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    Celiac Disease Associated with Higher Risk for Cardiovascular Disease

    Reviewed and edited by a celiac disease expert.

    Wondering about the connection between celiac disease and cardiovascular disease? A new studies highlights some concerns.

    Celiac Disease Associated with Higher Risk for Cardiovascular Disease - Image: CC BY 2.0--wuestenigel
    Caption: Image: CC BY 2.0--wuestenigel

    Celiac.com 02/13/2023 - Because earlier studies have been small, or relied on sources with limited socio-demographic and lifestyle data, there's conflicting information associating celiac disease with a higher risk of cardiovascular disease. 

    Prior studies examining the ties between celiac disease and cardiovascular disease have often omitted traditional cardiovascular risk factors, such as blood pressure or serum total cholesterol, despite research showing healthier cardiovascular profiles in people with celiac disease.

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    A team of researchers recently set out to investigate whether people with celiac disease are at increased risk of cardiovascular disease, including ischaemic heart disease, myocardial infarction, and stroke. The research team included Megan Conroy, Naomi Allen, Ben Lacey, Elizabeth Soilleux and Thomas Littlejohns. They are variously affiliated with theNuffield Department of Population Health, University of Oxford, Oxford, UK; the UK Biobank, Stockport, UK; and the Department of Pathology, University of Cambridge, Cambridge, UK.

    For their prospective analysis of a large group study, they turned to the UK Biobank database. From between 2006 and 2010, they pulled data on nearly 470,000 adults, just under 2,100 of whom had celiac disease. Participants were aged 40-69 years from England, Scotland, and Wales, and without cardiovascular disease at baseline.

    The team focused on the relative risk of cardiovascular disease, ischaemic heart disease, myocardial infarction, and stroke in people with celiac disease compared with people who do not have celiac disease, and used Cox proportional hazard models to determine risk levels.

    Over an average follow-up of about 12.5 years, the team found nearly 41,000 cardiovascular disease events, with about 220 events in celiac patients. 

    Celiacs were less likely to smoke or have traditional cardiovascular risk factors, such as systolic blood pressure, total cholesterol, high body mass index. Even so, they had a higher rate of cardiovascular disease, than their non-celiac peers.

    Participants with celiac disease had an incidence rate of 9.0 cardiovascular disease cases per 1,000 person years compared with 7.4 per 1,000 person years in non-celiacs. 

    The team connected celiac disease to an increased risk of cardiovascular disease, even adjusted for lifestyle factors. The connection was stronger after further adjusting for other cardiovascular risk factors. 

    The team found similar connections between ischaemic heart disease and myocardial infarction, but noted fewer stroke events, and saw no evidence of a connection between celiac disease and risk of stroke.

    People with celiac disease had a fewer traditional cardiovascular risk factors, but still had a higher risk of developing cardiovascular disease than non-celiacs. 

    Based on these findings, cardiovascular risk scores used in clinical practice may not adequately account for a the higher risk among celiacs. Ideally, this study will help people with celiac disease and their clinicians to improve their awareness regarding the higher cardiovascular risks, and to take relevant precautionary action.

    Still, more research is needed to improve our understanding of these connections.

    Read more at BMJ Medicine


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    Guest Patricia

    Posted

    There are possible indirect factors from Celiac disease that can be affecting the rate of heart disease. Having Celiac disease significantly impacts one's ability to eat out even at friends' houses, which impacts a person's social life negatively. Also more time is required to prepare meals since a gluten free diet requires more food to be prepared from scratch from whole foods and more money and time to shop for items which are not made from scratch. Also many Celiac's have other food allergies which exacerbates of cost and time of finding, preparing and socializing where food is involved.The total impact is less socialization, more stress do to greater costs for food and less free time because of the greater time needed to shop and prepare meals. The impact of less socialization and more stress could be a major factor impacting the risk associated with heart disease.

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    Guest Guest Aubrey

    Posted

    Very interesting and very possible theory, Patricia! You just described me to a “T”. I have additional food allergies (corn & soy) which are in just about every packaged food. All of the planning and prepping…. It’s stressful and exhausting in every way. Socially, physically, mentally, and financially. And stress definitely has an effect on the heart! 

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    Guest Kate

    I've often wondered if this association exists due to several factors but one that I have seen and heard of so often.  Many celiacs, especially newly diagnosed ones seem to work hard at first and foremost replacing the favored and dearly missed junk foods and other not so healthy processed foods, etc. I'm on a few celiac support groups on FB and the most often asked for recipes are where to buy the closest resemblance to old favorites like cookies, cakes, breads, donuts, pizzas, and other high fat and sugar snacks. I think of it as the addiction withdrawal phase of suddenly having to give up the junk foods with gluten. Much of the processed gluten-free snacks are even higher in fats and sugars than the gluten included ones, as it seems something has to go into the products to replace gluten and enhance flavor. I rarely hear of anyone rushing to seek out the healthy side of the gluten-free diet until later when it dawns on them they are not feeling much better or feeling worse and wondering why. We have an incredible food industry in the US that is ever so happy to meet those unhealthy demands but it's the individuals who create that demand. 

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    plumbago
    8 minutes ago, Guest Kate said:

    We have an incredible food industry in the US that is ever so happy to meet those unhealthy demands but it's the individuals who create that demand. 

