How a Gluten-Free Diet May Raise Arsenic Levels in Children With Celiac Disease (+Video)

Celiac.com 05/19/2025 - When children are diagnosed with celiac disease, switching to a gluten-free diet is essential for healing and managing symptoms. However, new research suggests that this important dietary change may come with an unexpected side effect: increased exposure to arsenic, a toxic heavy metal found in certain foods—especially rice. This study explored whether children newly diagnosed with celiac disease absorb more arsenic after starting a gluten-free diet and what that might mean for their health.

Why the Study Was Conducted

Celiac disease is an autoimmune condition triggered by eating gluten, a protein found in wheat, barley, and rye. The only treatment is a lifelong gluten-free diet. However, many gluten-free products use rice as a substitute for wheat-based ingredients. Rice has a natural tendency to absorb arsenic from soil and water, especially in areas where the environment is already contaminated. This has raised concerns that children on a gluten-free diet may end up consuming more arsenic through rice-based foods like crackers, cereals, and pasta.

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The researchers set out to test this idea by measuring arsenic levels in the urine of children with celiac disease—before and after they started a gluten-free diet.

How the Study Was Done

The study followed children between the ages of 2 and 18 who were undergoing medical testing for celiac disease. Researchers first took urine samples before the children began the gluten-free diet. Then, after six months on the diet, they collected urine samples again to see if arsenic levels had changed.

Out of 67 children who started the study, 50 were officially diagnosed with celiac disease. Ultimately, 35 of those children completed the full study, including urine testing both before and after the dietary shift.

The children in the study mostly came from middle-class, educated families and were primarily white. Most had common celiac symptoms like stomach pain and diarrhea.

What the Study Found

After six months on a gluten-free diet, the researchers found a noticeable increase in the children’s arsenic levels. On average, their urinary arsenic concentration went from 3.3 micrograms per liter before the diet to 13.6 micrograms per liter after switching to gluten-free foods. This was a statistically significant rise, meaning it is very unlikely to be due to chance.

The study also looked at possible factors that might explain why some children had higher arsenic levels than others. Two key findings stood out:

Children with a family history of celiac disease tended to have higher arsenic levels after six months.

Children who identified as Hispanic also had higher levels on average.

These associations might reflect different eating habits, cultural food preferences, or genetic factors, but more research is needed to understand the cause.

What the Results Mean

It’s important to emphasize that while arsenic levels increased, they remained below levels considered immediately dangerous. Still, even low levels of arsenic over long periods have been linked to potential health risks, including effects on brain development, the immune system, and possibly cancer. What this means is that although the levels in this study are not acutely toxic, the long-term effects of mild but continuous exposure—especially in young, growing bodies—are not yet fully understood.

This study does not suggest that families should stop gluten-free diets. For people with celiac disease, eating gluten causes direct damage to the intestines and leads to serious long-term health problems. However, the findings do raise important questions about how to make gluten-free eating as safe and healthy as possible.

What This Means for Families Managing Celiac Disease

For families of children with celiac disease, this study is a reminder to think carefully about the quality and variety of foods included in a gluten-free diet. Many gluten-free packaged foods rely heavily on rice flour and rice-based ingredients, which may increase arsenic intake if consumed regularly. Here are a few tips for managing this concern:

Mix up your grains: Try gluten-free alternatives like quinoa, buckwheat, millet, amaranth, or oats labeled gluten-free. These grains are naturally low in arsenic and offer a broader nutritional profile.

Limit processed foods: Many processed gluten-free snacks and baked goods rely heavily on rice flour. Focusing on whole, unprocessed foods can reduce unnecessary exposure.

Choose rice types carefully: Brown rice tends to have more arsenic than white rice, and rice grown in certain regions (like the southern United States) may contain higher levels. Look for rice from areas known to have lower arsenic content, or rinse rice thoroughly before cooking to reduce levels.

Stay informed: Talk to your doctor or a dietitian about any concerns and stay up to date with new research.

Why This Study Matters

This study shines a light on a little-known issue that could have long-term implications for children managing celiac disease. While going gluten-free is non-negotiable for those with celiac, it’s important to look beyond the label and think about what gluten-free really means nutritionally. By being aware of potential hidden risks like arsenic exposure from rice-based foods, families can make more informed decisions to support their child’s overall health.

The key takeaway? A gluten-free diet should be more than just removing gluten—it should be a balanced, thoughtful approach to nutrition that supports healing without introducing new risks. This research is an important step toward better understanding how to do just that.

Read more at: journals.lww.com

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