Coeliac Disease and Osteoporosis

Coeliac Disease and Osteoporosis

What is osteoporosis?

Osteoporosis is often described as a thinning of the bones that leaves them more prone to fracture, especially in the hips, wrists and spine. 

Who has a higher risk of osteoporosis?

As we get older there is an increased risk of low bone mineral density (known as osteopenia) and osteoporosis, and the risks are greater for women after the menopause. Osteoporosis is particularly common in people with undiagnosed coeliac disease due to the decreased absorption of calcium as a result of damage to the lining of the gut. Research has shown that low bone mineral density (BMD) can affect up to 75% of people when they are diagnosed with coeliac disease.

Bone health will usually improve after starting a gluten-free diet and it is important to stick to the diet to minimise the risk of low BMD and osteoporosis. It may be harder for women diagnosed with coeliac disease after the menopause to improve their BMD. However, for children with coeliac disease following a gluten-free diet, bone health is unlikely to be affected in the long term. 

At diagnosis and follow up, your healthcare professional may recommend a DEXA scan to assess the state of your bone health. 

Advice for stronger bones

Calcium is an important nutrient needed to ensure you have strong bones, helping to reduce the risk of osteoporosis. It is important for everyone to consume their recommend allowance of calcium each day. However, it is even more important for those with coeliac disease  as there is a higher calcium requirement for this nutrient than the general population. This is because the damage to the lining of the gut in those with undiagnosed or untreated coeliac disease leads to less calcium being absorbed from the diet. It is recommended that adults with coeliac disease have at least 1000mg  per day.  A 200ml glass of milk or calcium-fortified plant-based alternative contains approximately 240mg of calcium.

Good gluten-free calcium sources include dairy products, tinned sardines, green, leafy vegetables, oranges and dried figs.  When choosing dairy products, opt for low-fat options as these contain as much calcium but less saturated fat than full-fat versions.

We’ve compiled some simple tips to help you improve your calcium intake:

  • Add milk or yoghurt to your gluten-free breakfast cereal
  • Add green vegetables such as broccoli, cabbage, curly kale, watercress and green beans  to your main meals
  • Include dried fruits such as figs, seeds and nuts as gluten-free snacks
  • Use tinned fish with bones, such as sardines or pilchards, and include on gluten-free toast
  • Check non-dairy sources of calcium such as plant-based milks are fortified with calcium

Vitamin D

Vitamin D helps the body to absorb calcium from the diet. Most of the vitamin D is made by the action of sunlight on our skin. Foods rich in vitamin D include oily fish, eggs and fortified spreads and breakfast cereals. However, it is not possible to achieve an adequate intake of vitamin D from diet alone. Children over 1 and adults require 10 micrograms of vitamin D per day. In the autumn and winter months, when sun exposure is reduced, a daily supplement containing 10 micrograms of vitamin D should be considered.  People who have little sun exposure and those from ethnic minority groups with dark skin should consider taking a supplement all year round. Seek advice about suitable supplements from a healthcare professional.

Exercise such as weight-bearing activities like walking, running and tennis can all help to maintain your bone density too. If you already have osteoporosis, choose gentler activities such as swimming, gardening and Tai Chi.

© 2022. Glutafin. Dr. Schär UK Ltd. 401 Faraday Street, Birchwood Park, Warrington, WA3 6GA
© 2022. Glutafin. Dr. Schär UK Ltd. 401 Faraday Street, Birchwood Park, Warrington, WA3 6GA