People with digestive diseases, such as ulcerative colitis and Crohn’s disease, are especially susceptible to osteoporosis and bone fractures, due in part to nutrient deficiencies caused by malabsorption and medication side effects. A new study found that people with good vitamin D status early in the course of their disease had higher bone density and a greater likelihood of increasing bone density over time.
Healthy vitamin D levels predict healthy bones
The study, published in the American Journal of Gastroenterology, included 101 people who had recently been diagnosed with inflammatory bowel disease (IBD). Vitamin D levels in the blood and bone mineral density were measured at the beginning of the study, and bone density measurements were repeated approximately two years later.
Only 22% of the people had optimal vitamin D levels at the beginning of the study. Higher vitamin D levels were associated with higher bone density in the spine, hip, and total body. People with better vitamin D status were more likely than others to have an increase in bone mineral density over the course of the study.
The link between IBD and bone density
IBD is a group of inflammatory conditions affecting the large and small intestines. Ulcerative colitis and Crohn’s disease are the most common types, both of which are believed to be autoimmune (when the immune system attacks the body’s cells) in nature. People with IBD usually experience chronic abdominal pain and diarrhea, often with bleeding and mucus.
In people with IBD, inflammation in the bowel wall and diarrhea compromise absorption and result in nutrient deficiencies. In addition, corticosteroid medicines that are used to treat IBD can interfere with calcium absorption and metabolism. Maintaining healthy bone density requires the integrated work of a number of nutrients, including calcium and vitamin D, so it is not surprising that people with IBD have high rates of low bone density (osteopenia and osteoporosis).
Improving vitamin D status
Vitamin D is made in the body through a series of chemical reactions that begins in sun-exposed skin. Modern lifestyles with limited outdoor time and widespread use of sunscreens have led to increasing rates of vitamin D deficiency in the general population, and these rates are even higher in the elderly and people with chronic disease.
“Poorer vitamin D correlates with lower baseline bone mineral density and better vitamin D status is correlated with a gain in total bone mineral density. Early optimization of vitamin D may play an important role in preventing IBD-related bone disease,” said the researchers from the University of Manitoba in Winnipeg. Small amounts of vitamin D are found in eggs and fish, as well as fortified dairy foods and some dairy substitutes, but the authors noted that their findings suggest that adding vitamin D supplements is warranted for most people with IBD.
Maureen Williams, ND