Think Twice About a Gluten-Free Diet

One piece of good news: A new study in the British Medical Journal reveals that for most people, eating gluten—a protein found in wheat, rye, and barley—is not, as some believe, linked to a higher risk of heart disease.

In fact, unless you have celiac disease, going gluten-free might actually harm your heart, reports Andrew Chan, M.D., associate professor of medicine at Harvard Medical School and one of the study’s authors.

“When you start to restrict gluten, you may start to restrict foods that are high in whole grains,” Chan says. “Whole grains are linked to better cardiovascular health outcomes.”

Celiac disease is an autoimmune condition affecting about 1 percent of people in the U.S., where gluten causes inflammation and damage in the intestine. Some research suggests that the disease may also increase inflammation throughout the body, possibly raising heart disease risk in people with celiac disease. But this study provides evidence that this is not the case for people who don’t have the condition.

The research team, from Harvard University and Columbia University, reviewed data on 64,714 women and 45,303 men without celiac disease who reported on their food habits every four years from 1986 through 2010.

In the study, the researchers found that people without celiac disease whose diets contained the most gluten were no more likely to have developed heart disease than those who ate the least gluten.

They also found that avoiding food with gluten was linked to eating fewer whole grains.

The results aren’t surprising, according to Alice Lichtenstein, a professor of nutrition science and policy at Tufts University who wasn’t involved with the study. She says there’s no good theoretical reason why eating foods with gluten would be related to heart disease in people without celiac.

Who Should Go Gluten-Free?

A gluten-free diet is a must for people diagnosed with celiac disease. But in recent years, the number of people without celiac disease following a gluten-free diet has grown considerably, with surveys suggesting that about 30 percent of Americans are trying to minimize or avoid gluten.

Some people who don’t have celiac disease do report gastrointestinal symptoms caused by gluten—a condition known as non-celiac gluten sensitivity, which scientists don’t fully understand. But there’s little evidence for the claims that gluten can cause obesity, joint pain, low energy, depression and migraines in people.

Chan says the results of the new study should make people without celiac disease think twice before going gluten-free.

“We want people to be cautious about taking on extreme diets without knowing what the full implications of those diets may be,” he says.

The Downside of a Gluten-Free Diet

It is concerning that people on a gluten-free diet may be eating fewer whole grains, says Lichtenstein—mainly because of whole grains’ high fiber content.

“Fiber is an under-consumed nutrient,” she says.

Also, she points out, gluten-free foods tend to have more saltsugar, and fat, and they’re often more expensive, than their gluten-containing counterparts.

“From a straight nutrition perspective, there doesn’t seem to be an advantage to choosing gluten-free products,” she says.

And going gluten-free can have another unintended consequence: increasing your intake of arsenic and other heavy metals. Cereals, crackers, pastas and other gluten-free products are often made with rice flour.

Consumer Reports’ food safety experts have found that rice and rice-based products can have concerning amounts of arsenic, and recommend minimizing your intake of them.

A recent study published in the journal Epidemiology showed that people on a gluten-free diet had twice the amount of arsenic and 70 percent more mercury in their urine than people who were not.

“This study provides strong evidence that consumers on a gluten-free diet are exposed to a much higher level of arsenic, as a result of eating products that typically contain rice flour,” says James Rogers, Ph.D., Director of Food Safety and Research at Consumer Reports. “This new data, in addition to Consumer Reports’ own investigations into rice and arsenic, indicates that consumers should consider trading rice for alternative grains at least some of the time.”

Get Your Grains

Everyone needs to eat whole grains: 3 to 4 ounces per day for most adults.

And if you’re following a gluten-free diet, pay special attention to including whole grains in your diet, Lichtenstein says.

Double check the nutrition label, she says. “Whatever the product is that you choose,” she says, “make sure that it’s made with the whole grain and not the refined grain.”

Ideally, she says, the whole grain will be the first on the ingredients list, since those lists are organized from greatest amount to least amount by weight in the food.

Many whole grains don’t contain any gluten. However, if you have celiac disease, be sure to look for gluten-free labels on products because the grains may be processed on the same equipment as wheat or other gluten-containing grain products.

  • Amaranth
  • Brown rice (in limited amounts because of arsenic concerns)
  • Buckwheat
  • Oats
  • Quinoa
  • Sorghum
  • Teff

by Misha Roth

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