Gluten intake and metabolic health: conflicting findings from the UK Biobank

Inken Behrendt,Gerrit Eichner,Mathias Fasshauer

doi:10.1007/s00394-020-02351-9

Inken Behrendt, Gerrit Eichner + Show 1 more

Open Access

https://doi.org/10.1007/s00394-020-02351-9

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Abstract

PurposeThe impact of gluten intake on metabolic health in subjects without celiac disease is unclear. The present study aimed to assess the association between gluten intake and body fat percentage (primary objective), as well as a broad set of metabolic health markers.MethodsGluten intake was estimated in 39,927 participants of the UK Biobank who completed a dietary questionnaire for assessment of previous 24-h dietary intakes. Multiple linear regression analyses were performed between gluten intake and markers of metabolic health with Holm adjustment for multiple comparisons.ResultsMedian gluten intake was 9.7 g/day (male: 11.7 g/day; female: 8.2 g/day; p < 0.0001). In multiple linear regression analysis, association between gluten intake and percentage body fat was negative in males (β = − 0.028, p = 0.0020) and positive in females (β = 0.025, p = 0.0028). Furthermore, gluten intake was a negative predictor of total cholesterol (male: β = − 0.031, p = 0.0154; female: β = − 0.050, p < 0.0001), high-density lipoprotein cholesterol (male: β = − 0.052, p < 0.0001; female: β = − 0.068, p < 0.0001), and glomerular filtration rate (sexes combined: β = − 0.031, p < 0.0001) in both sexes. In females only, gluten intake was positively associated with waist circumference (β = 0.041, p < 0.0001), waist-to-height ratio (β = 0.040, p < 0.0001), as well as body mass index (β = 0.043, p < 0.0001), and negatively related to low-density lipoprotein cholesterol (β = − 0.035, p = 0.0011). A positive association between gluten intake and triglycerides was observed in males only (β = 0.043, p = 0.0001).ConclusionThis study indicates that gluten intake is associated with markers of metabolic health. However, all associations are weak and not clinically meaningful. Limiting gluten intake is unlikely to provide metabolic health benefits for a population in total.

Highlights

Gluten, the major storage protein of wheat, is a complex protein structure consisting of monomeric prolamins and polymeric glutenins which are present in other cereals such as rye and barley [1]
It is indisputable that the only effective treatment for celiac disease (CD) is lifelong adherence to a strict gluten-free diet (GFD) [2] but gluten-free and gluten-limited diets gained in popularity in healthy people [4]
Energyadjusted gluten intake was higher in male subjects [male: 1.10 (0.77–1.47) mg kJ−1 d−1; female: 0.93 (0.61–1.30) mg kJ−1 d−1; p < 0.0001; Online Resource 2b]

Summary

Introduction

The major storage protein of wheat, is a complex protein structure consisting of monomeric prolamins and polymeric glutenins which are present in other cereals such as rye and barley [1]. Gluten is partly resistant to intestinal digestion, resulting in the formation of immunogenic oligopeptides some of which are capable of triggering celiac disease (CD) in genetically susceptible individuals which is an autoimmunemediated disorder [2]. Gluten ingestion is considered to trigger further autoimmune diseases such as diabetes mellitus type 1 [3]. It is indisputable that the only effective treatment for CD is lifelong adherence to a strict gluten-free diet (GFD) [2] but gluten-free and gluten-limited diets gained in popularity in healthy people [4]. The prevalence of CD in Western populations is only about 1% of the general population [5]. Data from the National Health and Nutrition Examination Survey (NHANES) revealed that the prevalence of people on a GFD rose from 0.5% in 2009–2010 to 1.7% in 2013–2014 [7]

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