Optimising the management of bone disease for coeliac patients in a dietetic-led clinic

Martin, Kirsty J.; Woodall, Alison

dc.contributor.author	Martin, Kirsty J.	*
dc.contributor.author	Woodall, Alison	*
dc.date.accessioned	2016-06-15T11:52:33Z
dc.date.available	2016-06-15T11:52:33Z
dc.date.issued	2016-06
dc.identifier.citation	Martin, K. J., & Woodall, A. (2016). Optimising the management of bone disease for coeliac patients in a dietetic-led clinic. International Journal of Celiac Disease, 4(2), 48-54.
dc.identifier.issn	2334-3427	en
dc.identifier.doi	10.12691/ijcd-4-2-6
dc.identifier.uri	http://hdl.handle.net/10034/613200
dc.description.abstract	Coeliac disease (CD) is a chronic autoimmune inflammatory condition of the small bowel; the only treatment is lifelong adherence to a gluten free diet (GFD). Adherence to a GFD also minimises the risk of associated conditions such as osteoporosis in CD patients. The present study aimed to evaluate and optimise management of bone disease in CD patients in a dietetic-led clinic. This study was conducted in two parts: study 1 utilised retrospective data to evaluate management of bone disease with reference to British Society of Gastroenterology (BSG) guidelines in 229 CD patients. Based on the results from study 1, study 2 developed a tool to estimate dietary calcium intake in CD patients, which was then trialled on 50 patients. There were no significant differences between the population demographics for study 1 and study 2. 65% of patients had a diagnosis of osteopenia or osteoporosis, in a female predominant population (74.6%). Reported mean dietary calcium intake was over estimated at 1239.6mg/day (SD ± 377.1mg) in study 1 and corrected to 852mg/day (SD ± 264.57mg) using improved methodology (study 2) (p≤0.05). Understanding and compliance with dietary advice correlated positively with GFD (p≤0.001) but not osteoporosis or fracture risk. Overall patients attending the clinic did not meet the BSG recommended calcium intake. However, 30% of patients could meet the 2014 BSG target from oral diet alone. Utilising individual dietary prescriptions and targeted use of calcium supplementation maximised the opportunity to reduce risk of bone disease and improved compliance with BSG recommendations.
dc.language.iso	en	en
dc.publisher	Science and Education Publishing Co.
dc.relation.url	http://www.sciepub.com/journal/IJCD	en
dc.rights.uri	http://creativecommons.org/licenses/by-nc-nd/4.0/	en
dc.subject	calcium	en
dc.subject	coeliac disease	en
dc.subject	dietitian	en
dc.subject	gluten-free diet	en
dc.subject	oesteoporosis	en
dc.title	Optimising the management of bone disease for coeliac patients in a dietetic-led clinic	en
dc.type	Article	en
dc.identifier.eissn	2334-3486	en
dc.contributor.department	University Hospital Aintree and The Walton Centre NHS Foundation Trust; University of Chester
dc.identifier.journal	International Journal of Celiac Disease	en
dc.description.link	http://pubs.sciepub.com/ijcd/4/2/6/	en
dc.date.accepted	2016-05-09
or.grant.openaccess	Yes	en
rioxxterms.funder	unfunded	en
rioxxterms.identifier.project	unfunded	en
rioxxterms.version	AO	en
html.description.abstract	Coeliac disease (CD) is a chronic autoimmune inflammatory condition of the small bowel; the only treatment is lifelong adherence to a gluten free diet (GFD). Adherence to a GFD also minimises the risk of associated conditions such as osteoporosis in CD patients. The present study aimed to evaluate and optimise management of bone disease in CD patients in a dietetic-led clinic. This study was conducted in two parts: study 1 utilised retrospective data to evaluate management of bone disease with reference to British Society of Gastroenterology (BSG) guidelines in 229 CD patients. Based on the results from study 1, study 2 developed a tool to estimate dietary calcium intake in CD patients, which was then trialled on 50 patients. There were no significant differences between the population demographics for study 1 and study 2. 65% of patients had a diagnosis of osteopenia or osteoporosis, in a female predominant population (74.6%). Reported mean dietary calcium intake was over estimated at 1239.6mg/day (SD ± 377.1mg) in study 1 and corrected to 852mg/day (SD ± 264.57mg) using improved methodology (study 2) (p≤0.05). Understanding and compliance with dietary advice correlated positively with GFD (p≤0.001) but not osteoporosis or fracture risk. Overall patients attending the clinic did not meet the BSG recommended calcium intake. However, 30% of patients could meet the 2014 BSG target from oral diet alone. Utilising individual dietary prescriptions and targeted use of calcium supplementation maximised the opportunity to reduce risk of bone disease and improved compliance with BSG recommendations.