Years ago, a bread company boasted that its product “builds strong bodies 12 ways.” But if you’ve got a gluten problem, bread may actually be destroying your body, not building it. In particular, it may be weakening your bones. And unless you stop eating gluten-containing foods (made from wheat, barley and rye), the deconstruction of your bones may continue until you suffer debilitating osteoporosis.
Looking back on my own experience with celiac (an autoimmune reaction to gluten), I can remember several medical misfortunes that should have indicated to an alert healthcare practitioner that I was suffering a health problem that needed investigation. For example, in elementary school, while playing baseball, I broke a bone in my hand while fielding a relatively slow ground ball. The ball plopped into my glove and, as soon as it did, I felt a painful pop.
After the swelling refused to go down over the course of a week, an X-ray revealed the break. It was such a freakish injury that I now realize (with the benefit of 20-20 hindsight) that someone should have asked why that bone was so fragile. Instead, my hand was put in a soft cast, no questions asked, until the bone healed.
Gluten Demineralizes Bones
Researchers aren’t precisely sure how gluten weakens bones. For some, this weakening may take place when gluten-linked damage to the digestive tract restricts the absorption of calcium. Without adequate calcium coming in via the intestines, the body, which is constantly remodeling bone tissue, runs out of the material needed to strengthen new bone growth. The body also may not be able to absorb and use vitamin D or vitamin K sufficiently. Both vitamins are needed for the body to build reinforced bones.
When researchers at the University of Alberta in Canada studied 43 children with celiac ages 3 to 18 years, they found that they all tended to have weak bones. Consequently, the researchers recommended that children with gluten problems get more vitamins D and K in their meals along with eating a gluten-free diet. “Children with celiac disease are at risk for poor bone health, but by adding vitamins K and D to their diets, it can help reduce the risk of fractures and osteoporosis,” said Diana Mager, a professor of agricultural, food and nutritional science, and one of the researchers on the project.
Both of these vitamins can be consumed in supplements. (If you are on blood thinners, consult your health practitioner before taking vitamin K supplements.) Foods rich in vitamin D include fish, fish oil and fortified dairy products. Your skin also makes vitamin D from sun exposure. (In Northern states, the sun during the winter is considered to be too weak for this effect.) Vitamin K is found in vegetables like kale, spinach, turnip greens and collards.
Aside from restricting vitamin and mineral absorption, other research indicates that celiac may cause the body to attack bone tissue and damage bones directly. When researchers at the University of Edinburgh studied a protein called osteoprotegerin (OPG) in people with celiac, they found that in 20 percent of them the immune system was interfering with OPG and keeping it from functioning properly.
OPG regulates how fast the body breaks bone down and removes it. When the body’s reaction to gluten interferes with OPG, the body breaks down bone too quickly and allows it to weaken significantly. In these cases, says Stuart Ralston, a researcher at Edinburgh, “Testing for these antibodies (that attack OPG) could make a real and important difference to the lives of people with celiac disease by alerting us to the risk of osteoporosis and helping us find the correct treatment for them.”
Exercise is important for keeping bones strong in people with celiac as well as for everyone concerned with bone health. As Mager points out, “Enjoying activities such as walking and running outdoors when there is more sunshine is a great way to contribute to healthy bone.” The best bone-strengthening exercises are weight-bearing activities like strength training, walking, hiking, jogging, tennis and stair climbing. Swimming, however, where your body weight is supported by water, is not considered to be bone-strengthening.
When I was younger, aside from having fragile bones, I had other signs of inflammation in my body that should have called attention to my gluten problem. Instead, I had to wait until I was on the brink of dementia (caused by celiac) to understand what gluten was doing to me. But I hope that the extra attention now being paid to celiac and gluten-sensitivity means that the next kid who snaps a bone from simply catching a ball will catch a break and not have to wait decades like I did to have his autoimmune problem properly recognized and treated.