    I'm actually not so sure I buy that last part. We are marinating in a soup of highly processed carbohydrates. They're plentiful and they're cheap and often the only thing people can afford. It's a mix, at best. But not all countries allow their food industries to get away with what we in the US allow ours to get away with.

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    trents

    I agree with Guest Kate. The heart of the problem lies with the consumer, not with food companies or with government regulations. Food companies are in business to make money. They will give the public whatever the public wants and will buy. And the government is pretty responsive from a regulation standpoint if voters put pressure on them through representatives. Look at the progress the celiac community has already made with regard to labeling regs. And I believe that some in the celiac/gluten intolerant community have unreasonable expectations when it comes to labeling and regulations.

    Edited by trents
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    plumbago

    You cannot categorically say that with any accuracy, @trents

    I work day in and day out with people with metabolic disease. I've done education on this. There are truly things like food deserts. And there are things like government regulation.

    The celiac community is compared to the people I work with, very wealthy. People who have economic means are without question healthier and able in every single way to make better food choices than those without.

    The highly processed food industry is out of control. Yes, individuals can and absolutely should try as hard as they can to make good food choices.

    50 Years Ago, Sugar Industry Quietly Paid Scientists To Point Blame At Fat

    https://www.npr.org/sections/thetwo-way/2016/09/13/493739074/50-years-ago-sugar-industry-quietly-paid-scientists-to-point-blame-at-fat

    Hopefully the above link makes it into this comment.

    It behooves us not to speak categorically, I should think.

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    trents

    @plumbago, thanks for the link. An interesting read indeed. Not sure what you mean when you say, "There are truly thinks like food deserts. And there are things like government regulation." Seems obvious to me that deserts are food and that we do have government regulation.

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    plumbago

    Of course I meant what I said: food deserts; 'deserts,' as in the Sahara. The spelling is correct 😀

    What I mean is - and I'm not sure, but we may be talking about two different groups of people (those dx with Celiac, as in the participants here, and those suffering from metabolic diseases, the people I work with who are primarily on public health insurance) -  I liken sugar consumption with smoking. The US government came in big time on smoking and it has had a major impact. In that instance, like the one I'm referring to here (primarily ultra processed carbohydrates), individuals were smoking and individuals were buying the (bad) product in question. But the government intervened and impact was made. Leaving it up to individuals only (like with drug use, smoking, energy consumption, pollution) will not get us far. It may get those on higher end of income level far, but that's a tiny minority of the overall population and the overall numbers are what we need, to get that needle to shift. I work with it and am up to my elbows with it every day. At best, as I said, it's a mix.

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    trents
    1 hour ago, plumbago said:

     Leaving it up to individuals only (like with drug use, smoking, energy consumption, pollution) will not get us far. It may get those on higher end of income level far, but that's a tiny minority of the overall population and the overall numbers are what we need, to get that needle to shift. I work with it and am up to my elbows with it every day. At best, as I said, it's a mix.

    I do not believe that is a tiny minority of the overall population. Are you talking about the USA population? Certainly there is a segment of the population in the USA that cannot afford to make good food choices but I believe they are the minority at this point. If the current administration remains in power much longer that may change, however. I think the population you must work with must not represent a cross section of the public. And I don't think you have to be wealthy to eat healthy. I believe that is within range of the middle and lower middle class of people at least. Government regulation and taxing structure drove up the price of cigarettes such that many could no longer afford it. But I think that wasn't the only factor. I think many just came to the conclusion that it was bad for their health and unattractive, no longer fashionable. But it took a lot of years to get there.

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    plumbago

    With smoking it was (and still is) a massive publicly funded education campaign; regulation; withholding of federal funds to the states unless they enacted restrictions. It was massive federal involvement (including lawsuits) and it is working. You do not need to be wealthy to eat healthy. No. But it helps. And having a little bit more helps. Many came to the conclusion that it was not healthy precisely because of the efforts made by federal and state governments. The comparison to smoking is a good one, I think, and the sooner we can get the government involved to enact requirements on limitations on the amount of HFCS and fructose in general the better off we will all be. Of course, I work with sick people, often very sick people. But all you have to do is make a little bit of effort to find out the amount of metabolic disease among the American public and we are number one without a doubt. Individual education is a drop in the bucket. Give it a try some time, and you will see.

    Those who 1. have the time to learn about 2. the education to understand and 3. the time and energy to enact positive changes are indeed usually on the upper income scale and are a small minority of the overall American population.

    Again, I ask that you just look into the metabolic disease rates among American adults AND children.

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  • About Me

    Jefferson Adams

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University. His articles, essays, poems, stories and book reviews have appeared in numerous magazines, journals, and websites, including North American Project, Antioch Review, Caliban, Mississippi Review, Slate, and more. He is the author of more than 2,500 articles on celiac disease. His university coursework includes studies in science, scientific methodology, biology, anatomy, physiology, medicine, logic, and advanced research. He previously devised health and medical content for Colgate, Dove, Pfizer, Sharecare, Walgreens, and more. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of numerous books, including "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

    >VIEW ALL ARTICLES BY JEFFERSON ADAMS

     


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