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Could Going Gluten-Free Give You Heart Disease?

A recent study, published in the British Medical Journal (BMJ), reached a startling conclusion: a gluten-free diet could raise the risk of coronary heart disease (CHD)! Why? Because of a decrease in the consumption of beneficial whole grains.

You may be shocked to hear this, but I agree with the authors! The reason? The relationship of note is not about your consumption of gluten and CHD, but fiber and CHD. Gluten-containing products often contain the all-important fiber, so when we go gluten-free it’s essential to continue to incorporate fiber-rich foods into the diet. I discuss more in today’s video.

Download a full transcript of this video here.

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  • I thought that gluten promotes inflammation and inflammation contributes to heart disease. Am I wrong on that?

    • David Perlmutter

      You are correct John. The study highlights that CHD could be caused by a resulting loss in fiber consumption. Thus, it’s a bit of a false conclusion. Eliminating gluten is not the problem, fiber is.

      • Ícaro Alves Alcântara

        That’s the point I’ve been trying to highlight and reinforce here in Brazil in my networks: people stop gluten but put in place excess carbohydrates and little fiber and THAT is the problem!

    • did U listen to all of his video?

  • Helen Ruth Rogan

    I read this worrying medical article in the British press. So glad to get a proper perspective on this. Better to take in different types of fibre than just rough grain shell fibre, which would include soluable & inulin as a good prebiotic. Thanks for clearing up this up for me.

    • David Perlmutter

      Happy to share!

  • Kelly Grace

    What should be our goal for fiber consumption? Could you give us a daily gram amount? I think this is interesting in terms of Bruce Ames’ Chori Bar too. His bar is high fiber (and polyphenols among other things) and improves cardiovascular outcomes with no dietary change.

  • Laura

    There are plenty of gluten free breads that are whole grains. Breads are probably the highest gluten-containing foods that we consume. By eating these GF whole grain breads it would seem that this would avoid the low fiber problem. Am I right or wrong? Also, green smoothies would probably give you loads of fiber as well as eating more high-fiber produce.

  • twistedgenes

    I had huge problems with gluten especially wheat and corn. My migraines have disappeared after avoiding all grains including corn and rice in supplements and meds. 23andMe reveals I also have the celiac gene

  • Richie vegas

    veggies have ample fiber duh ill keep off refined carbs and toxic ways of eating wheat. wheat mafia screw them….

  • Rita

    Sometimes those who are eating gluten-free substitute high-sugar, fiber-poor grains for the whole gluten-free grains. Sugar and CHO could be the problem along with the lack of fiber.

    • David Perlmutter

      That’s exactly the problem Rita. Still need to be aware of the overall macronutrient profile of your diet!

  • Ronna Berezin

    Rice has been accused of being contaminated with Arsenic! Are you familiar with Dr. Osborne’s No Grain, No Pain? I would appeciate his take on the topic you are discussing, I respect you and would appreciate a more in debth discussion of this complex and controversial topic.

    • Ann

      Easily wash rice and remove arscenic. How ’bout that!!

      • Ronna Berezin

        Somehow I can’t believe that simply washing the rice would remove the arsenic. Further… the EPA wouldn’t be showing concern over the rice contamination if it could be so simply washed off. Where did you get your information?

  • vibert

    Grains, not just gluten are a problem with intolerant individuals. Most people I know who avoid grains and gluten also eat lots more raw fruits and vegetables as well as cooked vegetables and non gluten seeds such as quinoa, buckwheat, amaranth etc. This article and the Doctor does not give us credit for being smart about what we eat. We mostly avoid carbohydrate laden gluten free prepared foods. I wish someone with a lick of sense would write an article about this subject in response..

    • Ronna Berezin

      Quinoa contains gluten!

      • vibert

        Gluten is a general name for the proteins
        found in wheat (wheatberries, durum, emmer, semolina, spelt,
        farina, farro, graham, KAMUT® khorasan wheat and einkorn), rye, barley
        and triticale – a cross between wheat and rye.
        Read more at https://celiac.org/live-gluten-free/glutenfreediet/what-is-gluten/#kHbDPAild6LCW6Bc.99

        I am curious where you found that Quinoa has gluten?

        • Ronna Berezin

          No Grain No Pain by Dr. Peter Osborne. Ronna Berezin

      • AnnieLaurie Burke

        No, quinoa does not contain gluten — check out WebMD, glutenfreeliving.com, and many other sites supporting people that want to or need to eat gluten free. There is a possibility that quinoa could become contaminated with traces of gluten if processed on equipment that also processes gluten-containing grains.

