New York, NY (May 3, 2017)--A study of more than 100,000 men and women revealed that dietary gluten is not associated with heart disease risk in people without celiac disease. The findings also suggest that limiting whole grains as part of a low-gluten diet may increase the risk of heart disease in people who do not have celiac disease.
The study, led by researchers at Columbia University Medical Center and Massachusetts General Hospital/Harvard Medical School, was published online today in the British Medical Journal.
"Gluten is clearly harmful for people with celiac disease," said lead author Benjamin Lebwohl, MD, MS, assistant professor of medicine and epidemiology at CUMC, director of clinical research in the Celiac Disease Center at Columbia University and gastroenterologist at NewYork-Presbyterian/Columbia University Medical Center. "But popular diet books, based on anecdotal and circumstantial evidence, have pushed the notion that a low-gluten diet is healthy for everyone. 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."
Celiac disease is an autoimmune disorder where the ingestion of gluten, a protein found in wheat, rye, and barley, causes inflammation of the small intestine, preventing the absorption of nutrients. Over time, celiac disease can lead to other health issues, including heart disease, anemia, and osteoporosis. Celiac disease can be effectively treated with a gluten-free diet.
Celiac disease is estimated to affect about 1 in 100 Americans. Another segment of the population has a condition called non-celiac gluten sensitivity, in which gluten triggers some symptoms in the absence of celiac disease. However, estimates of the number of Americans with non-celiac gluten sensitivity vary widely. "Despite the relatively low prevalence of celiac disease and non-celiac gluten sensitivity, surveys suggest that about one-third of Americans are trying to cut down on gluten," says Dr. Lebwohl. "This certainly benefits companies that sell gluten-free products. But does it benefit the public? That is the question we wanted to answer."
To assess the effects of a low-gluten diet on heart health, Dr. Lebwohl and his colleagues analyzed diet and coronary heart disease data on 65,000 women in the Nurses Health Study and 45,000 men in the Health Professionals Follow-up Study, excluding anyone who had been diagnosed with celiac disease. Each participant filled out detailed diet questionnaires every four years, from 1986 to 2010. The participants were divided into five levels of estimated gluten consumption.
"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," said Dr. Lebwohl.
The researchers found that there was no association between gluten intake and risk of coronary heart disease, defined as fatal or non-fatal heart attacks. "Even those with the lowest amount of gluten consumption experienced the same rate of heart disease as those who were consuming the most gluten," said senior investigator Andrew 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, Harvard Medical School. "Based on our data, recommending a low-gluten diet solely for the promotion of hearth health does not appear warranted."
In subsequent studies, the researchers plan to look at the effect of gluten intake on other health outcomes, including cancer and autoimmune disease.
###
The study is titled, "Long-term Gluten Consumption in Adults without Celiac Disease and the Risk of Coronary Heart Disease: Prospective Cohort Study." The other contributors are: Yin Cao (Massachusetts General Hospital and Harvard Medical School, Boston, MA); Geng Zong (Harvard T. H. Chan School of Public Health, Boston, MA), Frank B. Hu (Harvard T. H. Chan School of Public Health, Brigham and Women's Hospital, Boston, MA, and Harvard Medical School); Peter H.R. Green (CUMC); Alfred I. Neugut (CUMC); Eric B. Rimm (Harvard T. H. Chan School of Public Health, Brigham and Women's Hospital, and Harvard Medical School); Laura Sampson (Harvard T. H. Chan School of Public Health), Lauren W. Dougherty Harvard T. H. Chan School of Public Health); Edward Giovannucci (Harvard T. H. Chan School of Public Health, Brigham and Women's Hospital, and Harvard Medical School); Walter C. Willett (Harvard T. H. Chan School of Public Health, Brigham and Women's Hospital, and Harvard Medical School); Qi Sun (Harvard T. H. Chan School of Public Health, Brigham and Women's Hospital, and Harvard Medical School).
The study was funded by grants the National Institutes of Health (K24 DK098311, UM1 CA186107, UM1 CA167552, R01 HL035464, R01 HL060712, R01 HL034594) and by an American Gastroenterological Association Foundation Research Scholar Award.
The authors declare no financial or other conflicts of interest.
Columbia University Medical Center provides international leadership in basic, preclinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest faculty medical practices in the Northeast. The campus that Columbia University Medical Center shares with its hospital partner, NewYork-Presbyterian, is now called the Columbia University Irving Medical Center. For more information, visit cumc.columbia.edu or columbiadoctors.org.
Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH Research Institute conducts the largest hospital-based research program in the nation, with an annual research budget of more than $800 million and major research centers in HIV/AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, genomic medicine, medical imaging, neurodegenerative disorders, regenerative medicine, reproductive biology, systems biology, photomedicine and transplantation biology. The MGH topped the 2015 Nature Index list of health care organizations publishing in leading scientific journals and earned the prestigious 2015 Foster G. McGaw Prize for Excellence in Community Service. In August 2016 the MGH was once again named to the Honor Roll in the U.S. News & World Report list of "America's Best Hospitals."
Journal
The BMJ