchers with the University of Milan offer the following advice for maintaining a healthy, nutritionally-balanced gluten free diet in children:
1. The first step is to get education from a qualified physician or dietitian. Yes, support groups and online forums can be helpful, but remember to get the basics from a healthcare provider with knowledge about celiac disease.
2. Ask your pediatrician for the amount of calories, protein and fat your child should be getting per day. Keep a food journal, especially at first, to track these macronutrients to ensure your child has enough for adequate growth and development.
3. Find out if your child currently has any nutritional deficiencies that need to be corrected, such as a low iron level. Also, keep a list of foods that are rich in the nutrients that are at risk of becoming deficient so that you can encourage those as well.
4. It is best to focus on naturally gluten-free foods, such as fresh fruits and vegetables, low-fat dairy, and lean protein for meals. Grains/starches that are naturally gluten-free include rice, corn and potatoes. Thankfully, though, store shelves are improving their inventory with wheat substitutes – such as gluten free flour mixes so that adults and children with celiac can enjoy some of their former favorites.
5. Remember to prevent cross-contamination. If you have both gluten free and non-gluten free people in your household, designate a safe area for the gluten free foods, such as having a separate toaster for gluten-free breads.
It is a challenge, but maintaining a nutritionally-balanced gluten free diet is essential for children with celiac disease.
Penagini F, Zuccotti GV et al. Gluten-Free Diet in Children: An Approach to a Nutritionally Adequate and Balanced Diet. Nutrients 2013, 5, 4553-4565; doi:10.3390/nu5114553
American Academy of Nutrition and Dietetics