Obesity, Metabolic Syndrome, and Cardiovascular Risk in Gluten-Free Followers Without Celiac Disease in the United States: Results from the National Health and Nutrition Examination Survey 2009–2014

• Published in: Digestive diseases and sciences 2017-09, Vol.62 (9), p.2440-2448
• Main Authors: Kim, Hyun-seok, Demyen, Michael F., Mathew, Justin, Kothari, Neil, Feurdean, Mirela, Ahlawat, Sushil K.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biochemistry; Blood cholesterol; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - diet therapy; Cardiovascular Diseases - epidemiology; Celiac Disease; Cholesterol; Comparative analysis; Diet, Gluten-Free - trends; Female; Gastroenterology; Gluten; Health risk assessment; Health surveys; Hepatology; Humans; Male; Medicine; Medicine & Public Health; Metabolic syndrome; Metabolic Syndrome - diagnosis; Metabolic Syndrome - diet therapy; Metabolic Syndrome - epidemiology; Middle Aged; Nutrition; Nutrition Surveys - methods; Nutrition Surveys - trends; Obesity; Obesity - diagnosis; Obesity - diet therapy; Obesity - epidemiology; Oncology; Original Article; Risk Factors; Surveys; Transplant Surgery; United States - epidemiology; Weight control; Young Adult
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-017-4583-1

Background Despite unclear benefits of gluten-free diets (GFD) in the general population, gluten-free followers without medical indications are driving the market. Few studies have investigated health benefits of GFD in the general population. Aims To estimate metabolic and cardiovascular disease (CVD) risk profiles among gluten-free followers without celiac disease (CD). Methods Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2009–2014. There were 13,523 persons without CD who had GFD information. People with known CVD were excluded. We compared gluten-free followers without CD and the general population by selective metabolic and CVD risk profiles using survey-weighted generalized logistic regression. Results There were 155 gluten-free followers without CD and CVD, corresponding to a weighted prevalence of 1.3% (3.2 million Americans). Gluten-free followers tended to be women and have a smaller waist circumference and higher HDL cholesterol. They also had a lower BMI with a borderline p value (0.053) and significant self-reported weight loss (−1.33 kg) over one year. Moreover, gluten-free followers were more likely to consider their weight appropriate. There was no statistical difference by age, smoking, hypertension, total cholesterol, triglyceride cholesterol, HbA1c, or fasting glucose. Despite a lower probability of having metabolic syndrome (33.0 vs 38.5%) and lower 10-year CVD risk score (4.52 vs 5.70%) in gluten-free followers, there was no statistical difference. Conclusions Although being on a GFD may be beneficial in weight management, there was no significant difference in terms of prevalence of metabolic syndrome and CVD risk score in gluten-free followers without CD.