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To evaluate the association of long-term gluten ingestion with the development of coronary heart disease, a cohort of 64,714 women and 45,303 men from the Health Professionals Follow-up Study were prospectively studied. They did not have a history of coronary disease, and completed a semi-quantitative food frequency questionnaire of 131 items in 1986, updated every four years until 2010.
During 26 years of follow-up covering 2,273,931 people per year, coronary heart disease developed in 2,431 women and 4,098 men. Fatal myocardial infarction occurred in 2,286 participants (540 women and 1,746 men) and non-fatal myocardial infarction in 4,243 participants (1,891 women and 2,352 men).
Among the individuals eligible for analysis (64,714 women and 45,303 men), the daily average intake of gluten ranged from 2.6 - 7.5 g for women and 3.3 - 10.0 g for men.
Intake of gluten correlated inversely with alcohol intake, smoking, total fat intake and ingestion of unprocessed red meat. Gluten intake was positively correlated with intake of whole and refined grain intake.
Participants who had an average intake of 2.6 to 3.3 g of gluten had a coronary heart disease incidence rate of 352 per 100,000 people, and those with a mean gluten intake of 7.5 to 10g had a lower rate of 277 events per 100,000 people. There was a difference of 75/100.000 fewer cases of coronary heart disease in those who had higher gluten intake.
The authors conclude that long-term dietary intake of gluten was not associated with the risk of coronary heart disease. However, the exclusion of gluten may result in reduced consumption of beneficial whole grains, which may affect cardiovascular risk. The promotion of gluten-free diets among people without celiac disease should not be encouraged.
Benjamin Lebwohl, Yin Cao, Geng Zong, Frank B Hu, Peter H R Green, Alfred I Neugut, Eric B Rimm, Laura Sampson, Lauren W Dougherty, Edward Giovannucci, Walter C Willett, Qi Sun, Andrew T Cha. Long term gluten consumption in adults without celiac disease and risk of coronary heart disease: prospective cohort study. BMJ 2017;357:j1892