Going gluten-free? A paediatric nutritionist on what you need to know.

With gluten sensitivities, intolerances, coeliac disease and being coeliac (or celiac as it is spelled in the US) becoming more and more commonplace, gluten-free products are being marketed to consumers as the ‘healthier choice’. But before you overhaul your family’s diet, it’s important to know that many of these products are not as healthy as they seem – and going gluten-free might not be for everyone.

Most supermarket gluten-free snacks and bread products are high in refined carbohydrate, fat and salt with their main ingredients including maize, potato starch and cornstarch as well as added sugars and preservatives. For the biggest nutritional punch, swapping from refined grains to gluten-free whole grains will give you a more noticeable boost than cutting out gluten and replacing with refined gluten-free products.

Even if you are not coeliac and there is no real reason to cut out gluten, it is best to understand that our diets have become so overloaded with food containing wheat and gluten that increasing variety to include gluten-free whole grains such as amaranth, quinoa, buckwheat, teff, millet and brown rice is the best strategy to ensure you and your family getting the full spectrum of nutrients available.

I would always suggest seeking expert advice from a dietician or nutritionist before making any drastic changes to your diet but if you are thinking about going G-free, my book is packed with simple and delicious gluten-free recipes for kids and below are some ideas to help make the transition as stress- and gluten-free as possible.

What is gluten?

Gluten is a sticky protein found in wheat, barley and rye. It’s the ingredient that gives bread its elasticity and is commonly used as a stabiliser to prolong food’s shelf life.

Due to the abundance of wheat and wheat products in our diet – especially processed and refined varieties – there has been a rise in the number of people suffering from coeliac disease, gluten intolerance or an allergy to gluten.

Not only are we eating it in foods such as bread, muffins, cupcakes and cakes, gluten is also added as a filler and binding agent in many processed foods such as soy sauce, processed meats like sausages or cold cuts, anything crumbed, sugar that is not labelled 'pure cane sugar', flavoured milk, store-bought stews and soups, mustard, gravies, sauces, salad dressings, pastries and even sweets.

It's no surprise that the typical Western diet is overloaded with wheat and food products containing gluten.

Gluten intolerance vs coeliac disease.

Coeliac disease is a genetic autoimmune disorder that causes damage to the small intestine when gluten is ingested. The smallest exposure to gluten can cause symptoms such as diarrhoea, constipation, nausea, vomiting, bloating and abdominal pain. For people with coeliac disease, eating gluten can also compromise nutrient absorption, causing deficiencies like anaemia and osteoporosis so they must follow a strict gluten-free diet for life.

A gluten-free diet may also be recommended for people with gluten intolerance or non-coeliac gluten sensitivity (NCGS). NCGS symptoms include diarrhoea, bloating and constipation as well as neurological disorders, joint pain and fatigue. Generally people with NCGS feel better avoiding gluten, but the cause and treatment is not well understood.

Emerging research indicates it may not be gluten that is the problem and that the malabsorption of fermentable sugars (FODMAPs) may be the culprit in those with Irritable Bowel Syndrome.

Is gluten-free healthier?

While 1 in 70 Australians have been diagnosed as coeliac, there's little conclusive evidence that a gluten-free diet offers any health benefits for people who aren't sensitive or allergic to gluten. If you were to cut out processed breads and refined carbs, it's likely you would feel healthier but this can't necessarily be put down to the absence of gluten!

However, depending on which gluten-free foods you choose, how often you eat them and whether your other food choices are healthy ones, making the switch to gluten-free can still be a healthy way to eat. If you are considering going gluten-free, make sure you choose whole food gluten-free options such as quinoa, amaranth, millet, brown rice, sorghum, teff and buckwheat which are also good natural sources of folate, thiamin, riboflavin, niacin and iron as well as protein and fibre.

How do I cut out gluten?

Make what you can at home from quality natural ingredients and aim to limit commercially prepared gluten-free snacks and bakery products, which are typically high in refined carbohydrate, fat, sugar and salt - just like their gluten-containing counterparts. Reading and understanding food labels is a vital part of making nutritious choices and it is something that I discuss in depth in my book.

Another thing to remember is to not only choose rice-based products. Too much rice and rice-based products, even wholegrain rice, can contribute to arsenic in the diet. Inorganic arsenic is found in nearly all foods and drinks but is usually only found in small amounts.

For a yummy, healthy, gluten-free snack, try these gluten-free bliss ball cake pops that the whole family will love.

However, slightly higher levels can be found in rice and rice-based products such as rice milk, rice syrup, infant rice cereal and rice bran. Even for those following a whole food gluten-free diet, it is still best to rotate your grains since each whole grain has something different to offer - from the calcium in teff to the protein in quinoa.

Good gluten-free choices include naturally gluten-free foods, such as lean meats, oily fish, natural dairy products (no added sugar or preservatives), plenty of fresh vegetables and fruit, whole gluten-free grains and healthy fats. But it's important not to replace gluten-containing foods with more processed meals, gluten-free snacks and sugary desserts, which can lead to a higher intake of sodium, sugar and additives.

Five steps to going gluten free.

1. Look for a preservative-free, gluten-free bread or make your own (see Wholesome Child: A Complete Nutrition Guide and Cookbook)

2. Replace quick and easy snacks with healthy alternatives, such as these delicious broccoli tots, roasted chickpeas and cheesy polenta chips.

3. Choose crackers made from buckwheat, rice or quinoa, or make your own like these delicious Zucchini Crackers which are not only gluten-free but packed with vitamin A and C.

4. Swap wheat-based breakfast cereals for gluten-free mueslis (no added sugar), gluten-free oat porridge, rice porridge, quinoa porridge or try one of Wholesome Child's delicious porridges. When hunger strikes, make sure you don't reach for bakery treats and instead whip up a healthy gluten-free trail mix or these yummy Beetroot and Spinach Bliss Balls.

5. Learn to read labels and look for hidden gluten in products such as soy sauce, salad dressings, French fries, confectionery and processed meats. (You can head here for more information on hidden names and reading nutrition labels.

6. Instead of denying your child their favourites, think about making healthy swaps - pasta can be replaced with brown rice or buckwheat pasta, soy sauce can be replaced with tamari, wheat flour can be easily swapped with gluten-free flours such as almond flour, coconut flour, buckwheat flour or the Wholesome Child gluten-free flour mix featured in my book. I've got lots of other easy and nutritious gluten-free swaps.

To learn more about Mandy Sacher please visit the Wholesome Child website. Her book "Wholesome Child: A Complete Nutrition Guide and Cookbook" is available to purchase online and through iTunes, and you can connect with Mandy on Instagram and Facebook.