        • Ronna Berezin

          Read No Grain No Pain as well as the Notes / References pp. 297-327

          • AnnieLaurie Burke

            Sorry, I’ll stick with the numerous science-based analyses that are available. I gave you references for two such sites. And whether quinoa contains gluten is not a “point of view”. It’s a matter of chemical composition.

          • Ronna Berezin

            Good luck to you … didn’t mean to offend you.

  • David Bennett

    Baloney Doc! 2.5 Million years of NOT eating grains suggests this research is a pile of steaming manure and that you agree with this “research” suggests being re$$ured by Big Agra and particularly the Grain Growers Association. Whole grains were added to the human diet on a broad scale only 10,000 years ago. Are you suggesting evolution eorks that rapidly? No thanks Doc since publishing your books your promotion of dietary guidelines anathema to your published infirmation suggests being paid off. My doctoral studies are focused on Nutritional Anthropology and clearly show grain were not a dietary staple of Paleolithic humans. Shame on you Doc.

    • AnnieLaurie Burke

      Did you listen to Dr. ‘s presentation? He specifically notes he does not agree with the researchers’ conclusion that going gluten-free can be problematic per se. He notes that the problem is that too many people depend on wheat for fiber, and that other fiber sources are available to those avoiding gluten. Your accusation of “being paid off” is unprofessional and unjustified.

      Further, although you qualify your assertion about the presence of whole grains in the human diet with the qualitative phrase “on a broad scale”, the anthropological evidence is strong that humans have been consuming grains — certainly not on a daily basis, and likely as one of many seasonal foods — for at least 33,000 years.

    • Debbie

      What is it like to think you’re the smartest person in the room? David, clearly you did not listen to the video. It’s fiber not gluten/grains that is the point. Doctor Purlmutter is not saying grains are suddenly ok. Go back and watch it. Then you can apologize to the good doctor for your rant. What a leftie. Geezch.

    • eileenfb1948 .

      You got so angry you didn’t hear what he was getting across. Eat veggies for your fibre.

  • ColoTenn

    I got off gluten several years ago when Dr. Petlmutter came out with his first book. I’m Totally not eating wheat flour & many other grains. When I do accidentally eat wheat I regret it, itching etc. I am also finding that it is wheat I’ve been allergic to for years, w many issues.
    They can keep their breads. I know I have less issues w headaches, allergies, swelling of my legs, bloating, and on a plus I lost about 30#’s.

  • ColoTenn

    I got off gluten several years ago when Dr. Perlmutter came out with his first book. I’m Totally not eating wheat flour & many other grains. When I do accidentally eat wheat I regret it, itching etc. I am also finding that it is wheat I was allergic to for years, having many issues to include swelling & itching of face, lips & eyes.
    They can keep their breads. I know I have less issues now such as headaches, allergies, swelling of my legs, bloating, and on a plus I lost about 30#’s!

    • Cathy McIvor

      ColoTenn, I agree! I am MUCH better of myself as well!

      • David Perlmutter

        Great to hear of these results from you both. Keep it up!

  • Cathy McIvor

    I am gluten intolerant and have been gluten-free for over 10 years. I eat almonds, sunflower seeds, baby kale and spinach for fiber daily. I feel I get plenty of fiber in my diet without eating gluten.

  • Really that is surprising and from now on i will add fiber in my regular meals

  • joanna

    I eat a low carb diet so I eat lots of raw curly kale, red onions, broccoli, usually as salads, and I’ve always thought I was getting loads of fibre with that?
    I also make my own kimchi but without the flour paste & I think that is fibre rich too with the raw leeks, onions, daikon & ginger.

    I don’t eat grains.

    • eileenfb1948 .

      You do have plenty of fibre from the vegetables.

  • Ian Ainslie

    Mmm. I ate masses and masses of cereals for decades (quality muesli, granolas etc) and was diagnosed with Dilated Cardiomyopathy a year ago. Plenty of fiber. Plenty of gluten.

  • eileenfb1948 .

    I’m coeliac and found the GF versions contain more sugar and additives. They made me feel unwell due to the vegetable flour where sulphites are used in the manufacturing process, going undeclared on the label. Thank you for this report.

  • Rochelle

    I agree with you, the ideal is go gluten-free and get fiber-rich foods. Thank you for sharing,

    • David Perlmutter

      That’s the key takeaway.

  • Daniel Tisi

    I would argue that if your primary dietary fiber sources are NOT vegetables and fruits, then you have much bigger problems.

