A factor that plays a significant role in osteoporosis risk is celiac disease (CD). Official estimates are that more than 1.5 million people in the U.S. may have celiac disease, a condition in which gluten reduces the small intestine's ability to absorb essential nutrients, such as calcium. I believe the real incidence is several times the estimated level.

Gluten is found in the grains: wheat, rye, oats and barley (remember WROB, because they rob you of health). It is vital to recognize that gluten is impossible to remove from any product that is made from any of these grains, which makes a genuinely gluten free diet quite a challenge for many people.

Unfortunately, the symptoms of celiac disease are often so subtle that many people don't even know they have it. Many who do know they are celiacs are unaware that its untreated long-term complications can be fatal and they deliberately ignore advice to follow a gluten free diet.

Part of the problem is that because there are no drugs for the disease and the only treatment is to follow a strict gluten exclusion diet, most regular doctors pay the disease little attention. This directly or subtly conveys inappropriate attitudes to the condition in diagnosed patients.

One study reported in the Archives of Internal Medicine earlier this year investigated the link between celiac disease and osteoporosis in 840 subjects (260 had osteoporosis). Blood tests revealed that CD was much more common among subjects with osteoporosis. In addition, subjects with the most severe cases of celiac disease tended to have the most severe cases of osteoporosis.

Subjects who were diagnosed with CD were asked to follow a gluten-free diet for one year. Bone mineral density (BMD) (measured before and after the follow up year) was considerably improved in subjects who followed the non-gluten diet.

It is very important that people take celiac disease seriously and learn to strictly avoid gluten. It does take effort but it does eliminate the dangers of untreated CD. Osteoporosis is a debilitating condition with an insideous onset. Avoiding osteoporosis is one very good reason for a celiac to be sure to remain gluten free.