Placing children on a gluten-free diet without consulting a physician could be damaging to their health, medical experts warn.
Gluten-free diets are critical for people living with celiac disease, an autoimmune disorder in which ingesting gluten — a protein found in wheat, barley, and rye — leads to damage in the small intestine. There is no treatment available for the disease and currently the only therapy is adhering to a gluten-free diet.
An estimated 1 percent of Americans live with celiac disease. That number has been growing in recent years — likely because of increased awareness and improved detection. However, that increase does not account for the explosive growth of the gluten-free food industry. Millions of people now shun gluten even though there’s no medical reason for them to do so.
A recent survey of more than 1,500 adults in the U.S. found that the most common motivations for going gluten-free were “no reason” and the belief that it’s somehow a “healthier option.”
Now, some health care providers raising concerns about the growing trend. A new commentary published in The Journal of Pediatrics specifically addresses the potential risk for children whose parents place them on a gluten-free diet without consulting a doctor, warning that it could do more harm than good.
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“I think there’s a side to the story of the gluten-free diet that’s not often in information that’s readily accessible to families and pediatricians,” the paper’s author, Dr. Norelle R. Reilly, a pediatric gastroenterologist at New York-Presbyterian/Columbia University Medical Center, told CBS News.
In the paper, Reilly explains that there are a number of misconceptions regarding gluten and going gluten-free. For example, many people believe that a gluten-free diet is a healthy lifestyle choice with no disadvantages. But in fact, for people who don’t have celiac disease or a gluten sensitivity or wheat allergy, there are no proven health benefits.
What’s more, without proper nutritional guidance, cutting out foods with gluten could lead to nutritional deficiencies and increase fat and calorie intake.
“Especially in a young child, when we’re looking at removing basically an entire food group from the diet, if there aren’t enough appropriate substitutions in there, we run the risk of poor growth, malnutrition and missing out on a lot of their necessary vitamins and minerals,” said Jennifer Willoughby, pediatric dietician at Cleveland Clinic Children’s. “They lose out on a lot of B vitamins, a lot of iron, and fiber if the diet is not followed in a proper way.”
This is because many of the replacement foods for gluten-free diets are not very nutritious and are less likely to be fortified with vitamins and minerals. “They tend to be very processed, higher in fat and higher in sugar, and surprisingly to a lot of people they’re actually higher in carbohydrates,” Willoughby, who was not involved in the paper, explained.
The commentary points out that studies have shown that some people become overweight or obese after starting a gluten-free diet.
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Of course, people who adhere to a gluten-free diet — either because it is medically necessary or out of preference — can do so in a healthy way, but they should always speak with their doctor first and consult with a registered dietitian to come up with a dietary plan.
Additionally, Reilly notes that since testing for celiac disease requires eating gluten, adhering to a gluten-free diet without consulting a doctor could obscure an actual medical diagnosis.
“Our detection rates for celiac disease are very low, especially in the United States, and if you have a population that’s gravitating toward an empiric implementation of a gluten-free diet you increase the likelihood of missed celiac disease,” she said.
Though this might not seem harmful, considering that the therapy prescribed would be to eliminate gluten anyway, not diagnosing the condition properly could lead to additional complications.
“An individual with celiac disease needs monitoring for a variety of autoimmune conditions and vitamin deficiencies that can go along with the disease, and there could be complications of the disease that require surveillance,” Reilly said. “So there is a difference between how we would manage somebody who’s gluten-free out of preference versus somebody who is gluten-free because they have celiac disease.”
Some people may also falsely believe that a gluten-free diet can prevent celiac disease, but Reilly points out that there is no scientific evidence to support that claim.
Ultimately, experts say they want to remind the public that while a gluten-free diet is necessary for some, it is not always the best option for others.
“Gluten-free diets are appropriate for some individuals but certainly not for all,” Reilly said. “Guidance from an experienced physician or dietitian can really go a long way to sort through the abundance of information available regarding this diet.”