With the current banting, paleo and gluten free diets being high on the health radar, I can imagine it is easy to assume that any of these are just part of another weight-loss fad. I agree that in some cases it could be. It is probably even more justifiable to argue that children should definitely not be on any of these strict eating plans, but rather have a balanced and healthy diet. There are, however, instances where it is medically necessary to follow a very specific eating plan. I have seen, with my own daughter, what the amazing impact of such a diet could be, once it is validated as necessary.
A year ago I began to pick up that our eldest daughter, Kayla (nearly 13) was mostly tired, very irritable, frustrated and almost always recovering from a cold. I tried additional supplements, forced her to sleep more (although our girls clock approximately 10 hours of sleep on a school night) and had many heart-to-heart discussions in a quest to find out what was “triggering” her irritability. Nothing seemed to work. I started doing some research and realised that she was gluten intolerant (GI). In this article I hope to shed some light on what gluten intolerance means, how to recognise it in your children and how to easily address it through introducing a gluten-free eating plan.
What is Gluten?
In order to grasp the term gluten intolerance, it is first necessary to understand what gluten is. Gluten is a two-part protein found in grains like wheat, rye, barley and spelt. These proteins are called glutenin and gliadin. The word ‘gluten’ is derived from the Latin word glue. Gluten is therefore the ingredient in grains, which gives food its elasticity and helps it keep its shape, for instance dough. Gluten is also found as a stabilising agent in processed foods and many other products such as sauces and even in some drinks.
What is gluten intolerance?
Gluten intolerance is the body’s abnormal innate immune response toward the intake of gluten, whereby inflammation is caused. This in turn damages the tissue that lines the small intestines. Normally, digested food enters into the bloodstream where nutrients are distributed throughout the body. In this case, because of the damaged tissue (lining), the undigested gluten is able to cross into the blood stream. The body attacks the gluten protein as it is seen as a foreign invader. It therefore minimises the body’s ability to absorb vital nutrients. Gluten intolerance can range from Non-Celiac Gluten Sensitivity to Celiac Disease. While gluten intolerance is an immune response to gluten, celiac disease is an auto-immune condition. Due to the fact that Celiac disease is a much more complex intolerance, I will review it in more detail in a follow up article. Research conducted in the US shows that between 5% to 10% of people suffer from some form of gluten intolerance.
Recognising gluten intolerance in your child
There are a few signs which should spark concern if you are wondering if your child could be GI:
- Skin rash, eczema and other skin problems: Skin rash could be an indicator of your child reacting abnormally to gluten intake. Especially if this occurs within a short time frame from digesting food containing gluten. As mentioned, it could also break out in the form of eczema.
- Dysfunctional digestion including gas, bloating, constipation, diarrhoea and abdominal pain: These are some of the more common signs of your child being GI. Any of these above mentioned symptoms could be an indication that his/her body is struggling to break down the protein in gluten.
- Fatigue and brain fog: If your child is feeling tired and has no energy, especially after eating a meal containing gluten, it can be seen as a warning sign and has to be looked into. Your child’s body is fighting gluten as it would any other virus, which diminishes his/her normal energy. In some instances, you would pick up that they find it difficult to concentrate and have short term memory lapses. In the case of insufficient digestion of gluten, it could also form a compound called gluteomorphines. This could act like morphine on the body, hence the lack of concentration and memory lapses.
- Dark circles under eyes: Dark circles are caused when the body is not in a healthy condition due to constantly fighting food it cannot digest, malabsorption of nutrients and constant inflammation.
- Low immunity: Fighting undigested gluten in the small intestines leads to a low immune system, which in turns trigger frequent colds and flu.
- Runny nose: In many cases your child may have recovered from flu or a cold but her/his runny nose doesn’t clear up. This could be a sign of mucus build up due to undigested gluten.
- Dizziness and loss of balance: If your child is gluten sensitive it could cause inflammation in the nervous system. This in turn causes dizziness or loss of balance.
- Headaches: There is a high correlation between being GI and experiencing constant headaches. These headaches are caused by inflammation, due to the food intolerance. Research has shown that up to 56% of people with gluten sensitivity suffer from chronic headaches.
- Joint pain: As mentioned, inflammation due to gluten can occur outside of the gut. Research conducted by The Arthritis Foundation indicate that there is a link between gluten intolerance and joint pain. It even plays a role in some arthritis cases.
