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 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
- Cheese slices
- Yogurt cup
- Yogurt stick
- Boiled egg
- Peanut butter or other nut butter
- Plain peanuts or other nuts
- 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
- 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)
- Cream cheese
- Salad dressing
- Yogurt fruit dip
- Vegetable dip
- 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.