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

Abstract

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.

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Author's contributions

HSK and SKA are involved in study and design. All authors are involved in acquisition, analysis, or interpretation of data. All authors are involved in drafting of the manuscript. All authors are involved in critical revision of the manuscript for important intellectual content. HSK is involved in statistical analysis. All authors are involved in administrative, technical, or material support. HSK, MFD, NK, MF, SKA are involved in study supervision. Dr. H.S. Kim had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors approved the final version of the manuscript.

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Correspondence to Hyun-seok Kim.

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Kim, H., Demyen, M.F., Mathew, J. et al. 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. Dig Dis Sci 62, 2440–2448 (2017). https://doi.org/10.1007/s10620-017-4583-1

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Keywords

  • Gluten-free diet
  • Obesity
  • Metabolic syndrome
  • Cardiovascular risk