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Is a Gluten-free Diet Bad for Your Heart?

Does eating a gluten-free diet increase risk for heart disease? Photo: CC--Paul Cross 05/08/2017 - Do non-celiacs who eat a gluten-free diet face a greater risk of developing coronary heart disease?

To shed some light on this question, a team of researchers recently set out to assess levels of long-term term gluten consumption in connection with the development of coronary heart disease. The research team included Benjamin Lebwohl, Yin Cao, instructor, Geng Zong, Frank B Hu, Peter H R Green, Alfred I Neugut, Eric B Rimm, Laura Sampson, Lauren W Dougherty, Edward Giovannucci, Walter C Willett, Qi Sun, and Andrew T Chan.

They are variously affiliated with the Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA; the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; the Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; the Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA; and the Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

For their prospective cohort study, the team looked at 64,714 women in the Nurses’ Health Study and 45,303 men in the Health Professionals Follow-up Study. None of the subjects had any history of coronary heart disease, and all completed a 131 item semiquantitative food frequency questionnaire in 1986 that was updated every four years through 2010.

The researchers estimated gluten consumption based on the results of the food frequency questionnaires. Their study looked for patients who developed coronary heart disease, specifically fatal or non-fatal myocardial infarction. The team’s study data covered 26 years of follow-up, totaling 2,273,931 person years, 2431 women and 4098 men developed coronary heart disease.

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Participants in the lowest fifth of gluten intake had 352 incidences of coronary heart disease per 100,000 person years, while those in the highest fifth had a rate of 277 events per 100,000 person years. This equates to 75 fewer cases of coronary heart disease per 100,000 person years.

After adjusting for known risk factors, the researchers noted that patients in the highest fifth of estimated gluten intake had a multivariable hazard ratio for coronary heart disease of 0.95 (95% confidence interval 0.88 to 1.02; P for trend=0.29).

After further adjusting for intake of whole grains, and leaving the remaining variance of gluten corresponding to refined grains, the multivariate hazard ratio was 1.00 (0.92 to 1.09; P for trend=0.77).

In contrast, after additional adjustment for intake of refined grains (leaving the variance of gluten intake correlating with whole grain intake), estimated gluten consumption was associated with a lower risk of coronary heart disease (multivariate hazard ratio 0.85, 0.77 to 0.93; P for trend=0.002).

Long term dietary intake of gluten was not associated with risk of coronary heart disease. However, the researchers do stress the importance of dietary whole grains, and that their absence may increase the risk of cardiovascular disease. Because of this, the team discourages people without celiac disease, or some other medical reason, from adopting a gluten-free diet.

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6 Responses:

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said this on
16 May 2017 3:18:53 AM PDT
Well obviously if people do not eat whole grains they are going to get less B vitamins and other essential nutrients especially if they are vegetarians or don't eat much meat, this means that they should be aware of this and supplement. In the long run a diet lowish in carbs of any sort is much more healthy, especially with today's GMO grains.

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said this on
22 May 2017 10:38:01 PM PDT
There are several pseudo grains that are rich in B. Quinoa, millet, Teff, Buckwheat, and others.

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said this on
16 May 2017 4:07:47 AM PDT
I was diagnosed with celiac at age 42 and prior to that ate a wide variety of whole grains. I now eat grains without the gluten protein that causes the irritation to my system and my cholesterol numbers which were already low, dropped again. Both sides of my family have a history of HBP and coronary disease but until me, were never tested for gluten intolerance. I feel your article would scare someone newly diagnosed into thinking there are no whole grains for them. Oats have been shown to be heart-friendly as are MANY other grains that were in use before wheat & barley were widely cultivated. Please do a bit more research!

CJ Russell
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said this on
16 May 2017 6:13:14 AM PDT
Interesting. I am confused by the accompanying photo. What do Valentine candies have to do with the subject matter? Don't tell me it's because of the shape: Valentines look nothing like hearts!

Gavin Ayling
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said this on
16 May 2017 6:16:28 AM PDT
As a coeliac (sorry, celiac) I am really grateful that non-celiacs are eating gluten free. This increases the market in a way that encourages manufacturers. It's a double-edged sword because some restaurants (e.g. Dominos in the USA) are providing contaminated gluten free food which - let's be honest - is perfectly edible for a fad-diet adherent. And wheat-based whole grains are not the only choice, so if there was a correlation between eating gluten and heart disease only because of whole grains, would not a Cheerios eater, or a brown-rice eater gain the same benefits?

Edward Epifani
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said this on
17 May 2017 10:52:21 AM PDT
Well, interesting. The fundamental issue is are people eating more refined gluten free grains, which are lower in nutrients, highly glycemic, and likely to stack on the pounds, leading to higher CV risk. As a Type 1 diabetic, refined GF flours are a disaster.

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