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Nutrient database for osteoporosis

The nutrition information below is from the National Institutes of Health.
Please read the information (here or at the NIH's website) thoroughly before using the food database. Based on the guidelines of the NIH, our website provides the uniquely accessible Vitamin D and Calcium database for you to evaluate foods most appropriate for your condition. Nutrient data for some common foods with gluten are included for comparison purpose.

The Link Between Celiac Disease and Osteoporosis

Osteoporosis is a complication of untreated celiac disease. The small intestine is responsible for absorbing important nutrients, such as calcium. Calcium is essential for building and maintaining healthy bones. Even people with celiac disease who consume enough calcium are deficient in this nutrient. And because calcium is needed to keep bones healthy, low bone density is common in both children and adults with untreated and newly diagnosed celiac disease.

What Is Celiac Disease?

Celiac disease, sometimes called sprue or celiac sprue, is an inherited intestinal disorder in which the body cannot tolerate gluten. Gluten is a protein found in wheat, rye, barley, farina, and bulgur. When people with celiac disease eat foods containing gluten, their immune systems respond by attacking and damaging the lining of the small intestine. The small intestine is responsible for absorbing nutrients from food into the bloodstream for the body to use. When the lining is damaged, so is its ability to absorb these nutrients.

Until recently, celiac disease was considered uncommon in the United States. However, recent studies suggest that the disease may be underdiagnosed and that as many as 1 percent of all Americans could have the disease.

Celiac disease affects people differently. Some people develop symptoms as children and others as adults. Symptoms vary and may or may not occur in the digestive system. They may include diarrhea, abdominal pain, weight loss, irritability, and depression, among others. Irritability is one of the most common symptoms among children. In some cases, a diagnosis of celiac disease is missed because the symptoms are so varied and may only flare up occasionally.

Children and adults with untreated celiac disease may become malnourished, meaning they do not get enough nutrients, resulting in anemia, weight loss, and, in children, delayed growth and small stature. Among the possible complications of untreated celiac disease is the inability to develop optimal bone mass in children and the loss of bone in adults, both of which increase the risk of osteoporosis. The only treatment for celiac disease is to follow a gluten-free diet.

What Is Osteoporosis?

Osteoporosis is a condition in which the bones become less dense and more likely to fracture. Fractures from osteoporosis can result in pain and disability. Osteoporosis is a major health threat for an estimated 44 million Americans, 68 percent of whom are women. Although postmenopausal Caucasian women have the highest risk for the disease, men and certain ethnic populations are also at risk.

Risk factors for developing osteoporosis include:

• thinness or small frame
• family history of the disease
• being postmenopausal and particularly having an early menopause
• abnormal absence of menstrual periods (amenorrhea)
• prolonged use of certain medications, such as those used to treat lupus, asthma, thyroid deficiencies, and seizures
• low calcium intake
• lack of physical activity
• smoking
• excessive alcohol intake.

Osteoporosis often can be prevented. However, it is known as a silent disease because, if undetected, osteoporosis can progress for many years without symptoms until a fracture occurs. It has been called a childhood disease with old age consequences because building healthy bones in youth helps prevent osteoporosis and fractures later in life. However, it is never too late to adopt new habits for healthy bones.

Osteoporosis Dietary Management Strategies for People with Celiac Disease

When people with celiac disease eliminate foods containing gluten from their diet, normal absorption of nutrients from the intestines is usually restored within a few months, although it may take up to 2 years in older adults. Eventually, most children and adults have significant improvements in bone density.

People with celiac disease who have successfully adopted a gluten-free diet also need to follow the same basic strategies for bone health that apply to others who don’t have the disease. These strategies include getting adequate calcium and vitamin D, performing weight-bearing exercise, not smoking, and avoiding excessive use of alcohol. In some cases, an osteoporosis treatment medication may be recommended.

A small percentage of people with celiac disease do not improve on a gluten-free diet. These people often have severely damaged intestines that cannot heal and may need to receive intravenous nutrition supplements.

A well-balanced diet rich in calcium and vitamin D is important for healthy bones. Good sources of calcium include low-fat dairy products; dark green, leafy vegetables; and calcium-fortified foods and beverages. Supplements can help ensure that the calcium requirement is met each day, especially in people with a proven milk allergy. The Institute of Medicine recommends a daily calcium intake of 1,000 mg (milligrams) for men and women up to age 50. Women over age 50 and men over age 70 should increase their intake to 1,200 mg daily.

Vitamin D plays an important role in calcium absorption and bone health. Food sources of vitamin D include egg yolks, saltwater fish, and liver. Older individuals—especially those who are housebound, live in northern climates, or use sunscreen—are often deficient in this vitamin and may need vitamin D supplements to achieve the recommended intake of 600 to 800 IU (International Units) each day.

