Going Gluten-FreeSeptember 4, 2013

Is Gluten Intolerance Making Your Child Act Out?

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Posted by Living Without contributor Kelly Dorfman, MS, LND

There are many reasons for a child to be angry or moody apart from food intolerance.  But if gluten is chronically irritating the body, other interventions to address angry outbursts may not be successful until you toss out the gluten.

Three or more positive responses to the following questions means gluten intolerance could be your child’s problem.

  • Does your child crave or strongly prefer gluten-based foods, such as bread, pasta, cereal and pizza?
  • Have psychological and/or behavioral strategies to control your child’s outbursts been mostly unsuccessful?
  • Are any of your child’s immediate family members intolerant of gluten or does anyone have celiac disease?
  • Does your child currently have or has he/she in the past had chronic digestive symptoms, such as excessive gas, diarrhea or stomach pain?
  • Is your child on the small side, despite eating plenty of food?

A Case Study

Tori was a petite, slim woman with a very large presence. Before she was even through the door, she was chatting a mile a minute. I was so busy trying to keep up with her conversation that I barely had a chance to greet her son and daughter who followed in her wake.

Eleven-year-old Gabriela was built differently from her mother. She was perhaps five to ten pounds overweight but next to her mother who was reed-thin, the extra ounces appeared disproportionally excessive. Devin, her nine-year-old brother, was wiry and thin like his mother. He was dragged along ostensibly to discuss how the whole family could eat better and his relaxed demeanor suggested he knew the session was not about him. I suspected the unspoken reason for the visit was Gabriela’s weight.

Tori wasted no time beating around the bush. “We are here to improve all of our eating,” she announced. She went on to say she was thankful everyone in the family was basically healthy but their diets needed help.

The critical juncture requiring nutrition intervention, she explained, was Gaby entering middle school. Tori claimed she wanted to be proactive regarding eating disorders. Many of Gaby’s peers were already talking about calorie counting and cutting down on carbohydrates.

“I am worried about Gaby picking up unhealthy attitudes about eating,” she said.

Getting to the Problem

Tory had provided me with a record of several days’ worth of food consumption for the three of them. Gaby ate larger quantities of food than her mother and brother. She tended to eat just a few bites of protein and vegetables, concentrating mostly on bread and pasta. Devin ate the same basic foods in smaller quantities with different proportions but also loved pasta and bread.

“Gaby is a good eater but she often complains she is hungry at the end of the meal,” Tori said, describing the situation as uncomfortable. Tori would suggest having some fruit but Gaby would insist on another serving of pasta.

We had arrived at the problem: Gaby was overeating and Tori was trying to stop her. They were having daily food battles thinly disguised as polite discussions.

Excessive hunger could be a sign of addiction to gluten. (See Trouble Losing Weight at /issues/4_24/trouble-losing-weight-3219-1.html.) I presented this theory to Tori and the kids. Gaby looked horrified at the thought of removing gluten from her diet. The easiest way to support Gaby is to declare the house a gluten-free zone, I explained.

Now Devin looked stricken. “What am I suppose to eat?” he challenged.

Tori had already revealed that she avoided gluten herself. She claimed it made her feel bloated and sluggish but she was concerned about restricting Devin who was already small for his age. I explained that failure to maintain weight and small stature were among the most common symptoms of gluten intolerance. I asked Devin if he had any digestive symptoms. His stomach was touchy but nothing “big” was his wary reply.

Next I asked about neurological symptoms. Mood swings? Depression? Anxiety? The three of them looked at each other. Finally Tori spoke up.  “Devin has been in counseling for the last year to help him manage his anger,” she stated carefully.

I asked how therapy was progressing. “Not very well,” was the grim reply.

Other than an explosive temper, Devin was a healthy, smart and sociable kid, his mother insisted. He had loads of friends, did well in school, and could be very agreeable unless something triggered him. The smallest frustration could set off a disproportional crazy fit. Dealing with him when he was in this state was exhausting and the family felt they were walking on eggshells waiting for the next trigger. Devin himself didn’t like the way he behaved when he was angry but once he got started, he couldn’t control himself.

Trauma or post-traumatic stress disorder can cause uncontrolled outbursts in otherwise mild-mannered people, but there were no known incidents in Devin’s life. I told Devin I thought changing his diet might help. When he frowned, I stepped out on a limb and predicted he was going to like the gluten-free diet after a few weeks.

Gluten Intolerance: The Clues

Nobody knows why gluten makes some people depressed or angry, but its capacity for causing neurological trouble is well documented. What are the clues suggesting Devin could benefit from a gluten-free diet?

  • He preferred pasta and gluten-based foods.
  • He had two immediate family members with either a known gluten sensitivity (his mother) or strong possibility of gluten sensitivity (his sister).
  • A year of psychological/behavioral intervention was unsuccessful.
  • There was no known trauma to explain his explosive behaviors.

We negotiated a six-week gluten-free diet trial period and agreed to meet again when it was over. The kids clearly did not want to stay on the diet unless there were big payoffs.

Six weeks later, Tori and the kids returned. When I asked how they were doing, Devin was the first to respond. He felt so much better that he wondered if he had celiac disease. His focused questions about what he could or could not eat made it clear that he was not planning on eating gluten ever again.

Between Tori and Devin, the story emerged. Devin’s moods had stabilized so quickly and solidly that two weeks earlier, he stopped psychotherapy. As long as he stayed away from gluten, he had manageable anger. The few times he slipped up or ate gluten by accident, his frustration tolerance feel to zero and his temper flared.

Published in the Oct/Nov issue of Living Without. Adapted from Cure Your Child With Food: The Hidden Connection Between Nutrition and Childhood Ailments (Workman 2013) by Kelly Dorfman, MS, LND. Dorfman is a licensed clinical nutritionist with a private practice in the Washington, DC, area.

*Celiac experts strongly advise getting screened for celiac disease before embarking on the gluten-free diet.

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