The Gluten-Free Diet and Cardiovascular Risk?


Why is it imperative that people diagnosed with Celiac Disease avoid all gluten? One key reason – eating gluten foods multiples their risk of serious heart disease. For celiac sufferers any food with gluten produces severe intestinal inflammation and, in turn, antibodies that disable enzymes throughout the vascular system (transglutaminase). This chain of events causes damage in their cardiovascular system, intensifying their danger of severe heart disease, even without other risk factors such as smoking.

The inflammatory effect of gluten in Celiac Disease led researchers to infer that gluten might cause somewhat similar inflammatory problems in people who do not have this exact medical diagnosis, referred to as ‘non-celiac gluten sensitivities.’ As an unexpected result, “gluten-free” has become a hot marketing term on labels across a wide range of foods. But medical and scientific controversies continue to surround these speculations. Still, certain findings have reinforced purported concerns, and the development of a gluten-free food industry has convinced large numbers in the general population that they must eliminate gluten from their diets.

The over-arching belief has developed that gluten is “the culprit” for many varied symptoms and is just plain “bad.” We definitely agree that foods made with white flour-based products and the accompanying sugar plus the wrong fats, such as, cakes, cookies, pastries, donuts and more are unhealthy for multiple reasons beyond any possible gluten concerns. And thus eliminating these items from daily intake has actually been very beneficial for people who don’t have either celiac disease or even ‘non-celiac gluten sensitivity.’

But was an improvement experienced or observed due to eliminating gluten? Or was it the elimination of ill-advised oils, fats (such as, hydrogenated or partially hydrogenated) and refined sugars that improved their health? A new study suggests that low or no gluten intake in the absence of a medical diagnosis might not diminish, in fact have some association with a critical health concern — cardiovascular risk.

This research is based on two long-term studies that tracked diet, lifestyle and illness in 110,000 health professionals. The study populations, who had neither heart disease nor celiac when they started the research, were tracked for 26 years, from 1986 to 2012. The researchers calculated their gluten intake, and tracked whether each participant developed heart disease.

The research team, based at Harvard and at Columbia, compared how frequently people in the lowest 20% of gluten intake versus those with in the highest 20% developed fatal or non-fatal heart disease. They found that, in fact, the low-gluten fifth of the population was more likely to develop heart disease than the highest gluten consumers – a difference of 75 more heart disease cases per 100,000 people observed for a year. They further explored this database to eliminate the effect of other variables. For instance, those with high gluten intake had lower alcohol, total fat, and red meat intake, higher whole grain intake, and were less likely to smoke. They did a thorough analysis and evaluation of these potentially confounding factors.

One very surprising discovery: Once they removed the effects of other factors, the difference in risk between the low- and high-gluten consumers disappeared. Also unexpected — when they re-examined the data to eliminate the ill effects of refined grain along with the other complicating factors, but leaving in the effects of whole grain consumption, they discovered that people who consumed the most gluten were 15% less likely to get heart disease than low gluten consumers.

Why might that be? The researchers attribute the apparent protective effect of high gluten intake to the associated whole grain intake. Many studies have linked high whole grain consumption to lower risks of death from cardiovascular disease in addition to reduced mortality from cancer and from all causes. And we know that some of the known benefits of whole grains include increased glucose tolerance and insulin sensitivity, lowering of cholesterol and improvements in healthy intestinal bacteria populations.

Of course, if you do have celiac disease or have been medically diagnosed with another specific gluten sensitivity, you definitely should avoid gluten – while still making sure you include certain unprocessed, gluten-free unprocessed whole grains in your diet. But if you’re one of the people who have no medical diagnosis and are just shunning gluten because you’ve read or heard it’s “unhealthy,” we urge you to re-examine your dietary patterns and not leave your heart at risk by eliminating valuable whole grains. Based on solid science, Block Center clinicians will be happy to discuss with you multiple health benefits of whole, unprocessed cereal grains as one key element in your personalized nutritional plan to help you minimize cardiovascular and cancer concerns.

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