Samara, now 12, is shunning gluten because it keeps her disease in check. Consultations with a registered dietitian and classes at Children's Hospital Colorado have helped the family learn how to steer clear of problematic ingredients while still planning varied meals. There are separate toasters for Samara and her parents, and when the family eats out, they ask that gluten-free pasta be cooked in fresh water. But about 2.7 million Americans without celiac choose to follow a gluten-free diet, too, according to an analysis published last year. Market research firm NPD Group finds that 28 percent of adults are eliminating the protein or cutting back. And more than a few of them, it seems, are doing the same for the whole family. While there are no hard statistics on how many kids are eating gluten-free for reasons other than celiac disease, pediatricians say they've noticed an uptick in parents putting their kids on the diet.
Most "have heard bad things about gluten and think that going gluten-free is simply healthier," says Dr. Claire McCarthy, a pediatrician at Boston Children's Hospital. Some are responding to symptoms like constipation or stomachaches, or have heard it might help their child with autism, she says. Dr. Edwin Liu, director of the Colorado Center for Celiac Disease Children's Hospital Colorado, says he sees parents turn to a gluten-free diet for a wide range of symptoms, including belly pain, fatigue and behavioral issues.
But both point out that a gluten-free diet for children isn't a move to be made lightly, before consulting a health-care provider. Importantly, a child who has symptoms that might indicate celiac disease, such as failure to gain weight, GI upset or chronic diarrhea, can have difficulty being properly diagnosed once gluten has been eliminated. Current methods of testing – blood work and an intestinal biopsy – will produce normal readings if gluten hasn't been eaten in a while. That can lead to medical limbo, says Dr. Norelle Reilly, a pediatric gastroenterologist in the department of pediatrics and the Celiac Disease Center at Columbia University Medical Center. To get a diagnosis, the child might have to go back to eating gluten for a few months – a so-called "gluten challenge."
If your child doesn't have celiac disease or an allergy to wheat, or a different condition known as non-celiac gluten sensitivity that causes discomfort when gluten is eaten, there are no data to support any health benefits of a gluten-free diet, wrote Reilly in a commentary published last year in the Journal of Pediatrics. The U.S. Preventive Services Task Force earlier this year said there's not enough evidence to recommend for or against screening people who don't have symptoms.
"People think a gluten-free diet is inherently healthy. But it's only healthy if you make it healthy," Liu says. All depends on what's replacing those gluten-containing foods. A Canadian study published in 2014 found that many gluten-free packaged foods were similar in calorie count to regular foods but higher in fat and carbohydrates, lower in protein and lower in some nutrients.
And gluten-free diets can be low in important nutrients, notably most of the B vitamins, vitamin D, iron, zinc and calcium. "Whole wheat has a really nice profile of nutrients," says Melinda Dennis, a registered dietitian and nutrition coordinator at the Celiac Center at Beth Israel Deaconess Medical Center in Boston. And the replacements for wheat, which are often more refined starches from rice, corn and potato, aren't as naturally nutritious, nor are they often enriched and fortified. Much better substitutes are a variety of whole pseudo-grains like quinoa, millet and amaranth, she says.
There is particular concern about rice, which can contain naturally occurring inorganic arsenic. Exposure in utero or in early life can raise the risk of cancer and affect neurological development, among other negative effects. The Food and Drug Administration last year proposed limiting the amount of inorganic arsenic in infant rice cereal.
A study published in February found that Americans on gluten-free diets had higher concentrations of arsenic and mercury in their urine and blood than people on a regular diet, perhaps from rice consumption. It's unclear whether that is translating to health problems for adults or for children, who are more vulnerable to contaminants because of their developing brains, says Tracy Punshon, a research assistant professor in the department of biological sciences at Dartmouth College. She and her colleagues are trying to find funding to study arsenic exposure in people with celiac disease who are on a gluten-free diet.
If your main goal is to get your kids to eat more healthfully, that can be accomplished (and more easily) without going gluten-free. More cheaply, too: "One grocery bag of gluten-free products costs $80 to $100," says Lana Schoch. The best diet is one that avoids refined carbs, is low in added sugar and is full of fruits, vegetables, a variety of whole grains, nuts, fish and other lean protein, McCarthy says. And yes, that diet would probably be a bit lower in gluten. But that's not what would make it more healthful, she says.
In restaurants, servers often ask Lana if her daughter is gluten-free by choice or because she's ill. She can't quite believe the question. "What kid," she wonders, "would choose to go gluten-free?"
source - http://health.usnews.com/wellness/food/articles/2017-08-14/going-gluten-free-a-few-caveats-for-kids
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