- Mood issues and behaviour, including anxiety, irritability, depression: Children who are GI could experience any of these symptoms. Eliminating the intake of gluten from some children’s diet has been shown to reduce ADHD behaviour. Research has also shown that in some cases where there is a high gluten intake (regardless if the child is GI or not) these mood issues could still occur. There are studies that even show that undetected gluten intolerance could play a role in epilepsy.
- Keratosis Pilaris (also more commonly known as ‘chicken skin’): KP is a skin condition, most likely to occur on the back of your child’s arms. This is due to a deficiency in vitamin A and fatty acids as a result of the body not being able to absorb the fat and nutrients efficiently.
If your child exhibits one or more of the above signs, it is worth looking into it a bit deeper.
How can you confirm gluten intolerance?
If your child shows one or more of the above symptoms it could be that he/she is GI. Where to now?It is always a good idea to be in contact with a medical practitioner as a starting point. There are at least two ways to go about it. This entails either a process of formal medical testing or home testing.
- Blood tests (medical test): There are extensive blood tests that could be done to determine whether your child is gluten sensitive. This option is not always reliable and could reflect false results. These tests are usually costly. If you are determined to do a blood test, these are some of the tests you could ask for according to Dr. Amy Myers:
*IgA anti-gliadin antibodies (these are found in about 80% of people with Celiac disease),
*IgG anti-gliadin antibodies,
*IgA anti-endomysial antibodies,
*Tissue Transglutaminase antibodies,
*Total IgA antibodies,
*Genetic testing (HLA DQ2 and HLA DQ8), and
*Intestinal biopsy (for celiacs).
Another option under formal medical treatment is to visit a functional medical practitioner. These practitioners treat the body as a whole in attempting to address the underlying causes of a disease as opposed to focusing solely on treating symptoms.
- Home test: The home test is a sufficient method to establish whether your child has a gluten sensitivity. A good start is to eliminate gluten from his/her diet for at least two weeks. For best results it is recommended to do this for approximately 30 days as it takes a while for gluten to completely work itself out of his/her system. You will most probably see an immediate change. In my daughter’s case, her runny nose and cold cleared up in a week. Her irritability (mood swings) subsided within days. She experienced a marked increase in energy. My suggestion is to eliminate gluten foods and asses the results. It is best to reintroduce it after this trial period, which will indicate if these symptoms reoccur. The good news is that it is possible to outgrow an intolerance in some cases. However, if you think your child suffers from celiac disease, I would recommend that you rather see a medical practitioner for advice and testing as it could be a life threatening disease if it is not addressed as soon as possible.
Lunchboxes and meals…eeeek!
I have to admit that to change a child’s eating plan to a non-gluten diet is quite something to get your head around. On a good day, healthy lunchboxes could be a challenge. To eliminate gluten, takes this challenge to a whole other level. But once you see what the impact is on your child, it is totally worth it. As a family we have all adjusted our eating to make it easier for Kayla. We have a lot of fun being creative and packing lunchboxes together (although we do have stories where my creativity in the lunchboxes did not go down as well as I thought it would). I found it helpful to include the kids in packing their lunchboxes as it gives me a chance to guide them through healthy, non-gluten choices. There are many wonderful non-gluten recipe books around, which opens up a world of discovery of new ideas.
As an easy start, cut out food containing grains like wheat, rye, barley, wheat flour, spelt and triticale (cross between wheat and rye). Although oats could be gluten free, it is often contaminated during processing. You do get specified non-gluten oats. Read the packaging of food carefully as many processed food, sweets, condiments, sauces and drinks contain gluten. Wheat free food can also contain gluten. Rice, corn, maize and food made from tapioca could be introduced as a substitute. Some alternatives include buckwheat, millet, legumes (beans, soybeans and peas), quinoa, seeds, nuts, eggs, fresh meat, fish, poultry, fresh fruit, fresh vegetables. Most dairy products could also form part of your new healthy non-gluten diet.
It is important to note that the idea is not to just eliminate food, but also introduce food that could repair the damage the gluten caused in your child’s gut. You will find amazing repair food such as plain yoghurt, kefir (a fermented milk drink that could be home made or bought) and probiotics. These are a few examples of beneficial food for good digestion and prolonged gut health.
To summarise, although a gluten intolerance in your child could have a major impact on your family, it is absolutely worth seeing your child healthy and happy. If you see this as a family adventure, rather than an impossible challenge, it is easy to adapt to the new-found gluten-free lifestyle. Enjoy discovering new creative family meals.