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Gluten-free diet not recommended for people without celiac disease

May 02, 2017

Long term dietary intake of gluten among people without celiac 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, finds a study published by The BMJ today.

As such, the researchers say the promotion of gluten-free diets among people without celiac disease should not be encouraged.

Dietary gluten triggers inflammation and intestinal damage in people with celiac disease - and is associated with an increased risk of coronary heart disease, which is reduced after treatment with a gluten-free diet.

But avoidance of gluten among people without celiac disease has also increased in recent years, partly owing to the belief that gluten can have harmful health effects.

Yet despite the rising trend in low gluten or gluten free diets, no long term studies have assessed the relation of dietary gluten with the risk of chronic conditions such as coronary heart disease in people without celiac disease.

So a team of US based researchers decided to examine the association of long term intake of gluten with the development of coronary heart disease.

They analysed 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 through to 2010.

Consumption of gluten and development of coronary heart disease was monitored over this 26-year period. 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 authors point out that this is an observational study, so no firm conclusions can be drawn about cause and effect, and they outline some limitations that could have introduced bias.

Nevertheless, they conclude that their findings "do not support the promotion of a gluten restricted diet with a goal of reducing coronary heart disease risk."

And they warn that "promotion of gluten-free diets for the purpose of coronary heart disease prevention among asymptomatic people without celiac disease should not be recommended."
-end-


BMJ

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