Does removing gluten from your diet increase your risk of heart disease?

One of the patients with Hashimotos I’ve been seeing on my Monday night student rotation a few weeks ago mentioned a study which convinced her that removing gluten from your diet increases your risk of heart failure.

 

We’ve had the discussion before, that she would likely benefit overhauling her diet, including ditching the grains. She definitely wins the award for one of my most difficult patients. Still love her, though.

 

The study she cited was recently published in the British Medical Journal. Lebwhol and friends found an inverse relationship between gluten intake and incidence of coronary artery disease in a large group of nurses studied.

 

So less bread more heart disease?

 

Don’t load up on the bread yet!

 

First… the authors found more gluten, less likelihood in this cohort of engaging in other potentially harmful behaviors (less care about health), highlighted was smoking, alcohol, total fat and unprocessed red meat intake.

 

 Gluten intake correlated inversely with alcohol intake, smoking, total fat intake, and unprocessed red meat intake.”

 

Second… after controlling for confounding factors or other noise that clouds correlations the authors found the differences between the first and fifth quintiles shrank.

 

after adjustment for race, body mass index, height, diabetes, regular aspirin or non-steroidal anti-inflammatory drug use, statin use, multivitamin use, alcohol, smoking, parental history of coronary heart disease, hypertension, hypercholesterolemia, physical activity, menopausal status, and menopausal hormone use, the association was no longer significant (hazard ratio 0.98, 0.91 to 1.06) in the pooled cohorts.”

 

Well now… isn’t that interesting. It looks like gluten intake… through whole grain consumption, is a flag for individuals who live a healthful lifestyle!

 

 

Your health is sum of all your behaviors

 

We call this healthy user bias. Food is only one needle mover. Be lighter, work a job you love, go to bed on time, get some exercise, maybe a little sunlight, make time for play, laugh a little. Health is like a big stew, with many ingredients. And for some folks eliminating gluten is a big component of the healthy stew.

 

The potential of gluten elimination in Hashimotos

 

Let me preface the below by stating that there isn’t a strong scientific basis for removal of gluten in hashimotos thyroiditis. However, what we see in the clinic is an important consideration as well.

 

In another case of stubborn autoimmune thyroiditis I’ve been working with, a great response was achieved after 4 weeks of a grain free diet, consisting only of lots of vegetables and meat.

 

She’s been on thyroid medication and replacement of some of her other sex hormones, but things just were not moving in the right direction.

 

Following the dietary change, she lost over 12 pounds, her whole body pain, which she likened to “being crushed by a car door” subsided, she hasn’t felt this well in years. It really shocked me that she was willing to try another elimination diet, because she had already done it twice, but based off of food allergy tests. (Stand by for future discussion of the pitfalls of food allergy testing).

 

We’re proud of her. We’ll be reassessing her TPO antibodies soon, which were ~700 before we started.

 

Can a gluten free diet really be harmful?

 

While I don’t believe the effects seen in this recent publication are because of whole grains and gluten, it’s important to recognize grains are ONE source of micronutrition. However, there is no micronutrient in grains you cannot get from another food item. And fiber you can get from vegetables.

 

One popular trend is to cut gluten containing processed food from one’s diet and replace it with gluten free processed food. This is likely not serving you for two reasons. The gluten free processed food tends to have the same lousy oils added and lots of sugar, depending on what we’re looking at. Second, gluten containing foods like bread tend to be more greatly fortified with b vitamins and minerals than is gluten free bread. So if you remove gluten from your diet, make sure you do it right – cut the boxed stuff as the biggest components of your diet and focus on more whole foods, organ meats, and seafood.

 

If you have any chronic condition going on you certainly owe it to yourself to give a gluten free diet a try, without any fear of clogging up your arteries.

 

Further reading

 

http://www.bmj.com/content/357/bmj.j1892

 

 

 

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