By Dr. Liji Thomas, MDReviewed by Lauren HardakerDec 15 2025. A major pediatric nutrition review reveals why going gluten-free is lifesaving for some children, but a potential health risk for others when adopted without medical guidance. Study: Gluten-related nutritional challenges in pediatric subjects: treatment and beyond. Image credit: aleksandr talancev/Shutterstock.com A recent review in the journal Frontiers in Nutrition addresses the management of these conditions in children with an emphasis on holistic health, including growth, neurodevelopment, metabolic health, and psychosocial well-being. Gluten-related disorders like celiac disease (CD) may require lifelong avoidance of gluten, or even of wheat, but at the potential cost of nutritional imbalance and other health risks. Introduction Gluten-free diets have become increasingly popular among the general population, often adopted without clear medical guidance, such as a diagnosed gluten-related disorder. Gluten-related disorders include sensitivity to gluten (celiac disease, CD), wheat allergy (WA), and non-celiac gluten sensitivity (NCGS). Despite significant overlap in their signs and symptoms, they involve different pathways and exhibit distinct diagnostic features, requiring different management approaches. In all three conditions, a gluten-free diet represents the primary dietary approach to management. In such cases, convenience often dictates the use of processed foods that are gluten-free. These are usually calorie-dense, increasing cardiometabolic risk. They are also likely to be deficient in essential nutrients. As a result of all these factors, children on a gluten-free diet may have abnormal growth and neurological development. Similar risks apply to individuals who unnecessarily adopt a gluten-free diet. The current study examined the distinctions between the three disorders while investigating the potential adverse effects of a gluten-free diet. Celiac disease CD affects about 1 % of the world’s population. Its current rising rates may indicate better awareness and diagnostic tools, as well as a marked change in eating habits. However, many people continue to go undiagnosed. The spectrum of CD varies from silent or asymptomatic forms to classic gut symptoms (chronic diarrhea, bloating, abdominal pain, weight loss, constipation) or extraintestinal symptoms (short stature, stunted growth, iron deficiency anemia, osteoporosis, peripheral neuropathy, reproductive impairment). In addition, some individuals have type 1 diabetes, autoimmune thyroid disease, Down or Turner syndrome, or selective IgA deficiency. Many have a first-degree family history of CD.. . CD is an autoimmune condition triggered by exposure to wheat, barley, and rye, all of which contain gluten. In genetically predisposed individuals, the immune system reacts to deamidated peptides released from gluten digestion. These peptides are presented to CD4 lymphocytes by HLA-DQ2 and HLA-DQ8 molecules. Read More