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Gluten-free diet not recommended for people without coeliac disease

Restricting gluten may lead to low intake of 'heart healthy' whole grains

Ingrid Torjesen

Wednesday, 03 May 2017

Long-term dietary intake of gluten among people without coeliac disease is not associated with risk of coronary heart disease - and restricting gluten may result in a low intake of whole grains, which are associated with cardiovascular benefits, a study* published by The BMJ shows.

The researchers said that promoting gluten-free diets among people without coeliac disease should not be encouraged.

Dietary gluten triggers inflammation and intestinal damage in people with coeliac disease - and is associated with an increased risk of coronary heart disease, which is reduced after treatment with a gluten-free diet. However, avoidance of gluten among people without coeliac disease has also increased in recent years, because of a belief that gluten can have harmful health effects.

US-based researchers examined the association of long-term intake of gluten with the development of coronary heart disease in 64,714 female and 45,303 male US health professionals with no history of coronary heart disease. Participants completed a detailed food questionnaire in 1986 that was updated every four years through to 2010.

Consumption of gluten and development of coronary heart disease was monitored over this 26-year period. During this 26-year period, people with a gluten intake in the lowest fifth had an incidence of coronary heart disease of 352 per 100,000 person years, and those with the highest fifth of gluten intake had a rate of 277 events per 100,000 person years. After adjusting for known risk factors, no significant association between estimated gluten intake and the risk of subsequent overall coronary heart disease was found.

However, further analyses suggest that restricting dietary gluten may result in a low intake of whole grains, which are associated with lower cardiovascular risk.

The researchers concluded that their findings "do not support the promotion of a gluten-restricted diet with a goal of reducing coronary heart disease risk". "Promotion of gluten-free diets for the purpose of coronary heart disease prevention among asymptomatic people without coeliac disease should not be recommended," they said.

* Lebwohl B, Cao Y, Zong G, et al. Long term gluten consumption in adults without celiac disease and risk of coronary heart disease: prospective cohort study. BMJ 2017;357:j1892. DOI: 10.1136/bmj.j1892

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