March is National Nutrition Month and to spread awareness about the importance of eating right, iTriage is hosting a series of guest blogs throughout the month. Today we hear from Mary Sharrett, a clinical dietician in Nutritional Support Services at Nationwide Children’s Hospital in Columbus, Ohio, who talks about whether or not gluten-free diets are healthy for children.
Gluten-free is the new vegetarianism. As more and more people are diagnosed with celiac disease, gluten-free products ranging from bread to beer, have appeared in increasing numbers on most grocery store shelves. Even some people who do not have celiac disease are opting for a gluten-free diet, converting their spouses and children. But is a gluten-free diet healthy for children?
The gluten-free diet can be healthy because it includes fresh fruits and vegetables, beans, lean meats, and milk products. If you substitute some of the processed foods with fresh fruits and vegetables, it is much healthier. Gluten-free is a diet where the individual does not consume wheat, rye, barley or anything made with these grains. There are several gluten-free grains and starches that can be milled into flour and used to make gluten-free bread products. However, switching gluten-free products for wheat based products may not be healthier.
Gluten-free grain products usually have higher carbohydrate and fat content. For example, some gluten-free pretzels have up to 6 grams of fat per serving compared to 0.5 to 1 gram for wheat-based pretzels. On the other hand, a gluten-free bagel may have twice as much fat and more carbohydrate which results in about 100 more calories than a wheat-based bagel and the gluten-free bagel is smaller. Another issue is that most gluten-free flours are not fortified and enriched like wheat flour. Therefore, some gluten-free cereals are not good sources of B-vitamins and iron.
Gluten-free grain-based products are usually 2-3 times more expensive than wheat based products.
There really is no evidence that a gluten-free diet has any advantages over a wheat-based diet, unless you have been diagnosed with celiac disease or gluten-sensitivity. If you think your child is not tolerating gluten, it is very important that you get screened for celiac disease before you start the gluten-free diet. To learn more about celiac disease and how it is diagnosed, visit www.nationwidechildrens.org/celiac-disease . When gluten is removed from the diet, the damage heals and celiac disease may not be diagnosed. The gluten-free diet will eliminate the damage that gluten can do to the body and of celiac disease will not be diagnosed. Without a diagnosis, your child will not be monitored for signs that gluten is getting in the diet.
If your child is following a gluten-free diet, here are some tips to make the diet healthier.
- Choose whole grain gluten-free products such as brown rice or products using nutrient-rich grains like quinoa, amaranth and teff.
- Choose fortified or enriched gluten-free cereal, pasta and bread whenever possible.
- Read the nutrition facts label and try to choose gluten-free grain products with 1 gram of fat per serving or less.
- Be sure to look at the serving size on the nutrition facts label. Gluten- free foods often have a smaller serving size.
- Encourage your child to fill half their plate with fruits and vegetables. Also, offer fruits and vegetables as snacks.
- Ask your dietitian or doctor about using a gluten-free multivitamin.
Mary Sharrett, clinical dietician in Nutritional Support Services at Nationwide Children’s Hospital in Columbus, Ohio, is a member of the expert workgroup for the Academy of Nutrition and Dietetics’ Evidence-Based Analysis Library on celiac disease. She is the founder and dietician advisor to the Gluten-Free Gang, a celiac support group for parents, children, family and friends of people with celiac disease in central Ohio. She has authored multiple articles/book chapters on celiac disease and the gluten-free diet. She is a frequent speaker at local and national celiac group meetings and professional education seminars. Mary is also a conference planner and host for 24 celiac disease conferences at Nationwide Children’s. She is currently the chair of the Academy and Nutrition and Dietetics’ Medical Nutrition Practice Group which includes a sub-unit for dieticians who work with gluten intolerance disease.