by When Lisa Rigney’s daughter was diagnosed with celiac disease six years ago, one word came to mind.
“Rigney was under siege,” Rigney recalls. “It was a really great experience.”
A disorder that causes the body to overreact to gluten in foods such as barley, rye and wheat, celiac disease damages the lining of the intestines, preventing proper absorption of nutrients vital to good health.
With no family history before the disease, Rigney knew almost nothing about it, but he had to immediately make fundamental changes to his child’s diet.
“I knew that being gluten-free was associated with celiac disease, but that was the extent of my knowledge.”
Trips to the grocery store, a job she always did “with my eyes closed,” were now a careful exercise in reading package labels.
And even after switching her daughter to gluten-free foods, Rigney still had nagging questions about whether the meals had enough fiber and essential nutrients.
“In the early days of the diet, she was lethargic, so it was a case of, is she getting what she needs?”
With so many details to learn about, the whole experience was “a steep learning curve,” Rigney recalls.
That journey is about to get a little easier for families like the Rigneys, thanks to a new gluten-free food guide created specifically for children and young adults by University of Alberta nutrition researcher Diana Mager, pediatrics professor Justine Turner and their colleagues .
The guidance generally addresses the nutritional needs of children with celiac disease, including limitations in the gluten-free diet that may affect those needs, says Mager, a registered dietitian and professor in the Faculty of Sciences. Agriculture, Life & Environment and Faculty of Medicine. & Dentistry.
“We wanted to develop a comprehensive resource for families on how to start a gluten-free diet, to take some of the burden off of worrying about whether their child is eating healthy.”
The 40-page document, which is available for free online, helps answer some of the many questions families have when a child is diagnosed with celiac disease.
“There are so many changes to make, with cooking, recipes, food shopping and questions about ongoing development and growth of children, so we wanted to provide a nutrition-based tool that provides ongoing resources in conjunction with dietetic support,” says Mager. .
Meeting the nutritional needs of children with celiac disease is especially important, she notes.
“It is a critical period of growth and development. In particular, undiagnosed children often have poor bone health as adults, putting them at long-term risk of bone fractures.”
And while a gluten-free diet is the cornerstone of treating celiac disease, it also has some nutritional limitations, including high fat or sugar content in processed gluten-free foods, and low levels of folate, a vitamin important for healthy cell growth and function. .
The guide is based on research conducted by Mager and her colleagues, and is a science-based resource for families, who often resort to online searches for nutrition information, she notes.
“There are a lot of nutrition myths about the gluten-free diet on the internet. If, for example, the advice is to eliminate wheat from the child’s diet, that does not address the problem, because there are other grains with gluten.
“It was important for us to develop a tool that could provide consumers with evidence-based guidelines.”
The guide would have made a “huge difference” in learning how to plan a healthy diet for her daughter years ago, says Rigney, program coordinator for the Edmonton chapter of Celiac Canada, who helped develop the guide.
“It includes small things like combining foods to improve nutrient absorption. That’s something healthcare professionals would know about, but not necessarily the general public.”
Taking a multifaceted approach over the past five years, the research team surveyed parents of children with celiac disease, along with doctors, nurses and dietitians across Canada, on what they wanted to see in a food guide for people young
The researchers also studied the dietary patterns of Canadian children and adolescents with celiac disease and reviewed similar data from other countries. They then developed more than 1,000 fully nutritious gluten-free simulated menus for young people aged four to 18.
“From there, we developed a plate model of many food options for what children and young people would eat in a day to promote healthy eating.”
Their recommendation is to fill just over half the plate with fruit and vegetables, and to eat gluten-free grains such as pasta or rice, along with proteins such as seeds, nuts, fish, eggs and other animal proteins. The serving plan also includes a serving of unsweetened milk or a fortified plant-based drink.
Focus groups of children, their families and health care professionals also evaluated the guide’s content and layout to ensure it was simple to read, especially for young people, Mager notes.
At a glance, colorful photos show the many healthy gluten-free food options available.
“We wanted it to be user-friendly so that a six-year-old could identify different foods. There are many challenges, such as social events, in a child’s life because he does not adhere to a gluten-free diet. Kids want to fit in with their peers, so they want to know what they can eat, not what they can’t have.”
Among the topics covered in the guide is a comprehensive description of the essentials of a gluten-free diet such as iron, fiber, pulses, healthy fats and natural sugars, which was important for teenagers involved in sports.
“They wanted to know what the best food choices are for dealing with issues like bone health.”
There is also a list of what grains are and are not gluten-free, and how to cook and store gluten-free foods. Includes recipes, as well as vegetarian, vegan and lactose-intolerant diets.
Along with that information, the guide shows how to read nutrition labels and ingredient lists on gluten-free processed foods. It also offers tips on grocery shopping, eating on a budget, eating out and preparing healthy school lunches and snacks.
“People wanted content that their kids could relate to, so if teenagers were buying their own food, they would know how to stick to a gluten-free diet.
“It also helps parents come up with new ideas to make gluten-free meals tasty, fun, and not the same thing over and over again.”
The guidebook, which Rigney keeps in her kitchen, she says, is an “invaluable” resource.
“Because all the information is in one place, you can refer to it and educate yourself over and over again.”
And because of its easy-to-digest format, the guide is a good patient handout for registered dietitians in general practice, who may not have specialized expertise in gluten-free diets, Mager says.
The guidance is now being shared with children and their families taking part in ongoing clinical research, and early results show an encouraging improvement in the diet of newly diagnosed children over six months, including eating more fruit and vegetables, which she says.
The researchers will continue to measure the health impact of the guide as well as other lifestyle factors, such as whether it helps families shop more wisely to address high food costs.
In the meantime, the guide provides parents like her with “peace of mind” and a sense of confidence for their children to eat a healthy gluten-free diet, Rigney says.
“It’s definitely empowering for kids to understand their diet and how it affects their overall health.”
Research and development of the food guide was supported by the Stollery Children’s Hospital Foundation through the Women’s and Children’s Health Research Institute, which provided postgraduate or summer scholarships to Amanda Liu, Samantha Cyrkot and Rita Jiang. Funding was also provided by the Alberta Maternal and Child and Adolescent Strategic Clinical Network and Diabetes, Obesity & Nutrition Strategic Clinical Network, as well as a Dr. JA Campbell Research Award from Celiac Canada and the Edmonton and Calgary chapters. Diana Mager and Justine Turner are members of the Women’s and Children’s Health Research Institute.
More information about the new guidance
Listen to Diana Mager podcast about how parents can use the food guide and related resources. She is also hosting a free webinar on Thursday, January 25, at 5 pm to talk about why she created the gluten-free guide for kids and how it can help families enjoy gluten-free meals, and to answer questions about gluten-free living.
