Winter 2008

Nutrition Guidelines for Children on “Restricted” Diets

Coping with food allergies, food intolerance and vegetarian diets

An interview with Mary Ellen DiPaola, R.D., CDE, IBCLC

A well-balanced diet is essential for healthy growth in childhood. Sometimes, however, a child’s diet must be limited because of food allergies, intolerances or family dietary preferences. In those cases, it’s still possible to provide balanced nutrition through careful food selection.

Food Allergy—Or Intolerance?

“Only a small percentage of children have true food allergies,” says Mary Ellen DiPaola, registered dietitian, certified diabetes educator and internationally board certified lactation consultant. “Allergic reactions can be serious and may require medical attention. Food intolerances, such as lactose intolerance, are more common and are a discomfort, but do not involve an immune system response.”

Three common high-allergen foods are milk, eggs and wheat. These may be eliminated from a child’s diet in early life, but are often outgrown by later childhood. “If your child cannot drink milk, alternative sources of calcium, protein and vitamin D are required,” DiPaola says. “If the problem is lactose intolerance, cheese is lactose-free and yogurt can often be tolerated. If eggs must be eliminated, there are other adequate sources of protein to substitute. Processed foods can contain milk, wheat and eggs; therefore, label reading is necessary.”

Mary Ellen DiPaola, registered dietitian

Gluten intolerance associated with celiac disease must be diagnosed by a physician and requires strict avoidance of gluten, a protein in wheat, barley and rye. This is an autoimmune disease, commonly a genetic disorder, and requires close management to aid proper nutritional balance to avoid serious health issues. Vitamin/mineral supplementation is often necessary. “Avoiding wheat can create deficiencies in the B vitamins and iron,” DiPaola cautions. “Unnecessary restriction can be difficult and may affect total caloric intake required for growth. Pursue the medical testing required to assess the need for complete gluten restriction.”

Concerns for Vegetarians

Families may decide on a vegetarian diet for health reasons or concern for animals. “Although vegetarians must be sure to consume adequate sources of protein, iron and vitamin B12—especially if the diet has no animal products—a well-planned vegetarian diet can actually be a healthy way to eat,” DiPaola says. “If your child’s diet is restricted in any way and nutrient intake or growth is questioned, seek the professional advice of a registered dietitian,” she adds.

To Learn More

To obtain basic nutritional guidelines, visit www.mypyramid.gov, click on MyPyramid Plan, and enter your child’s information.