Gluten-free diet is not recommended for people without celiac diseaseBMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2135 (Published 03 May 2017) Cite this as: BMJ 2017;357:j2135
Gluten is not associated with a risk of coronary heart disease in people without celiac disease—and restricting gluten may result in a low intake of whole grains, which are associated with cardiovascular benefits, a study in The BMJ has found.1
The researchers said that promoting gluten-free diets among people without celiac disease should not be encouraged.
The number of people without celiac disease who avoid gluten has increased in recent years, the researchers said, partly because they think that gluten can have harmful health effects. But no long term studies have assessed the relation between dietary gluten and the risk of chronic conditions such as coronary heart disease in people without celiac disease.
A team of US based researchers decided to tackle this by analysing data on 64 714 female and 45 303 male US health professionals with no history of coronary heart disease who completed a detailed food questionnaire in 1986 that was updated every four years until 2010.
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 00 person years. After adjusting for known risk factors, no significant association was found between estimated gluten intake and the risk of subsequent overall coronary heart disease.
In contrast, after additional adjustment for intake of refined grains the estimated gluten consumption was associated with a lower risk of coronary heart disease (multivariate hazard ratio 0.85 (95% confidence interval 0.77 to 0.93); P for trend=0.002).
The authors noted that, because this was an observational study, no firm conclusions could be drawn about cause and effect. Other limitations included the fact that the researchers did not ask about consumption of gluten-free foods or whether participants adhered to a gluten-free diet.
Nevertheless, they concluded that their findings “do not support the promotion of a gluten restricted diet with a goal of reducing coronary heart disease risk.” And they warned that “promotion of gluten-free diets for the purpose of coronary heart disease prevention among asymptomatic people without celiac disease should not be recommended.”