In this video Dr. David Perlmutter reacts to a recent British Medical Journal prospective cohort study that tracked 26 years of dietary data from the Nurses' Health Study and Health Professionals Follow‑up Study. The study concluded that long‑term gluten intake was not linked to coronary heart disease, but warned that avoiding gluten could lower consumption of whole‑grain fiber, potentially affecting cardiovascular risk. Perlmutter largely agrees with the null association between gluten and heart disease, but emphasizes that the health risk comes from reduced dietary fiber when people adopt a gluten‑free diet without adequate fiber replacement. He explains that fiber supports gut microbiota and reduces inflammation, which are important for heart health. He recommends that anyone on a gluten‑free regimen ensure sufficient fiber by choosing gluten‑free whole‑grain sources (e.g., non‑GMO rice, corn) and, especially, prebiotic‑rich foods such as jicama, Mexican yam, garlic, onions, leeks, Jerusalem artichoke, chicory root, and dandelion greens, or by using quality fiber supplements. The take‑home message is that a gluten‑free diet is not inherently harmful for the heart, provided fiber intake is maintained.
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Hi everybody, Dr. David Perlmutter here. I'd like to respond to an interesting article that was published just today. The article is entitled Long-Term Gluten Consumption in Adults Without Celiac Disease and Risk for Coronary Heart Disease: Prospective Cohort Study, a study published by the British Medical Journal. And it's certainly getting a lot of attention because of the conclusion that the authors reached and certainly being amplified in the news media. That going gluten-free doesn't seem to have any beneficial effect for the heart. In fact, the study, which was a very long-term study, went on for 26 years, looked at women who were involved in the Nurses' Health Study as well as health professional studies. So these are ongoing studies, and they looked at the data, looked at what are called food frequency questionnaires. In other words, what were people eating between the years of 1986 Through 2010, and what they found was that going gluten-free did not offer any specific advantage in terms of the heart. Let me read their conclusions. Long-term dietary intake of gluten was not associated with risk of coronary heart disease. However, the avoidance of gluten may result in reduced consumption of beneficial whole grains, which may affect cardiovascular risk. We're going to talk about that in just a moment. The promotion of gluten-free diets among people without celiac disease should not be encouraged. And, you know, you may be surprised to hear this from me, but by and large, I pretty much agree with what these authors have concluded in that they found no real relationship between going gluten-free and the risk for developing heart disease. And I think the reason for that is I know, you know, we all understand there are benefits to going gluten-free, but if you're not gluten-free, eating gluten, you are going to be eating more fiber, and fiber is really important. To some degree, I believe that dietary fiber in gluten-containing products offsets the damaging effects of the gluten. The reason that I disagree with how this article is being promoted is that, you know, I think that people who do go gluten-free and don't get adequate amounts of fiber are at risk for a variety of problems, in this case coronary artery disease. And in fact, you know, again, to reiterate what the authors stated, they stated that avoidance of gluten may result in reduced consumption of beneficial whole grains. So, you know, to be clear, we need dietary fiber to nurture our gut bacteria for a variety of reasons, not the least of which to help reduce inflammation. So the take-home message here for me, and hopefully I can transmit that to you, is that we still want to remain gluten-free, but by all means, We've got to make sure we get adequate amounts of fiber intake so that we can get the best of both worlds, of both being gluten-free and having enough good fiber in our system. So gluten-free fiber-containing grains are a good option, things like non-GMO rice and corn, for example. Rice recently has been a bit castigated because of its toxicity. That's another discussion. But, you know, understand that fiber doesn't necessarily just have to come from grain, and I would vote for getting fiber from fiber-rich foods, especially foods rich in prebiotic fiber like jicama, Mexican yam, garlic, onions, leeks, Jerusalem artichoke, and things like chicory root and even dandelion greens, or Just get some good prebiotic fiber from the health food store. So, all in all, I think that there are some interesting conclusions of this study, but I think to say that people should therefore not go gluten-free is not necessarily an appropriate conclusion because as they stated themselves, when people go gluten-free, one of the issues that may be compromising their health, in other words, increasing their risk for problems, is because going gluten-free seems to be associated with decreasing consumption of dietary fiber. I'm Dr. David Perlmutter, and thanks for joining me.
