February was designated American Heart Month in 1964, when it was established by President Lyndon Johnson to increase awareness of heart disease, then a significant cause of death in the United States. As heart disease is the leading cause of death today both in the U.S. and globally, it remains very relevant to incorporate heart-healthy recommendations into our dietary routines. For individuals with celiac disease there may be even more reason to do so. Some research has indicated there may be an increased risk of heart disease among individuals with celiac disease, and that this may be related to the inflammatory process which is characteristic of the condition – specifically, systemic subclinical inflammation. At the same time, researchers have noted that other aspects of celiac disease could also be related to increased risk of atherosclerosis. These include a decrease in nutrients like B vitamins and folic acid which can result from intestinal damage, factors which are generally reversed with strict adherence to a gluten-free diet. Meanwhile, inflammation in the body has been implicated in various disease states, including heart disease. It is not proven that inflammation causes heart disease, but the American Heart Association acknowledges that inflammation is common for heart disease and stroke patients, while adding that its exact role remains a topic of ongoing research. Considering the topic of heart disease among those living gluten-free from a different angle, one study looked at a large population group which did not have celiac disease, and assessed whether or not there was a relationship between long term dietary intake of gluten and risk of heart disease. These data (spanning 26 years and from over 100,000 participants) indicated that the potential association found between lower gluten intake and increased heart disease had to do with the fact that avoidance of gluten may lead to reduced intake of beneficial whole grains. So, whether related to residual effects of inflammation or to a gluten-free dietary pattern which may be lower in beneficial foods like whole grains, it is wise for individuals with celiac disease as well as others following a gluten-free diet to pay extra attention to heart healthy dietary habits.
Guidelines for a Heart Healthy Gluten-Free Diet
Choose a variety of nutritious foods, and aim to maintain a healthy weight. Some gluten-free packaged foods are high in fat, sugar, salt and calories. While it’s okay to consume these on occasion, over-reliance on these foods may contribute to weight gain, high cholesterol and high blood pressure, all of which increase risk of heart disease.
- Eat plenty of vegetables and fruits, without high-calorie sauces or added salt and sugars. Try to fill at least half your plate with fruits and vegetables, and include a wide variety of colors.
- Make about half of your grain intake whole grains. If you haven’t done so yet, now’s the time to try gluten-free whole grains like sorghum, millet, and teff. (https://gluten.org/resources/diet-nutrition/whole-grains/)
- Include nuts, legumes (beans, peas, and lentils), and seeds regularly.
- Choose foods low in saturated fat (which come mainly from animal sources, including meats and dairy).
Select lower fat dairy products and poultry (skinless).
- If you choose to eat meat, look for the leanest cuts available.
- Eat a variety of fish at least twice a week, especially fish containing omega-3 fatty acids (for example, salmon, trout and herring).
- Cut back on beverages and foods with lots of added sugars.
- Choose foods with less sodium. Prepare foods with little or no salt, and use herbs, spices and lemon for flavoring instead.
- Other components of a heart-healthy lifestyle are regular physical activity, avoidance of smoking, and, if alcohol is consumed, keeping quantities moderate.
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