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

Nutr Rev. 2009 Oct;67(10):599-606. doi: 10.1111/j.1753-4887.2009.00232.x.


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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Bone Demineralization, Pathologic / diagnosis
  • Bone Demineralization, Pathologic / etiology*
  • Bone Demineralization, Pathologic / therapy
  • Bone Density / physiology*
  • Bone Remodeling
  • Calcium, Dietary / administration & dosage
  • Celiac Disease / complications*
  • Celiac Disease / diet therapy
  • Diet, Gluten-Free*
  • Dietary Supplements
  • Early Diagnosis
  • Female
  • Fractures, Bone / complications
  • Humans
  • Inflammation
  • Intestinal Absorption
  • Male
  • Osteoporosis / complications
  • Osteoporosis / prevention & control
  • Vitamin D / administration & dosage


  • Calcium, Dietary
  • Vitamin D