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Metabolic osteopathy in celiac disease: importance of a gluten-free diet


LA Martini, Nutrition Department, School of Public Health, São Paulo University, Av. Dr. Arnaldo 715, CEP 01246-904, São Paulo – SP, Brazil. E-mail:, Phone: +55-11-30617701, Fax: +55-11-30617705.


Reduced bone mineral density (BMD) is frequently found in individuals with untreated celiac disease (CD), possibly due to calcium and vitamin D malabsorption, release of pro-inflammatory cytokines, and misbalanced bone remodeling. A gluten-free diet (GFD) promotes a rapid increase in BMD that leads to complete recovery of bone mineralization in children. Children may attain normal peak bone mass if the diagnosis is made and treatment is given before puberty, thereby preventing osteoporosis in later life. A GFD improves, but rarely normalizes, BMD in patients diagnosed with CD in adulthood. In some cases, nutritional supplementation may be necessary. More information on therapeutic alternatives is needed.