Celiac.com 11/22/2012 - Cardiovascular disease has many causes, and can be influenced by so many factors. It also happens to be the main cause of death in developed countries.

With regard to celiac disease and cardiovascular disease, there are two conflicting schools of thought. The first suggests that the gluten-free diet might help people with celiac disease to reduce the risk of developing cardiovascular disease. The second suggest the opposite: that a gluten-free diet may leave people with celiac disease at greater risk of developing cardiovascular disease. So far, the research has provided conflicting data that offer no clear answers.

Photo: CC--PranaA group of researchers recently tried to figure out if a gluten-free diet protects people with celiac disease against the development of cardiovascular disease, or weather it increases their risk.

The research team included Lorenzo Norsa, Raanan Shamir, and Noam Zevit, who are affiliated with the Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children’s Medical Center of Israel at Clalit Health Services in Petach Tikva, Israel, with the Sackler Faculty of Medicine at Tel-Aviv University in Tel Aviv, Israel, and with the Department of Pediatrics at San Paolo Hospital and University of Milan in Milan, Italy.

The idea that a gluten-free diet may protect celiacs against cardiovascular disease hinges on the fact that eating gluten-free reduces intestinal inflammation and improves intestinal absorption.

This hypothesis argues that the reduction in inflammation is important because a number of studies over the past decade have shown that a large percentage of people with acute coronary syndrome show signs of increased inflammation.

Studies also show that several clinical conditions that are accompanied by persistent low grade of inflammation, such as autoimmune disorders, may result in a higher risk of cardiovascular problems.

Also, researchers note that, from a nutritional point of view, improving nutritional uptake may help lipid levels return to normal, and to increase HDL-C. Better nutritional uptake may also lead to an increase in soluble vitamin absorption, which may help to lower homocysteine levels in the blood.

As such, supporters of this hypothesis argue that, by helping to reduce intestinal inflammation, and to increase nutritional absorption, a gluten-free diet may thus lower the risk of cardiovascular disease in people with celiac disease.

For the most part, studies suggesting that a gluten-free diet may increase the risk of cardiovascular disease tend to hinge on the idea that an unguided gluten-free diet may be more likely to be unbalanced, and to include higher fat intake, which could increase risk factors for cardiovascular disease.

Supporters of this hypothesis point to a recent study that suggests that consuming saturated fatty acids increases the LDL-C concentration in plasma and has therefore been suggested to increase the risk of ischemic heart disease (IHD), or myocardial ischaemia, which is a type of heart disease characterized by reduced blood supply to the heart muscle.

Furthermore, studies have shown that a gluten-free diet can increase weight and percentage of fat, which may reveal an additional risk factor for cardiovascular disease in developed countries, where the incidence of overweight and obesity are rising, both in the general population, and in celiac disease patients.

Unfortunately, recently published review of the research team's available evidence on the relationship between celiac disease, a gluten-free diet, and cardiovascular disease and its risk factors does little to provide a clear answer one way or the other.

In the face of conflicting data regarding gluten-free diet and cardiovascular disease, the takeaway seems to be that it is important that people with celiac disease follow a gluten-free diet that is well-balanced, and not too high in saturated fat; a conclusion that many would likely find to be good, common sense.

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