Providing a healthy nutritious diet for kids can be challenging at the best of times. The challenge rises exponentially for parents of children with coeilac disease. Children with coeliac disease are intolerant to gluten and therefore need to consume foods free of gluten. Gluten is in so much of our regular foods and everyday presents a significant dietary planning challenge. I take my hat off to these parents and hope that the information below provides some assistance in your journey.

The problem

Coeliac disease is an autoimmune disease of the small bowel that can show up as early as infancy. Those affected are effectively allergic to gluten because when gluten enters the small bowel, inflammatory reactions occur and symptoms such as diarrhoea, pain, and fatigue result. A person with celiac disease including kids need to follow a strict long term gluten free diet, needing to take special care to avoid nutrient deficiency in calcium, iron, folate, B group vitamins and fibre.

Gluten is a protein found in wheat, rye, barley and triticale (The cross between wheat and rye). Therefore the basic household food items commonly cooked or purchased from the supermarket, such as bread, cereals, cakes, pastry, biscuits, pizza and pasta all need to be avoided. To make things worse, many processed foods like sausages, hot dogs, spring rolls, stuffed roast chicken, sauces, and gravies also contain wheat or gluten. Thanks to food labelling, finding gluten free food is becoming a lot easier.

Where can I find gluten free food?

Naturally gluten free food

There is a great range of naturally gluten free food, such as:

*Fresh fruits and vegetables

*Fresh meat, fish, seafood, eggs, nuts, seeds and legumes

*Milk, cheese and yoghurt

*Fats and oils

*Grains like rice, buckwheat, corn, soy, sago, quinoa, arrowroot and millet

“Gluten free” labelled food products

According to the Australian Food Standard, the “food labelled gluten free” must contain “no detectable gluten” in order to be safe to consume.

Food to check and avoid

Please pay special attention to the following food groups, which need to be checked and avoided.

Fruits and vegetables

*Canned or frozen vegetables with gluten containing sauce

*Commercially thickened fruit pie fillings

*Vegetarian products such as textured vegetable protein (TVP)

Meat, fish, poultry and seafood

*Crumbed, battered or coated meat and fish.

*Pre seasoned or marinated meat or fish.

*Sausages, devon, processed ham or meat of any kind (Please check ingredients)

*Sausage rolls and meat pie made with gluten

*Flavoured tuna (Please check ingredient)

*Commercial vegetarian products using hydrolysed vegetable protein

*Sauces, thickeners, and stocks used to prepare meals.

Dairy products

*Malted milk (e.g. Horlicks, is a powdered food product made with malted barley, wheat flower and whole milk), milk flavourings (e.g. Milo)

*Ice cream thickeners, flavourings, cones and waffles

*Commercial cheese spread and powder.

Bread, cereals and grains

*All bread, cereals, biscuits, cake, pastries, chrispbread, muffins and tortillas using gluten- containing flour.

*Commercial yeast mixture

What key nutrients can be missed in a Gluten free diet?

These nutrients can be missed by following a gluten free diet: B group vitamins, fibre and folate, however they can all be easily obtained through an extra serve of vegetables. legumes, fruit and alternative grains such as rice, potato and soy.

Other nutrients such as calcium and iron are likely to be deficient due to poor absorption, due to the damaged intestinal lining in a coeliac patient. Ensure a recommended serve of calcium rich food, such as dairy products or fish-with edible bone- (e.g. sardines) are met. Iron rich food such as red meat and dark green leafy vegetables, accompanied by vitamin C rich food can help increase the intake of iron in the body.

Food sources for B group vitamins, folate, fibre, calcium and iron

For a more comprehensive list please see articles in - Vitamins and Minerals – What They Do and Where to Get Them

Take home messages

*Check food label before consuming any unsure food items.

*If you are dining out, ring the restaurant first to advise staff that a gluten free meal is required.

*Avoid contamination by cleaning all cooking utensils well.

*Cook for 2 or 3 meals at one time, not only will it save you time but will also avoid chances of contamination.

*Store gluten free products in clearly marked containers and separate storage areas to avoid mix-ups.

*Keep a weekly food diary once a month to ensure the recommended serves of the five food groups are met. (See healthy eating habits article for more information on five food groups)

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