For kids with celiac disease, eating gluten-free isn't a trendy diet—it's absolutely necessary for health. Celiac disease is an autoimmune disorder in which people aren't able to digest gluten, a protein found in wheat, barley, and rye. For those with celiac, eating gluten damages the walls of the small intestines. Left untreated, it can lead to other autoimmune disorders, plus conditions like anemia and infertility.
But there's no denying that many people go gluten-free without a medical diagnosis. The gluten-free food market is a billion-dollar industry, but most of the people who purchase those foods actually don't have celiac. In a survey of adults done by the Hartman Group, those who buy gluten-free foods cite "no reason" or "healthier option" as their top two motivations. So what does this mean for kids?
In a commentary published in the Journal of Pediatrics, author Norelle Reilly, MD, an assistant professor of pediatrics and director of pediatric celiac disease at Columbia University, warns that without a medical diagnosis, there's no evidence to support a gluten free diet for children. Here are some of her reasons:
A gluten-free diet isn't necessarily healthier. Because grains are typically fortified, avoiding them means your child may not be getting enough B vitamins, folate, and iron. Fiber may be an issue too. Gluten-free packaged foods aren't necessarily healthier either, since they tend to have more fat and sugar than gluten-containing ones. They're usually more expensive too. (And no, despite what you may have heard, gluten is not "toxic"!)
A gluten-free diet can interfere with proper diagnosis. Some people make the mistake of going gluten-free before being tested for celiac disease. But if you've already cut out gluten, the test won't be accurate.
A gluten-free diet can be hard. There's evidence that quality of life suffers for children who follow a gluten-free diet. For instance, when kids can't partake in food at social gatherings or at school, it can lead to feelings of social isolation.
A gluten-free diet doesn't protect babies from celiac. Even if a child has a family history of celiac disease, there's no evidence that delaying introduction of gluten helps prevent it.
If you think gluten may be a problem for your child, talk to your pediatrician who can refer you to a specialist. Beyond celiac disease, some people also have what's called nonceliac gluten sensitivity, which means they don't have celiac but have symptoms related to eating gluten (though there's not much research on how common that is among children). If you do decide to go gluten-free, work with a registered dietitian to help you plan your family's diet to make sure your kids are getting the nutrients they need.
Sally Kuzemchak, MS, RD, is a registered dietitian, educator, and mom of two who blogs at Real Mom Nutrition. She is the author of The Snacktivist's Handbook: How to Change the Junk Food Snack Culture at School, in Sports, and at Camp—and Raise Healthier Snackers at Home. She also collaborated with Cooking Light on Dinnertime Survival Guide, a cookbook for busy families. You can follow her on Facebook, Twitter, Pinterest, and Instagram. In her spare time, she loads and unloads the dishwasher. Then loads it again.