Does My Child Need a Gluten Free Diet?

By Karen Ansel, MS, RDN, CDN
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Lately, gluten free diets are getting a lot of attention. Going gluten free has been rumored to increase energy and concentration, cure digestive ills, and even improve symptoms of autism and ADHD in children. With so much hype it’s hard not to wonder if your child might not benefit from a g-free diet.

Gluten is a protein found in certain grains like wheat, barley and rye. Because gluten helps make foods taste better and improves their texture, it's also added to everything from deli meats to French fries. For most children gluten is completely harmless, with two exceptions. "Children should be following a gluten-free diet if they've been diagnosed with celiac disease or with non-celiac gluten sensitivity," says Tricia Thompson, MS, RD, co-author of Easy Gluten Free: Expert Nutrition Advice with More than 100 Recipes.

What exactly are celiac disease and non-celiac gluten sensitivity? Celiac disease, also known as celiac sprue, is an autoimmune condition that affects one in 133 people. For children with celiac, even the slightest morsel of gluten can spell trouble, triggering the release of antibodies which mount an assault on the intestines. These attacks damage the intestine, making it difficult to absorb many of the nutrients children need to grow and thrive. They also cause many unpleasant symptoms such as gas, bloating, diarrhea and weight loss or weight gain. Untreated, celiac can also lead to complications such as anemia, neurological disorders and osteoporosis. Non-celiac gluten sensitivity (or NCGS) is believed to be more widespread that celiac, affecting an estimated 18 million Americans. It's similar to celiac in that it also involves an immune reaction to gluten. But unlike celiac disease, that reaction doesn’t cause the body to produce damaging antibodies. So while a child with NCGS may have many celiac-like symptoms, he or she won’t experience the same intestinal damage, nutrient deficiencies or long term complications.

Currently, the only treatment for celiac disease or NCGS is a gluten free diet. "A gluten free diet is extremely restrictive so it can be difficult for a child to follow," says Dee Sandquist, MS, RD, a spokesperson for the Academy of Nutrition and Dietetics. "It can also be psychologically and socially challenging." Birthday parties, sleepovers, eating out and even snack time at school can be difficult to navigate. But the good news is that when children with celiac disease do give up gluten their growth returns to normal and their symptoms quickly improve according to a 2008 Journal of the American Dietetic Association (now Journal of the Academy of Nutrition and Dietetics) review article.

If you suspect your child has celiac or NCGS, experts recommend having your child screened by your health-care provider before going gluten free. In fact, testing for these conditions only works if your child is eating a gluten containing diet. Because gluten is found in so many foods, unnecessarily restricting it can actually cause your child to miss out on important nutrients like iron and B vitamins children normally get from enriched and fortified foods like cereals, bread and pasta. If, after testing, you do find that your child needs to go gluten free, working with a registered dietitian nutritionist can help develop a plan that ensures he or she gets all the nutrients needed for optimal health.

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