Celiac disease risk higher for children in Northern Alberta: Study
Children with celiac disease may be at an even higher risk for poor bone health if living in northern Alberta, says a study out of the University of Alberta.
Diana Mager, assistant professor of Clinical Science with the department of Agriculture, Food and Nutritional Science, says the lack of sun exposure during long, dark winters, paired with a lack of essential vitamins, can lead to a heightened risk of low bone mineral density in the formative bone-building childhood years.
Celiac disease is an autoimmune disease causing an intolerance to gluten which then leads to various other problems.
"Gluten is found in food products like wheat, barley and rye, and when I say they react to it, they get gastrointestinal damage in response to it," explained Mager.
"It's not a full-blown allergy like you might think of peanut allergies, but it's an intolerance to the gluten molecule that makes their gastrointestinal tract very sick and causes a lot of inflammatory changes.
"As a result, when children or adults with this disease eat gluten containing foods, they get a very damaged gastrointestinal tract and malabsorb nutrients that are important to bone health, like vitamins D and K and calcium, because the damage can be so severe that it can interfere with the normal absorption of food from the diet."
While people can be diagnosed at any point throughout their lives, Mager's study focused on 43 children between the ages of three and 17 with the disease.
"Some kids are diagnosed in infancy and others aren't diagnosed until they're 85," said Mager. "More recently, there have been better screening tests that have blood tests that help screen for the disorder a little bit better, so people have been finding out a bit sooner."
The tests are costly, so they are not performed as a regular part of checkups. But because of the increase in celiac diagnoses, the rates are estimated at one in 100 people may have it, though not everyone may be aware.
"About 50% of people with celiac disease don't actually have gastrointestinal symptoms," said Mager. "The other half do. They can have symptoms that range from lots of diarrhea when they eat gluten to bloating and constipation with abdominal pain. The other half don't really show a lot of specific symptoms. They might have problems with iron deficiency and anemia, they probably will have poor bone health because that's a silent complication of it, and they might have some general aches and pains in other parts of their bodies, but not anything that you can say is specific to the gastrointestinal tract."
Where the lack of sun factors into the equation is in regards to Vitamin D. An essential element to bone growth and overall health, Vitamin D is synthesized interaction between UV rays from the sun and specific cells in the skin.
"Because we have decreased sunlight exposure, especially in northern Alberta during the winter months, that doesn't happen. The UV intensity is much lower," said Mager.
"And in the summertime when the UV exposure is much better, we all need to wear sunblock, because sunblock is important in reducing the risk of skin cancer."
To supplement Vitamin D intake, Mager recommends eating a diet rich in D, and avoiding going straight for liquid forms of the vitamin, adding that this goes for all Albertans, not just celiac sufferers.
"The first, best choice is to try and eat Vitamin D containing foods, and the main sources of that are cow's milk and Vitamin D fortified dairy products and things like salmon and fatty fish," said Mager.
Dairy products with Vitamin D fortification will be labelled, something people should specifically look for.
"Around three servings of dairy products a day for kids between the ages of nine and 18 is what's recommended, and it's really critical during childhood and adolescence to get enough Vitamin D because that's the period in the life cycle when we're building our peak bone body mass," explained Mager.
In addition to the Vitamin D rich diet, Mager preaches the benefits of weight-bearing exercises for children, saying the also help to build good bone health.
"It is healthy for children to play outside," she explained. "Weight-bearing activity and sports are really important for kids to build healthy bones, so make sure that children have the opportunity to play outside in the summer, not only for the Vitamin D, but for the actual physical activity."