Vitamin D

Vitamin D is a fat-soluble vitamin that is naturally present in very few foods, added to others, and available as a dietary supplement. It is also produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis.

Vitamin D can be found in small amounts in a few foods, including fatty fish such as herring, mackerel, sardines and tuna. To make vitamin D more available, it is added to dairy products, juices, and cereals that are then said to be “fortified with vitamin D.” But most vitamin D – 80% to 90% of what the body gets – is obtained through exposure to sunlight. Vitamin D can also be made in the laboratory as medicine.

Vitamin D is used for preventing and treating rickets, a disease that is caused by not having enough vitamin D (vitamin D deficiency). Vitamin D is also used for treating weak bones (osteoporosis), bone pain (osteomalacia), bone loss in people with a condition called hyperparathyroidism, and an inherited disease (osteogenesis imperfecta) in which the bones are especially brittle and easily broken. It is also used for preventing falls and fractures in people at risk for osteoporosis, and preventing low calcium and bone loss (renal osteodystrophy) in people with kidney failure.

It is also used for boosting the immune system, preventing autoimmune diseases, and preventing cancer.

Because vitamin D is involved in regulating the levels of minerals such as phosphorus and calcium, it is used for conditions caused by low levels of phosphorus (familial hypophosphatemia and Fanconi syndrome) and low levels of calcium (hypoparathyroidism and pseudohypoparathyroidism).

Vitamin D Effectiveness

information from the National Institutes of Health

The effectiveness ratings for Vitamin D are as follows:

Effective for

• Treating conditions that cause weak and painful bones (osteomalacia).

• Low levels of phosphate in the blood (familial hypophosphatemia).

• Low levels of phosphate in the blood due to a disease called Fanconi syndrome.

• Psoriasis (with a specialized prescription-only form of vitamin D).

• Low blood calcium levels because of a low parathyroid thyroid hormone levels.

• Helping prevent low calcium and bone loss (renal osteodystrophy) in people with kidney failure.

• Rickets.

Likely effective for

• Treating osteoporosis (weak bones). Taking a specific form of vitamin D called cholecalciferol (vitamin D3) along with calcium seems to help prevent bone loss and bone breaks. Preventing falls in older people. Researchers noticed that people who don’t have enough vitamin D tend to fall more often than other people. They found that taking a vitamin D supplement reduces the risk of falling by up to 22%. Higher doses of vitamin D are more effective than lower doses. One study found that taking 800 IU of vitamin D reduced the risk of falling, but lower doses didn’t.

• Also, vitamin D, in combination with calcium, but not calcium alone, may prevent falls by decreasing body sway and blood pressure. This combination prevents more falls in women than men.

• Reducing bone loss in people taking drugs called corticosteroids.

Possibly effective for

• Reducing the risk of multiple sclerosis (MS). Studies show taking vitamin D seems to reduce women’s risk of getting MS by up to 40%. Taking at least 400 IU per day, the amount typically found in a multivitamin supplement, seems to work the best.

• Preventing cancer. Some research shows that people who take a high-dose vitamin D supplement plus calcium might have a lower chance of developing cancer of any type.

• Weight loss. Women taking calcium plus vitamin D are more likely to lose weight and maintain their weight. But this benefit is mainly in women who didn’t get enough calcium before they started taking supplements.

• Flu. Some research in school aged children show that taking a vitamin D supplement during winter might reduce the chance of getting seasonal flu.

• Reducing the risk of rheumatoid arthritis in older women.

• Reducing bone loss in women with a condition called hyperparathyroidism.

• Preventing tooth loss in the elderly.

Calcium and Vitamin D: Important at Every Age

The foods we eat contain a variety of vitamins, minerals, and other important nutrients that help keep our bodies healthy. Two nutrients in particular, calcium and vitamin D, are needed for strong bones.

The Role of Calcium
Calcium is needed for our heart, muscles, and nerves to function properly and for blood to clot. Inadequate calcium significantly contributes to the development of osteoporosis. Many published studies show that low calcium intake throughout life is associated with low bone mass and high fracture rates. National nutrition surveys have shown that most people are not getting the calcium they need to grow and maintain healthy bones.

Vitamin D
The body needs vitamin D to absorb calcium. Without enough vitamin D, one can’t form enough of the hormone calcitriol (known as the “active vitamin D”). This in turn leads to insufficient calcium absorption from the diet. In this situation, the body must take calcium from its stores in the skeleton, which weakens existing bone and prevents the formation of strong, new bone.

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