Long-term effect of gluten restriction on bone mineral density of patients with coeliac disease

Aliment Pharmacol Ther. 1997 Feb;11(1):157-64. doi: 10.1046/j.1365-2036.1997.112283000.x.


Aim: To assess the long-term effect of a gluten-free diet on bone mineral density of adults with untreated coeliac disease.

Methods: Bone mineral density was assessed at baseline and after a mean duration of 37 months of treatment in 25 unselected newly diagnosed coeliac patients.

Results: At baseline, osteopenia (> -1 s.d. below normal) was evident in the lumbar spine and total skeleton in 18 (72%) and 21 (84%) patients, respectively. At the end of the study, bone density had increased (mean bone mass Z-score increase: Z-score +1.0 for the lumbar spine and +1.1 for total skeleton) in 22 and 23 patients, respectively. Patients who adhered to strict gluten restriction (n = 15) demonstrated a similar bone remineralization in the spine than those patients with partial compliance (n = 10) (mean Z-score increase: +1.0, in both areas). A greater mean annual change in Z-score in the total skeleton was noted in patients who followed strict gluten restriction (0.4 +/- 0.1) respect to those with partial compliance (0.3 +/- 0.1); however, this difference was not statistically significant. Pre-menopausal women had significantly greater remineralization that post-menopausals (P > 0.05). Remineralization showed an inverse correlation with the degree of basal osteopenia (r = -0.525; P < 0.002).

Conclusions: Long-term treatment with gluten-free diet produces a significant improvement in bone density in coeliac patients. Remineralization was more pronounced in patients who better comply with gluten-free diet, in pre-menopausal women and in patients with the lowest baseline bone mineral density.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Bone Density*
  • Bone Diseases, Metabolic / diet therapy*
  • Bone Diseases, Metabolic / etiology
  • Celiac Disease / complications
  • Celiac Disease / diet therapy*
  • Female
  • Glutens / administration & dosage*
  • Humans
  • Male
  • Middle Aged


  • Glutens