In the Journals

Gluten-free diet could increase cardiovascular risk in people without celiac disease

Researchers found that long-term consumption of gluten was not associated with coronary heart disease risk, and recommended against a gluten-free diet for people without celiac disease as it could limit their intake of “heart-healthy” whole grains.

“Gluten is clearly harmful for people with celiac disease, but popular diet books, based on anecdotal and circumstantial evidence, have pushed the notion that a low-gluten diet is healthy for everyone,” Benjamin Lebwohl, MD, MS, assistant professor of medicine and epidemiology at Columbia University Medical Center, director of clinical research in the Celiac Disease Center at Columbia University, and gastroenterologist at NewYork-Presbyterian/Columbia University Medical Center, said in a press release. “Our findings show that gluten restriction has no benefit, at least in terms of heart health, for people without celiac disease. In fact, it may cause some harm if they follow a low-gluten diet that is particularly low in whole grains because those grains appear to have a protective effect against heart disease.”

Benjamin Lebwohl, MD, MS

Benjamin Lebwohl

While the prevalence of celiac disease (affecting about 1 in 100 Americans) and non-celiac gluten sensitivity is relatively low, about a third of Americans are attempting to reduce their gluten intake by some estimates, Lebwohl added.

Therefore, he and colleagues evaluated the link between gluten consumption and coronary heart disease using data on 64,714 women enrolled in the Nurses’ Health Study and 45,303 men enrolled in the Health Professionals Follow-up Study. All study participants had no history of coronary heart disease nor celiac disease, and completed food frequency questionnaires every 4 years from 1986 through 2010.

“We decided to look at heart disease because it’s a leading killer, and because it’s generally understood that heart health can be affected by diet,” Lebwohl said in the press release.

Overall, 2,431 women and 4,098 men developed coronary heart disease — defined as a fatal or non-fatal myocardial infarction — over 26 years of follow-up. Participants in the lowest fifth of gluten consumption had a coronary heart disease incidence rate of 352 per 100,000 person-years, while those in the highest fifth had an incidence rate of 277 per 100,000 person-years. Adjusted analysis showed there was no significant association between gluten intake and coronary heart disease.

“Even those with the lowest amount of gluten consumption experienced the same rate of heart disease as those who were consuming the most gluten,” Andrew T. Chan, MD, MPH, gastroenterologist and chief of the Clinical and Translational Epidemiology Unit in the Massachusetts General Hospital division of gastroenterology, and associate professor of medicine at Harvard Medical School, said in the press release.

Andrew T. Chan, MD, MPH

Andrew T. Chan

Additional analyses suggested that avoiding gluten could also limit consumption of whole grains, which have been linked to a lower cardiovascular risk.

“Based on our data, recommending a low-gluten diet solely for the promotion of hearth health does not appear warranted,” Chan said.

The investigators plan to further study the effect of gluten consumption on other health outcomes like cancer and autoimmune disease, according to the press release. – by Adam Leitenberger

Disclosures: The researchers report no relevant financial disclosures.

Researchers found that long-term consumption of gluten was not associated with coronary heart disease risk, and recommended against a gluten-free diet for people without celiac disease as it could limit their intake of “heart-healthy” whole grains.

“Gluten is clearly harmful for people with celiac disease, but popular diet books, based on anecdotal and circumstantial evidence, have pushed the notion that a low-gluten diet is healthy for everyone,” Benjamin Lebwohl, MD, MS, assistant professor of medicine and epidemiology at Columbia University Medical Center, director of clinical research in the Celiac Disease Center at Columbia University, and gastroenterologist at NewYork-Presbyterian/Columbia University Medical Center, said in a press release. “Our findings show that gluten restriction has no benefit, at least in terms of heart health, for people without celiac disease. In fact, it may cause some harm if they follow a low-gluten diet that is particularly low in whole grains because those grains appear to have a protective effect against heart disease.”

Benjamin Lebwohl, MD, MS

Benjamin Lebwohl

While the prevalence of celiac disease (affecting about 1 in 100 Americans) and non-celiac gluten sensitivity is relatively low, about a third of Americans are attempting to reduce their gluten intake by some estimates, Lebwohl added.

Therefore, he and colleagues evaluated the link between gluten consumption and coronary heart disease using data on 64,714 women enrolled in the Nurses’ Health Study and 45,303 men enrolled in the Health Professionals Follow-up Study. All study participants had no history of coronary heart disease nor celiac disease, and completed food frequency questionnaires every 4 years from 1986 through 2010.

“We decided to look at heart disease because it’s a leading killer, and because it’s generally understood that heart health can be affected by diet,” Lebwohl said in the press release.

Overall, 2,431 women and 4,098 men developed coronary heart disease — defined as a fatal or non-fatal myocardial infarction — over 26 years of follow-up. Participants in the lowest fifth of gluten consumption had a coronary heart disease incidence rate of 352 per 100,000 person-years, while those in the highest fifth had an incidence rate of 277 per 100,000 person-years. Adjusted analysis showed there was no significant association between gluten intake and coronary heart disease.

“Even those with the lowest amount of gluten consumption experienced the same rate of heart disease as those who were consuming the most gluten,” Andrew T. Chan, MD, MPH, gastroenterologist and chief of the Clinical and Translational Epidemiology Unit in the Massachusetts General Hospital division of gastroenterology, and associate professor of medicine at Harvard Medical School, said in the press release.

Andrew T. Chan, MD, MPH

Andrew T. Chan

Additional analyses suggested that avoiding gluten could also limit consumption of whole grains, which have been linked to a lower cardiovascular risk.

“Based on our data, recommending a low-gluten diet solely for the promotion of hearth health does not appear warranted,” Chan said.

The investigators plan to further study the effect of gluten consumption on other health outcomes like cancer and autoimmune disease, according to the press release. – by Adam Leitenberger

Disclosures: The researchers report no relevant financial disclosures.