  • Cristofano

    What this study couldn’t have observed is what the gluten free participants added to their diets when going gluten free. Many, perhaps the majority, miss their gluten products and look for gluten free substitutes of those same products. These are almost never organic, and contain gluten substitutes that are far less healthy, aside from the actual gluten proteins, than what the gluten containing foods consisted of. As already mentioned, sugar is high on that list and usually GMO sugar, especially considering the study time-frame. But sugar is far from the only less healthy substitute.

  • David Fantle MD

    The conclusion of this study is substantially flawed by the inherent selection bias of the study design. Avoiding gluten in the diet is a major lifestyle change, and also a big social challenge for most people coming from a typical Western diet. Most people don’t just ‘go gluten-free’ for no reason. One can only assume that a large proportion of the study participants who elected a gluten-free diet, did so for a compelling reason. This population was likely suffering from symptoms of physical illness, and certainly, some of them likely had coeliac disease itself (which has been linked to increased risk of CAD). Comparing an already-ill population to a non-ill population can produce no useful conclusions as to whether avoiding gluten could contribute to an increased incidence of vascular disease. The gluten-free group likely had a much greater amount of inflammatory disorders at baseline, leading them both to have an increased risk of vasculopathy, as well as for them to adopt a gluten-free diet, in attempt to manage their symptoms.

  • Shreckle

    I agree with the comments about using a correlation design with a population already potentially exhibiting symptoms and the problem with gluten free labelled foods which often contain more sugar and high gi ingredients. However most of the high fiber foods, including prebiotics, are high in fodmaps. Lots of people stop eating gluten because of ibs, so these foods are going to play havoc with their digestive system. Please can you recommend low fodmap sources of whole grains?

  • Julie Voss

    I am so confused with the diet info these days. Dr Perlmutter I followed your grain brain, then Dr Mcdougalds diet, now eating fats again. Mcdougalds diet I lost weight, felt lousy and my diabeties went sky high. I want to be healthy, loose weight and feel good. Can you recommend what diet I follow? Thank you

  • Sandra Clagett

    You made a great point on the fiber. We need to make sure we get our daily fiber.

    • David Perlmutter

      That’s a key takeaway for sure.

      • Sandra Clagett

        There is so much misinformation out there.

  • Naima Belmili

    i think part of the reason that people on Gluten free diet have increase in heart disease is that most store Gluten free foods are unhealthy they are made with soy, high sugar, trans fat and GMO , heavy metal included arsenic found all rice ingredients
    i doubt that people on real healthy Gluten free diet with Good fat, lot Greens, low sugar index, and GMO free are at risk for any disease, make no sense
    real Gluten free diet is from scratch , cooking at home , no ready meals that are on the shelf many months

    • Judith McAllister

      I agree.

  • Tina

    Hello..I am a mum of a 15 daughter who has a condition called CVID.. commum variable immune deficiency.
    2 years ago I had a brain injury and was told about David research and been reading everything I can to get better. I have found from researching that my daughter and I have a lot in common as the gut plays a major roll !! I constantly get told that nothing can be done to help her apart from monthly infusions but I know that her gut health is the key..she has had since birth major tummy issues and I’ve pushed and pushed to ask why this seems common with her condition only to be told there is no relation.. so my question is how can I learn more ? Tina x

  • Jeanne Kotsakis

    After reading your books and watching your blogs that conclude that gluten acts as a glue in your brain and creates many inflammatory responses, including contributing to Alzheimer’s, I was convinced. Plus, I understand grains are not essential nutrients. Now you have reversed yourself with this wish-washy video. You can get all the fiber you need from vegetables, legumes and nuts and seeds. I’m appalled.

    • Judith McAllister

      Sounds as though you misunderstood Dr Perlmutter. He did say to get fiber from vegetables, etc.

  • Roberta Green

    Gluten free products are often rice. Rice has been shown to contain arsenic.

  • Catherine Carlisle Magee


  • Caro Vega

    Dr. David … I am from Colombia, I am 28 years old and I was detected 8 months ago optic neuromyelitis .. I would like to take a high gluten-free diet in fiber? THaNK You!

  • Bluefire

    Well I can’t eat grains on a regular basis because I get joint pain.. even from corn and rice. Quinoa gives me shoulder pain every time I eat it and I’ve experimented eating it on different occasions and every time, I’d get painful shoulder pain an hour after eating it. Wheat causes me brain fog, IBS, lethargy and depression. I’ll have to increase my vegetables to get the fiber. I had a bilateral hip replacement at 49 which I suspect was from grains destroying my joints. I wonder who funded that study? Big Agriculture? I’m not so big on studies anymore since finding out how the scales are tipped to whoever funds them.

  • Michal Piják
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