Relationship between the Diet and the Bone Mineral Density in Children with Celiac Disease

Objective: To analyze whether there were any deficiencies in the celiac diet that could affect dual X-ray absorptiometry (DXA), comparing a diet with gluten to one without gluten. Methods: Forty-three children aged 1-13 years diagnosed with celiac disease (CD) were studied. Bone mineral density (BMD) was measured using DXA. A food questionnaire was completed before the start of the gluten-free diet (GFD) and again one year after diagnosis, when the patient was on a strict GFD. Results: Lumbar spine BMD (g/cm2) increased over the one-year follow-up (P<0.001). We did not find significant differences in the percentages of energy intake and nutrients: carbohydrates (47.94% vs. 47.02%), lipids (34.73% vs. 36.24%) and proteins (17.65% vs. 16.60%). We found deficient vitamin D intake in both the gluten-containing and the GFDs. In observing the relationships between dietary intake and Z-score BMD, we found a significant correlation with the vitamin D intake at diagnosis. Conclusion: The GFD is a healthy diet, similar in both macronutrients and micronutrients to a diet with gluten. The principal factor for BMD improvement is adequate proper compliance with the GFD.