Should you try it?
The diet is a big commitment. Since gluten isn't inherently unhealthy in the way that something like trans fat is, you shouldn't consider nixing it without good reason. "There's no research showing that kids who tolerate gluten just fine should cut it out," says Amy R. DeFelice, M.D., associate professor of clinical pediatrics at Columbia University Medical Center. Fortified bread and cereal are a major source of vitamins and minerals for kids, and gluten-free products aren't always enriched with these nutrients. Gluten-free processed foods also often contain extra fats and sweeteners. Even more incentive to think twice: Gluten-free products are usually more expensive than their counterparts. But if you think that gluten may be a problem for your child -- whether you suspect celiac or want to help alleviate autism or ADHD symptoms -- follow this expert advice.
Have your child tested. Ask your doctor for a referral to a pediatric gastroenterologist for a blood test and, if needed, an intestinal biopsy (it's a 20-minute procedure, but involves anesthesia). Avoid the number-one mistake: having your child try the diet before the tests, which can result in false-negative results. If the tests are positive, your child has celiac disease. But kids who have gluten sensitivity -- and possibly autism or ADHD -- may test negative but still do better without gluten.
Seek professional help. Work with an experienced practitioner, such as a registered dietitian, who can help you map out meals and snacks. Gluten is found in so many foods -- and many kids with autism are already very picky eaters -- so eliminating it can leave gaping holes in your child's diet. Find out whether he needs vitamin or mineral supplements.
Plan ahead. Expect to eat at home most of the time and to spend extra time shopping for food and organizing meals, especially when you first begin the diet. "Every Sunday afternoon we make a menu for the week," says Esther Snodgrass, of Baltimore, whose 7-year-old daughter, Laura, has celiac. "This gives me a sense of control that I felt was lost when she first got the diagnosis." If your child has celiac, you'll need to be mindful of cross-contamination with gluten, since even a few crumbs of bread can cause damage to the intestine. That means that you can't share serving spoons, cutting boards, or even toasters.
Do some detective work. If you're going gluten-free for ADHD or autism, it's helpful to pinpoint what improvements you're hoping to see. "Take a day or two to establish a baseline of your child's symptoms," says Dr. Coury. How many words is she saying? How many tantrums does she have in a week? How long can she focus on her schoolwork? Then you can reassess over the course of weeks and months on the diet. If you're not seeing any significant changes, the diet may not be worth your while.
Be patient. Children who have gluten sensitivity will feel better within a few days on a gluten-free diet, says Dr. Fasano. But with celiac, it can take at least 4 to 6 months for the intestines to heal completely. Experts say that you'd need to stick with a gluten-free diet for at least 3 to 6 months for a child with autism or ADHD to see if there will be any improvement.
Focus on quality. Though experts disagree about whether a gluten-free diet is helpful beyond celiac disease, they all believe that a healthy diet full of fresh whole foods is the best way to feed kids. That may be the key lesson from the gluten-free diet, which tends to eliminate a lot of processed foods. Says Dr. Hyman, "When children eat better, they're going to feel better."
The base of any diet -- including a gluten-free one -- should be whole foods such as produce and lean protein. But for convenience, it's nice to have a small stash of packaged goods. "Products finally taste great and are easy to find in stores or online," says Jen Cafferty, a Chicago mom who founded the Gluten & Allergy-Free Expos. We asked gluten-free families for their picks; the products below topped their list.
- Udi's Gluten Free Snickerdoodle Cookies
- Pamela's Baking & Pancake Mix
- King Arthur Flour Gluten-Free Brownie Mix
- Edward & Sons Let's Do...Gluten Free Sugar Cones
- KinniToos Sandwich Cream Cookies
- Glutino Gluten Free Pretzel Twists
- Annie's Gluten Free Creamy Deluxe Rice Pasta Dinner
Originally published in the April 2013 issue of Parents magazine.
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