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Undiagnosed coeliac disease linked to lower bone density

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Adults with undiagnosed coeliac disease (UCD) tend to have lower bone density despite consuming more calcium and phosphorous, according to new research led by George Mason University’s College of Health and Human Services.

Coeliac disease is a common digestive condition that is caused by an adverse reaction to gluten. Symptoms can include diarrhoea, abdominal pain and bloating.

The study analysed data from the US National Health and Nutrition Examination Survey and its dietary component What We Eat in America (WWEIA), including self-reported dietary and supplement intake for more than 13,000 adults who were not pregnant or eating a gluten-free diet.

Results published in the Journal of the American College of Nutrition show that adults with UCD had lower bone density in their thigh bones and femur necks — the top of the femur and most common site for hip fractures.

“Our findings suggest that lower bone density among adults with UCD is not a result of their diets, and in fact, they took in more calories and nutrients than the control group,” explained study co-author Lara Sattgast, formerly a Master of Science in Nutrition student at George Mason University and now a doctoral student at Oregon State University. “This may mean that these adults are not correctly absorbing nutrients.”

Co-author Dr Margaret Slavin noted although the time to diagnosis has improved in recent years, it can still take several years between the first symptoms of coeliac disease and diagnosis. She urged anyone who suspects that they may have the condition to see a doctor to get a proper diagnosis and treatment, and not self-initiate a gluten-free diet on their own.

The study provides further support for monitoring the bone health of individuals with coeliac disease, George Mason University said.

The researchers suggest that future work should explore optimal levels for consuming and/or supplementing nutrients for bone health and whether poor absorption in the small intestine fully explains the differences observed in bone health or whether other metabolic pathways are impacted.