Recently, the media felt it necessary to once again alert us to the dangers of a gluten-free diet (GFD). This time their warning concerned the potential harm a GFD could do to your heart.
A Foxnews.com’s headline read,
Wow, that’s pretty scary.
I’ve been following a strict GFD for over 13 years. Am I now at a greater risk of heart disease because of that diet choice?
Nutritionally, I thought I was doing the healthy thing?
Researchers have shown concern over gluten’s potential to cause serious health problems.
Also, since I have non-celiac gluten sensitivity (NCGS) I have to stay far away from gluten.
But have I been doing serious harm to my heart by going gluten-free?
According to the Foxnews.com headline, it’s possible.
Not to be outdone in sensational reporting, the Daily Mail responded with its own unique headline:
Wow, is Gwyneth Paltrow headed for heart disease too?
Consumer Reports (CR) was a little more restrained in their headline:
I like that headline a little better. It’s a little less frightening.
But, what’s going on here?
Is there something seriously wrong with a GFD? What prompted these news outlets to spread fear amongst the GFD community?
A New Harvard Medical School Study On Gluten Diets
All of the above news stories were in response to a recent study by Harvard Medical School in conjunction with Columbia University.
(I’ll be referring to the study as the H/C study throughout the rest of this post.)
By looking at the study’s title, you’d be hard pressed to know what it actually found.
However, based on the previous news article’s headlines, it would appear that the study had discovered an important link between a GFD and the increased risk of heart disease.
You might also assume that this link was so strong that we had to be strongly warned of the deadly nature of a GFD.
Fear not, all you GF’ers out there. In reality, no such link was found.
However, what I found particularly disturbing was that those headlines seemed to be prompted not by the study itself but by researcher comments about a GFD.
Before I get into the study results, I’d like to take a look at how the study was presented to CR by one of the researchers.
The Intent Of The Study
The Consumer Reports (CR) article begins with this brief summary of the study’s results:
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.
CR was accurate in its summary of the study’s finding.
The study found that gluten consumption is not associated with a higher risk of heart disease.
If CR had focused solely on this result everything would have been fine.
But they chose to go in a different direction.
A Harvard Researcher Believes That Unless You Have Celiac Disease A GFD Might Harm Your Heart
Before commenting on the study results, CR included a series of quotes from Andrew Chan, M.D., associate professor of medicine at Harvard Medical School.
Chan was one of the lead researchers of the study.
According to CR, Chan believes that, unless you have celiac disease, going gluten-free might actually harm your heart.
Notice that’s not what CR said the study actually found.
Here’s Chan’s reason why going gluten-free might actually harm your heart:
When you start to restrict gluten, you may start to restrict foods that are high in whole grains. Whole grains are linked to better cardiovascular health outcomes.
Chan didn’t discuss the results of the study but simply offered a rather poor argument against a GFD.
I suspect you can readily see the error in his argument.
While a GFD may restrict whole grains, a person may introduce other foods that equal or surpass the heart healthy effects of whole grains.
I’m sure Dr. Chan knows this.
But why did he find it necessary to attack a GFD when his study revealed nothing negative about a GFD?
We can only speculate.
Incidentally, as we’ll see later, I didn’t take Dr. Chan’s comments out of context.
The study itself, as well as other researchers, made similar comments.
Let’s take a look at the study.
Why The Need To Dispel The Gluten-Heart Disease Connection?
I initially found it odd that H/C researchers conducted a study to disprove a connection between gluten intake and heart disease.
However, if you read the study carefully you would see that the researchers cite evidence that celiac disease is associated with an increased risk of coronary heart disease (CHD), which is reduced after treatment with a GFD.
Did you get that? Celiacs may have a reduced risk of CHD after going GF.
Can you imagine if that data could be extrapolated to non-celiacs?
It would turn the medical community upside down. I believe that’s the myth that this study was designed to dispel.
We’ve been told for decades to chow down on those whole grains.
