A nurse is teaching a group of clients about dietary needs to prevent osteoporosis. Which of the following dietary choices should the nurse recommend as having the highest calcium content?

Choice A reason: Dietary restrictions will not eventually allow the intake of gluten to resume. Gluten is a protein found in wheat, barley, rye, and some oats. It causes damage to the small intestine in people with celiac disease. The only treatment for celiac disease is a lifelong gluten-free diet.

Choice B reason: This condition may cause secondary lactose intolerance. Lactose is a sugar found in milk and dairy products. It is broken down by an enzyme called lactase in the small intestine. People with celiac disease may have reduced levels of lactase due to the damage to the small intestine caused by gluten. This can lead to lactose intolerance, which is the inability to digest lactose properly. Symptoms of lactose intolerance include bloating, gas, diarrhea, and abdominal pain after consuming dairy products.

Choice C reason: Nutritional therapy for this condition does not include limiting proteins and calories. People with celiac disease need adequate amounts of proteins and calories to maintain their health and prevent malnutrition. They also need to ensure that they get enough vitamins, minerals, and fiber from gluten-free sources.

Choice D reason: A normal diet cannot resume after a period of remission. Celiac disease is a chronic autoimmune disorder that does not have a cure. Even if the symptoms improve or disappear, the damage to the small intestine can still occur if gluten is consumed. Therefore, a strict gluten-free diet must be followed for life.

Choice A reason: BMI of 18.5 is at the lower end of the normal range (18.5-24.9), but it does not indicate severe malnutrition.

Choice B reason: Potassium 3.7 mEq/L is within the normal range (3.5-5.0), and it does not indicate electrolyte imbalance due to malnutrition.

Choice C reason: Phosphorus 3.5 mg/dL is within the normal range (2.5-4.5), and it does not indicate mineral deficiency due to malnutrition.

Choice D reason: Albumin 2.5 g/dL is below the normal range (3.5-5.0), and it indicates protein deficiency due to malnutrition. Albumin is a major protein in blood plasma that helps maintain fluid balance, transport hormones, and fight infections. Low albumin levels can cause edema, weakness, infection, and poor wound healing.