Osteoporosis and Celiac Disease

by Nicole LeBlanc, Dt.P. (Translation by Mark Johnson)

Osteoporosis is a frequent complication of celiac disease, linked to the malabsorption of calcium.

This nutrient is absorbed in the first portion of the small intestine, which is also the main area of intestinal damage in someone with untreated celiac disease. Osteoporosis is a condition that affects the skeleton and is characterized by low bone density and the deterioration of bone tissue, rendering the bones more fragile. This problem can lead to pain as well as deformities in the spine.


Indeed, osteoporosis is a major public health problem in Canada, and the prevalence is only increasing with the aging population. Looking at gender, women are four times more likely than men to have osteoporosis – the decline in estrogen production results in a 2-5% loss of bone density per year over the course of the first few years post-menopause. Osteoporosis is also more common in people with a new celiac diagnosis than among the general population – and with celiacs, men have the same percentage of risk as women do.

Risk factors

People are at greater risk if they present with the following factors:

  • Family history of osteoporosis (e.g. fractures in the hip, wrist or vertebrae)
  • Being a woman and over 50 years of age
  • Weakened bone structure and a weight at the lower end of the healthy range – BMI between 18.5 and 25
  • Early menopause (before the age of 45)
  • Smoking
  • Lack of physical activity
  • Low intake of dietary calcium
  • Excessive caffeine consumption (more than four cups per day)
  • Excessive alcohol consumption
  • Using certain medical drugs, including cortisone, for more than three months
  • Diseases that interfere with the absorption of nutrients (e.g. Crohn’s disease, celiac disease)

How to Prevent Osteoporosis:

To prevent osteoporosis, medical experts advise above all to have a balanced diet, heavy on plant consumption, and sufficient intake of calcium and vitamin D, and be sure to get physical exercise. In celiac patients, strict adherence to the gluten-free diet is the most important factor that will contribute to the regeneration of the intestinal mucosa, ensuring better absorption.

Get physical exercise
Physical activity, from childhood onwards, promotes the formation of strong bones. Throughout your life, exercise helps to maintain optimal bone mass and musculature, which supports your body’s weight. For example, walking, running, tennis, soccer, etc. Exercise that requires handling or pushing heavy objects is also beneficial.

Choose foods that are rich in calcium
Calcium is an important mineral. It contributes to bone metabolism, the maintenance of blood pressure levels, muscle contraction, and the activation of many enzymatic systems involved blood coagulation. Though the matter continues to be debated, currently calcium
requirements are estimated at between 700 and 1,300 mg per day, depending on age and sex. These recommendations may change in the future, depending on the findings of research that is underway.

Choose foods that are rich in vitamin D
This vitamin helps the body to better absorb calcium, no matter the source (food or supplements). It is difficult to meet your vitamin D requirements without the regular consumption of dairy products or milk substitutes that are fortified with calcium and vitamin D. Very often, one’s vitamin D requirements can only be met through food. In addition, living in the north (as we do) and aging both make it more difficult to produce vitamin D following sun exposure. It is therefore recommended that people over the age of 50 take a daily
supplement of 1,000 IU of vitamin D.

Reduce excess intake of calcium, alcohol, salt and meat
Although their influence on bone health remains unclear, it is suggested to moderate your consumption of animal protein, caffeine, alcohol and salty foods as these promote an increase in calcium loss through the urine.

Quit smoking
Stopping smoking has long been encouraged to support heart health and to help prevent lung cancer. Many studies confirm that smoking is also harmful to bone density.

About David Fowler

David Fowler is an online marketing consultant specializing in AdWords PPC, SEO, and website updates. He is the webmaster of Kelowna Celiac and was co-chair of the Kelowna 2012 CCA National Conference in Kelowna.