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ARS Home » Northeast Area » Beltsville, Maryland (BHNRC) » Beltsville Human Nutrition Research Center » Food Surveys Research Group » Research » Publications at this Location » Publication #345170
Title: Nutritional intake and bone health among adults with probable undiagnosed, untreated celiac disease: What We Eat in America and NHANES 2009-2014

Author
item SATTGAST, LARA - George Mason University
item GALLO, SINA - George Mason University
item FRANKENFELD, CARA - George Mason University
item Moshfegh, Alanna
item SLAVIN, MARGARET - George Mason University

Submitted to: Journal of American College of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/1/2019
Publication Date: N/A
Citation: N/A

Interpretive Summary: Celiac disease as a gastrointestinal, malabsorptive leads to malnutrition and secondary conditions including osteoporosis. Calcium and phosphorus are two nutrients that play a role in bone health. The dietary habits of those with undiagnosed celiac disease has not been observed, but presents a critical piece in understanding the effects of the disease on bone health. Using nationwide data on dietary intake and bone health from What We Eat in America and NHANES 2009-2014, we evaluated the nutritional intake of adults with undiagnosed, untreated celiac disease as it relates to their bone health. One in 283 adults in this study had undiagnosed, untreated celiac disease. They consumed higher amounts of total calcium and phosphorus compared to adults without celiac disease. They additionally had lower bone mass in their femur and femoral neck. Thus, despite greater overall calcium and phosphorus intake, adults with undiagnosed, untreated celiac disease had poorer overall bone health than those without celiac disease.

Technical Abstract: Celiac disease is a gastrointestinal, malabsorptive leads to malnutrition and secondary conditions including osteoporosis. The dietary habits of those with untreated, undiagnosed celiac disease has not yet been observed, but presents a critical piece in understanding the effects of the disease on bone health. Cross-sectional data from What We Eat in America (WWEIA) and the National Health and Nutrition Examination Survey (NHANES) 2009-2014 cycles including self-reported dietary and supplement intake from 24-hour recalls, serologic indicators, and dual x-ray absorptiometry (DXA) scans were analyzed in adults testing positive for celiac disease to the tissue transglutaminase endomysial antibody assay (tTG-EMA). The prevalence of undiagnosed celiac disease in this study was 1 in 283. Positive serologic status for active celiac disease (n=49) predicted a 285.2 mg (95% CI: 78.0, 492.5) increase in daily calcium intake and a 136.5 mg (95% CI: -11.9, 284.8) increase in daily phosphorus intake compared to negative serologic status. The diets of this group were significantly denser in calcium (114.5 mg / 1,000 kcal (95% CI: 29.7, 199.4) and phosphorus (49.6 mg / 1,000 kcal (95% CI: 5.7, 93.5). Positive serologic status predicted a -0.1 g/cm^2 (95% CI: -0.2, -0.0) lower femur bone mineral density (BMD) and a -0.1 g/cm^2 (95% CI: -0.1, -0.0) lower femoral neck BMD. Despite greater overall calcium and phosphorus intake, adults who tested positive for active celiac disease (EMA+) had lower overall bone mass than adults without celiac disease.