Now there’s a study out there saying that reducing gluten, which just so happens to be contained in those grains, might reduce the risk of heart disease.
This puts the mainstream medical community in a rather tight spot.
They’ve been recommending whole grains as a heart healthy food for years.
Now it’s possible that there may be something in those whole grains that is not particularly healthy for your heart.
You can see why H/C thought this study necessary.
Curiously, H/C researchers presented additional evidence for medical harms associated with gluten.
Possible Adverse Health Effects Of Gluten Consumption
While citing the possible decrease of CHD in celiacs on a GFD, the H/C study also presented evidence for the possible adverse effects of gluten consumption.
1. Evidence that gluten may promote inflammation in the absence of celiac disease or non-celiac gluten sensitivity.
2. Evidence that gluten may increase the risk of obesity, metabolic syndrome, neuropsychiatric symptoms, and cardiovascular risk among healthy people.
Interestingly, the study cites evidence for all these concerns. These are not just made up myths.
Bravo for the H/C researchers.
Maybe the mainstream health community is finally waking up to the potential dangers of gluten for the general population.
Unfortunately, the authors of the study quickly make a u-turn.
H/C Researchers Say A GF Diet May Be Sub-optimal
The study notes that evidence citing the benefits of a GFD has persuaded many to try a GFD.
In fact, by 2013, nearly 30% of adults in the US reported that they were trying to minimize or avoid gluten.
It seems that the popularity of a GFD has caused some worry for the study’s researchers.
Immediately after noting the large numbers of people turning to a GFD, the study commented,
Concerns exist that a gluten-free or gluten-restricted diet may be nutritionally suboptimal.
The study’s results don’t reveal who is concerned or what exactly is suboptimal about a GFD.
This is simply the opinion of the researchers.
The study itself was not designed to research the efficacy of a GFD.
This was the implied reason for the study,
Despite the rising trend in gluten restriction, no long term, prospective studies have assessed the relation of dietary gluten with the risk of chronic conditions such as coronary heart disease in people without celiac disease.
The only result that would argue against a GFD was if they found that gluten restriction increased the risk of CHD.
That’s not likely.
As I said, the real reason for the study was to counter the evidence that a GFD might be cardioprotective for non-celiacs.
Let’s see what they found.
The Results Of The Study
Researchers collected data from 64,714 women and 45,303 men from the famous Nurse’s Health and Health Professionals Follow-up Studies respectively.
Participants were followed via biennial self-administered questionnaires on health and lifestyle habits, anthropometrics, environmental exposures, and medical conditions.
They were studied from 1986 to 2012.
People who had a myocardial infarction, angina, stroke or coronary artery bypass graft surgery, cancer or celiac disease were excluded from the study.
Participants were also evaluated as to their gluten consumption.
At the end of the 26 years, researchers observed the incidence of coronary heart disease among the participants.
They found that among the female and male health professionals followed, the quantity of gluten consumption was not associated with coronary heart disease.
In other words, a low gluten diet as compared to a higher gluten diet doesn’t improve or harm cardiac health.
Let’s see what the data really showed.
Are The Study Results An Accurate Picture of The Correlation Between Gluten Consumption And Heart Disease?
Here is a snapshot of the results found from the study.
As you can see, the median intake of gluten ranged from 2.8 – 9.4 grams per day (g/d).
To put that in understandable terms an average piece of whole wheat bread contains about 4.8 grams of gluten.
This means that the lowest gluten consumers were consuming the amount of gluten per day contained in about a half slice of bread.
People with the highest gluten consumption ate a total amount of gluten per day equal to about two slices of bread per day.
Therefore, what the study found was that there was no statistical difference in the development of heart disease in people who ate 2.8 g/d of gluten (a half a slice of bread) as opposed to 9.4 g/d (2 slices of bread).
This doesn’t sound like a revelatory study to me.
Did The Study Observe Average Gluten Intake?
This study is simply observing the results of gluten consumed in half a slice of bread compared to 2 slices.
