wooden spoons filled with flour

Gluten-Free Eating: Food and Nutrition Tips for Your Child

Even though only one percent of the population has celiac disease, there are many people who are on a gluten free diet for other reasons. Some studies, including a 2015 survey by Consumer Reports, show that more than one-third of the U.S. population is limiting or cutting out gluten. Many of these people think eating gluten-free will help them lose weight or improve their mental or physical health. However, for people who don’t have celiac disease, non-celiac gluten sensitivity, or wheat allergy, there is no benefit to eating gluten free. In fact, gluten-free foods usually contain more fat, sugar, calories and salt than their regular, gluten-containing counterparts.

For this reason, if people are only replacing regular foods with gluten-free foods, many will actually gain weight. People who lose weight on a gluten-free diet are likely doing so by eating more fruits, vegetables and healthy whole foods instead of processed foods and baked goods. Gluten-free foods may contain less iron, B vitamins, folic acid and fiber than regular foods, so people on a gluten-free diet need to make sure they get enough nutrients. In addition, gluten-free foods usually cost up to five times more than regular versions of the same foods.

Non-Celiac Gluten Sensitivity

Up to six percent of the population has a condition called non-celiac gluten sensitivity. Sometimes this is called gluten intolerance or gluten sensitivity. These patients can have similar symptoms to patients with celiac disease when they eat gluten, but blood tests for celiac disease are negative and biopsies do not show damage in the small intestine. It is important to see a doctor and get tests to determine whether you have celiac disease or non-celiac gluten sensitivity. People with non-celiac gluten sensitivity may be able to tolerate eating small amounts of gluten or, in the future, they may be able to eat a regular diet again. However, people with celiac disease will always have to eat a very strict gluten-free diet.

Wheat Allergy

Wheat allergy is also a reason to avoid wheat, but patients may not need to avoid rye and barley. Reports on the prevalence of wheat allergy vary, but generally it is thought to be less than one percent of the population and often when kids have wheat allergy they can outgrow it as they get older. Symptoms of wheat allergy may include; hives, itching, wheezing, vomiting, shortness of breath, swelling of the tongue or anaphylaxis. Patients who have anaphylaxis to wheat need to be seen by an allergist and need to carry an epi-pen. This is different from patients with celiac disease, because celiac disease is not an allergic reaction.

Challenges with eating gluten-free

Following a gluten-free diet is challenging, especially at first. For kids, school lunches can be especially challenging. Your child’s school should know about his or her diagnosis of celiac disease so they can accommodate him or her, both in the lunchroom and also in the classroom, where kids might be exposed to gluten in arts and crafts projects or in other ways. Your doctor, dietitian and social worker can help you talk to the school about what your child needs.

Many parents of kids with celiac disease choose to pack a lunch for their child. Below are suggestions for packing a healthy, well-balanced gluten-free lunch with 1-2 items from the protein group, 1-2 items from the grain group, and at least 2 servings of fruits and vegetables. Treats like pudding, gelatin, homemade trail mix, potato chips, corn chips, gluten-free cookies, marshmallows or a small piece of gluten-free candy should be limited to 1-2 times per week.

Protein Group (pick 1-2)
String cheese
Lunchmeat
Cheese slices
Yogurt cup
Yogurt stick
Boiled egg
Tuna
Peanut butter or other nut butter
Plain peanuts or other nuts
Milk
Pepperoni
Hummus
Homemade chicken, egg or ham salad
Baked beans
Grain Group (pick 1-2)
Rice cake
Soft corn tortilla or gluten free flour wrap
Taco shells
Tostada shell
Popcorn
Small bag of gluten-free cereal
Pumpkin seeds
Bakes corn tortilla chips
Homemade gluten-free cereal snack mix
Gluten-free cereal bars
Gluten-free crackers
Gluten-free pretzels
Gluten-free waffle (toasted)
Gluten-free pancakes
Gluten-free pizza crust
Gluten-free bread
Gluten-free animal crackers
Homemade corn muffins or other gluten-free muffins
Fruit & Vegetables (at least 2)
1 piece fresh fruit
Apple slices
Fruit cups
Cut up fresh vegetables
Tossed salad
Fired fruit
Small container of frozen fruit
Tomato sauce
Sliced avocado
Extras (limit to 1-2 tbsp per meal)
Jelly Cream cheese
Salad dressing
Ketchup
Mustard
Salsa
Yogurt fruit dip
Vegetable dip
Maynnaise
Guacamole dip

Sometimes there can be small amounts of gluten found in medications that can trigger intestinal damage in patients with celiac disease, so it is important that everything you eat (from food to medicine) is gluten free.

Starting a gluten-free diet for your child with celiac disease, a non-celiac gluten sensitivity, or a wheat-free diet for your child with wheat allergy can be a daunting and difficult task at first, but it will get easier! It is essential that children strictly follow their diet to allow them to be healthy and grow and develop typically. Be sure to get help from your dietitian, doctor and other people you meet online or at in support groups. Local and national resources are available to offer information on living gluten-free successfully including; Gluten Free Gang, Gluten.org, Celiac.org and GIKids.org.

At Nationwide Children’s Hospital, our annual Celiac Conference helps to educate kids of all ages, their parents and adults about celiac disease and a gluten-free diet. This year, our 30th annual Celiac Conference will be on Saturday, October 14, 2017 with programs for school-aged kids, teenagers, and adults. Attendees of all ages will learn a lot, have a great time and eat delicious gluten-free food! Register online here or through the Celiac Disease Center website.

Mary Kay Sharrett
Mary Kay Sharrett has been a registered dietitian at Nationwide Children’s Hospital for more than 30 years. She is the founder and dietitian advisor to the Gluten Free Gang, a support group for adults and children and their families with Celiac Disease or gluten sensitivity. Mary Kay lives in Columbus with her husband and two little white dogs. You will often find her cheering on the Ohio State Buckeyes and the Columbus Crew.

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