Should the gluten-free craze come to an end? Study thinks so

By Emma Jane Cash

- Last updated on GMT

© iStock
© iStock
Gluten-free diets should not be encouraged for those without coeliac disease, as restricting gluten may result in low intake of beneficial nutrients found in whole grains, say researchers.

A 24-year long study published in The BMJ this week has said people without coeliac disease shouldn't be cutting out gluten from their diets as it could mean they are missing out on "heart healthy"​ whole grains.

The researchers warn that "promotion of gluten-free diets for the purpose of coronary heart disease prevention among asymptomatic people without coeliac disease should not be recommended".

The trend of gluten-free or low gluten diets has increased recently due to beliefs that gluten can cause risk of chronic conditions such as coronary heart disease.

A growing trend

Gluten is a storage protein found in wheat, barley, rye and oats, and can cause inflammation and intestinal damage to those with coeliac disease.

Sufferers of coeliac are also at a higher risk of coronary heart disease, which can be reduced with a gluten-free diet.

Recently, growing worry has formed that gluten can have detrimental health effects including heart disease, obesity, metabolic syndrome and neuropsychiatric symptoms, regardless of coeliac status.

It is as a result of these concerns that the trend of gluten-free has become so popular.

According to the National Health and Nutrition Examination Survey (NHANES), the adoption of a gluten-free diet by non-coeliac sufferers has risen more than threefold from 0.52% of people to 1.69%, since 2009-10 to 2013-14.

In 2013, 30% of US adults said they were trying to minimise, or cut out completely, their gluten intake, despite the much higher prices of gluten-free alternative foods.

Say yes to gluten

The study found that for mean daily estimated intake of gluten at baseline was 7.5g for women and 10g for men in the highest fifth and 2.6g for women and 3.3g for men in the lowest fifth.

it was found that gluten intake correlated inversely with alcohol intake, smoking, total fat intake and unprocessed red meat intake.

However, gluten intake correlated positively with whole grain intake and refined grain intake.

Coronary heart disease was diagnosed for 6,529 participants, fatal myocardial infarction developed in 2,286 participants and non-fatal myocardial infarction developed in 4,243 participants.

In the lowest fifth of gluten intake, coronary heart disease was measured at an incident rate of 352 per 100,000 person years, whereas in the highest fifth the incident rate was 277 per 100,000 person years.

No significant association between estimated gluten intake and either fatal myocardial infarction or non-fatal myocardial infarction was found.

The lack of association was the same for gluten intake and coronary heart disease risk, for both men and women.

The study concluded that avoiding gluten had no effect on risk of coronary heart disease but did mean participants may be avoiding whole grains which have cardiovascular benefits.

The study

The US based researchers monitored just over 110,000 healthy participants with food questionnaires every four years from 1986 to 2010.

Participants were excluded if they had diagnosis of myocardial infarction, angina, stroke or coronary artery bypass graft surgery, or cancer.

Those with a diagnosis of coeliac were also excluded.

The food questionnaires asked participants about their food items and portion sizes. The researchers then used the Harvard T.H. Chan School of Public Health nutrient database to calculate the amount of gluten consumed.

Any deaths occurring throughout the study were examined through hospital records and autopsy reports.

As it was an observational study the researchers say no firm conclusions can be drawn about cause and effect.  

However, the researchers did conclude that their study results “do not support the promotion of a gluten restricted diet with a goal of reducing coronary heart disease risk”.

Source: The BMJ

Published online ahead of print: doi.org/10.1136/bmj.j1892

“Long term gluten consumption in adults without celiac disease and risk of coronary heart disease: prospective cohort study”

Authors : A.T. Chan, et al.

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3 comments

Hygiene consultation

Posted by Ricci Divito,

Hi. Without gluten free I would eventually kill my self. I am very grateful that companies are trying harder to provide this food for sufferes. My only complaint is the price of goods with no discount for people who suffer.

Best regards

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Misleading

Posted by Mary S,

I understand that the unnecessary practice of cutting out any ingredient from the diet can pose more harm than good but this article is very misleading as the writer, concentrates on the false belief that only those with Celiac disease need to cut out gluten when in actual fact there are millions of people around the globe who are genuinely Allergic to Wheat and Gluten and more who are genuinely Intolerant. To deny that Allergy and Intolerance is a real thing is very dangerous and can put lives at risk. So let's not start killing people with poorly researched articles.

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What about gluten free oats?

Posted by Paul R,

The growth in GF market has happened far more significantly in Gluten free oat products. GF oats can also offer genuine health claims: 3% betaglucan and other soluble fibres to reduce type 2 diabetes including an EFSA backed cholesterol reduction at 3g per day of betaglucan.
Rice and potato starch products are not very exciting health or taste wise and people want a direct replacement that GF oats do give. So GF oats are properly healthy AND gluten free.
The difficulty is that many oat mills are not safe or reliable if they are ordinary mills or have poor controls and so specialist dedicated gluten free oat mills with full farmer knowledge and supply chain experience are essential.
We still see growth rate of 110% per year in GF oats. Note that GF oats are whole grain cereals too!

.. there is a rising tide of bashing GF from journalists but it's not clear where this is coming from! A 'Whole grain' lobby?

Many people would be seriously ill and dying young without GF food.

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