May is Celiac Awareness Month

Maintaining a healthy diet is important for all children. For children with celiac disease, there is the added challenge of keeping their food free of gluten. Venus Kalami, a clinical pediatric dietitian with Lucile Packard Children’s Hospital and Stanford Medicine Children’s Health shares some information to help you navigate healthy eating for your child with celiac disease.

What is celiac disease?

Gluten is a protein that is found in wheat, barley, rye, and non-gluten-free oats. It is what makes bread dough stretchy. Gluten is also what gives bread a chewy texture when it is baked.

When people with celiac disease eat gluten, their body has a reaction to that, and it can make them sick. They could get a stomachache or diarrhea. Often, patients don’t have symptoms. Even if patients are symptom-free, eating gluten causes inflammation in their intestines that can lead to serious problems if not treated. There is no cure for celiac disease. However, it can be treated by eating a strict gluten-free diet.

“Gluten is spread out all throughout our food system. It’s not easy to avoid. It takes an active effort,” Kalami explained. “It is found in grains such as wheat, barley, and rye, and sometimes oats. So, anyone who has celiac disease has to make a really big dietary change when they’re diagnosed in order to control their celiac disease.”

How to have a nutritious gluten-free diet

It is possible to eat healthy and delicious meals that don’t have any gluten. Fresh fruits, vegetables, gluten-free whole grains, legumes, nuts, and meats make up the foundation of a balanced diet for many of our patients. It is key to give children lots of exposure to more nutritious foods like fruits, vegetables, healthy proteins, healthy fats, and gluten-free whole grains to make sure that your family is getting well-rounded meals.

Grocery store shelves are full of options that can make it a little easier to go gluten-free. However, Kalami recommends caution when it comes to choosing gluten-free substitutes. Many gluten-free products are made from refined starches and are not fortified with vitamins in the same way as wheat products. Plus, they often have added ingredients to improve the taste. This means they can be full of empty calories and not provide much nutrition.

“You can find whole-grain, gluten-free products that are made from quinoa, brown rice, millet—all these different kinds of very nutritious grains that have fiber and more vitamins and minerals compared to their refined counterparts. That is one way that you can be mindful about having a nutritious gluten-free diet,” Kalami advised. “Emphasize fresh fruits and vegetables at every eating opportunity if you can, especially with kids who are learning to eat and developing their tastes and their opinions about food.”

The best way to approach this is to read the nutrition labels carefully to find the best options. “It may take a little extra homework, but as long as you’re mindful and make intentional choices, you can find whole-grain gluten-free products that are nutritionally sound,” she said. “Focus on foods with a good amount of fiber that are not heavy in added fats, sugars, and salts.”

Keeping a gluten-safe kitchen

Some families choose to go completely gluten-free when a member is diagnosed with celiac disease. However, this is not always practical for everyone. It is very important to keep foods that contain gluten or kitchen items that have touched gluten away from the gluten-free foods. Here are some tips for maintaining a kitchen that is safe for children with celiac disease:

• Have separate kitchen items like a toaster and cutting board that will be used only for gluten-free foods.
  
  
• When using spreads like peanut butter, jelly, mayonnaise, or butter, never double-dip your spreader; you can also keep separate condiments that will be designated as gluten-free.
  
  
• Keep the gluten-free snacks and foods in a different area to reduce the risk of cross-contamination, or vice versa: confine gluten-containing foods to one area of the kitchen.
  
  
• Consider keeping a few pots and pans only for gluten-free foods. While stainless steel can be thoroughly cleaned between uses, cast iron and nonstick pans can hold on to gluten even after washing and transfer it to the next meal.
  

There are so many options for developing a healthy gluten-free diet. While taking on a gluten-free diet is a huge adjustment, with a bit of information, practice, and support from their celiac team, children and their families won’t feel like they are missing out. And you don’t have to do it alone. Stanford Medicine Children’s Health has a team of doctors and dietitians to support you and your family as you navigate celiac disease and the gluten-free diet.