While half a slice of bread has enough gluten to immediately induce a severe reaction in celiacs, 2 slices a day may not be enough to cause heart disease when ingested over a 26 year period.
Let’s suppose the researchers of this study added another category of gluten consumption.
In this category, participants regularly consumed a quantity of gluten contained in a morning bagel, a big Subway hero for lunch, a donut at coffee break, and then for dinner a plate of pasta with some warm French bread to dip in that delicious Marinara sauce.
This diet will, naturally, result in a significantly higher gluten consumption compared to 2 slices of bread.
Considering the epidemic-like numbers of people suffering from diseases such as prediabetes, type 2 diabetes, obesity, and metabolic syndrome, I suspect my scenario is more indicative of the general population.
This is well above the amount consumed by the participants in the study.
If we were to examine these people then we might learn something more important about gluten consumption and heart disease.
Unfortunately, the H/C study told us little about gluten consumption and heart disease.
Let’s see how the study was skewed in another way.
The Body Mass Index Of The Participants
If you were to look at the mean body mass index (BMI) of the participants you would see that they are in the 24.9 – 25.9 range.
This would put the mean population of the study right on the cusp between the normal and overweight categories.
Considering that two-thirds (68.8 percent) of adults are considered to be overweight or obese, this study’s population seemed to be a rather healthy group of people.
In other words, the researchers are looking for heart disease in a relatively healthy population.
This population was probably not the best population for an investigation into the role of gluten’s effect on heart disease.
Overall, I believe this was a poorly designed study which tells us little about gluten consumption.
However, I wasn’t too disturbed about the poor design of the study. We see this all the time.
What really frosted me was the study’s discussion of the results.
The H/C Study’s Conclusion On The Relation Between Gluten And Heart Disease
The study offered two main conclusions from its observations.
I pointed out before that the study was not very well designed so the fact that no correlation was found between gluten and heart disease didn’t shock me.
However, as you see the H/C researcher’s commentary on a GFD, whole grains and CVD are unclear.
What do they have to do with the study itself?
This statement is obviously the source of Dr. Chan’s statements to the press.
Another lead researcher, Dr. Benjamin Lebwohl, clues us into the study’s real intent.
Dr. Benjamin Lebwohl On Gluten Consumption And Heart Health
Benjamin Lebwohl, MD, is the director of clinical research at the Celiac Disease Center at Columbia University. He is also one of the chief researchers of the above study.
Here is his statement in the official Columbia University press release about the above study,
Popular diet books, based on anecdotal and circumstantial evidence, have pushed the notion that a low-gluten diet is healthy for everyone. Our findings show that gluten restriction has no benefit, at least in terms of heart health, for people without celiac disease. In fact, it may cause some harm if they follow a low-gluten diet that is particularly low in whole grains because those grains appear to have a protective effect against heart disease.
Sounds to me like Dr. Lebwhol has an agenda.
Dr. Lebwhol Is Critical Of Books That Advocate A Low Gluten Diet Without Evidence For Its Efficacy
Lebwhol doesn’t cite any of the books he’s critical of.
This means his statement is anecdotal itself and doesn’t provide us with any real information.
It’s possible that he may be talking about books like Dr. William Davis’ Wheat Belly, Dr. David Perlmutter’s Grain Brain or books that advocate a paleo (Loren Cordain’s Paleo Diet) or a low carbohydrate diet (Dr. David Ludwig Always Hungry).
These books generally advocate (but for different reasons) that a low gluten or a GFD is a healthy way of eating for most people.
The authors of these books would also argue that there is good scientific evidence proving the efficacy of their diets.
Secondly, Lebwohl says his study reveals that a GFD has no benefit for heart health for non-celiacs.
Okay, he simply repeats the study’s results.
But he continues.
Did Dr. Lebwhol State That A Low Gluten Diet May Be harmful?
Okay, Dr. Lebwhol didn’t say exactly that.
He said a low gluten diet may cause some harm if non-celiacs follow a low-gluten diet that is particularly low in whole grains.
