Long-term consumption of gluten is not associated with coronary heart disease in adults without celiac disease, according to a study published in the BMJ.
Andrew T. Chan, MD, MPH, from Massachusetts General Hospital and Harvard Medical School, and colleagues conducted a prospective cohort study including 64,714 women from the Nurses’ Health Study and 45,303 men in the Health Professionals Follow-up Study without a history of coronary heart disease. The participants completed a 131-item semiquantitative food frequency questionnaire in 1986 that was updated every 4 years through 2010.
A total of 2,431 women and 4,098 men developed coronary heart disease during 26 years of follow-up (2,273,931 person years).
Compared with participants in the lowest fifth of gluten intake who had a coronary heart disease incidence rate of 352 per 100,000 person years, participants in the highest fifth of gluten intake had an incidence rate of 277 events per 100,000 person years, resulting in an unadjusted rate difference of 75 fewer cases of coronary heart disease per 100,000 person years. Participants in the highest fifth of gluten intake had a multivariate hazard ratio for coronary heart disease of 0.95 after adjustments for known risk factors.
After adjustments for intake of whole grains, the multivariate hazard ratio was 1.00. However, after adjustments for intake of refined grains, estimated gluten consumption was associated with a lower risk of coronary heart disease (multivariate hazard ratio, 0.85).
“Although people with and without celiac disease may avoid gluten owing to a symptomatic response to this dietary protein, these findings do not support the promotion of a gluten restricted diet with a goal of reducing coronary heart disease risk,” the study authors wrote.
“In addition, the avoidance of dietary gluten may result in a low intake of whole grains, which are associated with cardiovascular benefits. The promotion of gluten-free diets for the purpose of coronary heart disease prevention among asymptomatic people without celiac disease should not be recommended.”
- 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. doi:10.1136/bmj.j1892