The Professional Advisory Council of the CCA has written a paper on bone health. It’s now been published and will become one of our standard resources. It’s also 6 pages long, so here are the key points.
- Celiac disease (CD) is a chronic disorder that affects bone structure. It requires strict lifelong adherence to a gluten-free diet (GFD), and long-term monitoring of patients with CD should include assessment of bone health.
- Bone health assessment in CD with malabsorption requires bone mineral density (BMD) testing at diagnosis. Correction of malabsorption of calcium, phosphate, and vitamin D should be ensured. At the time of diagnosis, patients should receive counselling on a GFD and on the nutrition required to restore bone health. Intake of calcium and vitamin D should be optimized using dietary sources, whenever possible. Patients should be encouraged to participate in weight-bearing exercises, limit alcohol intake, and avoid cigarette smoking.
- Evidence for management of low BMD and prevention of fractures in CD is limited. Strict adherence to a GFD seems to be the only effective treatment to improve BMD in adults with CD and decrease the risk of fractures.
If you would like to read the whole paper, you can find it at http://www.cfp.ca/content/cfp/64/6/433.full.pdf