But aren’t all low gluten diets by nature low in whole grains?
Therefore a GFD must be harmful.
Does his argument make sense?
Dr. Lebwohl Say Low Gluten Diets May Be Harmful Because They Are Low in Whole Grains Which Appear To Protect Your Heart
Okay, your logic detectors should be running at max warp right now.
Why do whole grains only appear to have a protective effect? Do they or don’t they?
He can’t say for sure because scientific studies showing positive cardiovascular benefits of whole grains have only been observational.
There haven’t been studies that show a causal link between whole grains and heart health.
However, let me pose a couple of simple questions.
Are whole grains the only food that can provide heart healthy benefits?
Do whole grains possess some unique compounds for heart health that only they can provide?
Let me provide a simple answer, No!
This whole anti-GFD argument is based on the premise that it eliminates whole grains and, without them, your heart will suffer.
Is that true? Not necessarily.
Let’s see why.
Are Whole Grains Necessary For Your Health?
Lebwhol and his associates object to a GFD or a low gluten diet for non-celiacs on the basis that they restrict whole grains.
They don’t tell us specifically why this is a problem, but I suspect it’s because whole grains contain a significant amount of fiber.
The medical community believes that dietary fiber is necessary for optimum heart health.
Thus the contention is that if you restrict whole grains from your diet, then you will be restricting your intake of fiber and, subsequently, your health will be in danger.
Of course, dietary fiber is important for your health. It’s essential for good bowel health and is also important for controlling blood sugar.
However, if you’re a non-celiac and you want to eliminate gluten from your diet, does it necessarily follow that you have to eliminate fiber?
Sources Of Fiber Other Than Whole Grains
There are many commercially available GF breads and pastas on the market that provide the same amount of fiber as in gluten containing products.
I personally don’t consume them because of their high carbohydrate content, high sugar content, and other additives, but they do contain fiber.
However, it’s also possible to get quality fiber from other foods sources.
Consider these sources of fiber.
One slice of whole wheat bread provides 2 grams of fiber. Arnold’s Whole Grains Wheat bread has about 3 grams. Ezekiel bread made from sprouted grains also has 3 grams.
Now consider these sources of fiber.
A medium apple has about 3 grams of fiber. A half cup of avocado has 5 grams. Brussels Sprouts have about 3.8 grams of fiber per half cup. A quarter cup of pistachio nuts have about 3.25 grams of fiber.
If you consumed the above 4 foods, you would be getting about 15 grams of fiber.
However, you can see that it wouldn’t be difficult to get the recommended 25 – 30 g/d of fiber from foods other than whole grains.
And they’d probably be a lot healthier for you too.
Why doesn’t the mainstream medical community just say if you want to go GF then just make sure you get enough fiber?
Wouldn’t that make a lot more sense?
The Bottom Line
The media with help from the mainstream medical community used the H/C study as evidence for another attack on a GFD.
A GFD containing a wide array of whole, unprocessed foods has repeatedly been proven to be a healthy diet.
Read the books I mentioned if you need convincing.
Aren’t we getting a little tired of fear mongering from the mainstream medical community concerning a GFD?
For years we were told to be careful of too much cholesterol consumption only to now be told that dietary cholesterol has no effect on blood cholesterol.
For years we’ve been told to eschew high-fat diets and switch to low-fat foods, many of which are filled with sugar.
But we were never told to avoid the over-consumption of sugar.
Now we are told that the sugar industry was heavily involved in funding scientific research favorable to itself.
Isn’t it time the mainstream medical community quit bashing a GFD and bash something more devasting to our health like fructose containing soda, refined carbohydrates with high sugar content, and foods prepared with PUFA oils?
These foods are doing more damage to the health of the American people than a GFD.
I suspect in the coming years we’ll continue to see more studies confirming the efficacy of a GFD.
Whether a majority of the medical community’s attitude towards a GFD diet eventually changes remains to be seen.
What’s your take on this? We’d love to hear from you.
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