If you have celiac disease, you are at increased risk of a number of other medical problems, such as autoimmune disorders like certain kinds of thyroid disease and type 1 diabetes. You are also at increased risk of developing conditions resulting from not enough nutrients getting absorbed into your body, such as anemia from deficiency of iron or B vitamins, and osteoporosis (thin bones) from not enough calcium and vitamin D.
However, new research seems to indicate that there are some illnesses you may be less likely to develop, such as type 2 diabetes and possibly also cardiovascular disease. Different studies have given conflicting reports about the risk for cardiovascular disease and its consequences in people with CD. However, a recent study did find evidence of decreased risk, and while the reasons that celiac disease may prevent cardiovascular disease are not certain, researchers have some theories as to why.
Cardiovascular disease (CVD) refers to what used to be commonly called “hardening of the arteries.” It means that there are abnormalities in the body’s arteries, from the coronary arteries supplying the heart, to the carotid arteries going to the brain, and the renal arteries bringing blood to the kidneys. The arteries are clogged due to an accumulation of plaque, which to a large extent occurs because of too much bad cholesterol. High blood pressure can also damage the arteries. If the arteries are very clogged, this can lead to a heart attack or stroke.
There are a number of factors which increase the risk of CVD including:
- Elevated blood pressure (as explained)
- Elevated “bad” cholesterol (LDL) and low “good” cholesterol (HDL)
- Obesity (often determined by BMI – Body Mass Index, a measure of obesity)
Past research has found lower levels of these risk factors in people with celiac disease than in the general population. One study from the United Kingdom showed that people with untreated CD had lower blood pressure, less likelihood of smoking, and lower cholesterol levels than people without CD. The study did not show a lower risk of stroke or heart attack in this group. Other studies have shown no difference in risk or a higher risk of stroke or heart disease in people with celiac disease.
A Swedish study found an increase in CVD in people with untreated celiac disease, risk that decreased with time on a gluten-free diet, especially if small intestinal biopsies became normal.
The recently published study looked at 637 people with celiac disease, compared with a group of people who were similar in other respects (matched controls). They were followed between 4.5 and 4.75 years.
The people with celiac disease had a lower risk of developing cardiovascular disease. This included strokes, coronary artery disease, heart failure, or vascular disease elsewhere in the body. They also had a lowered rate of many of the risk factors. They were less likely than the control group to have high blood pressure, elevated cholesterol and diabetes. They also were less likely to smoke, and less likely to be obese.
Other recent studies have shown lower rates of type 2 diabetes in people with celiac disease. Type 1 diabetes is thought to be more common in people with celiac disease, but in this study, there were lower rates of both types of diabetes among the participants with celiac disease.
The older the patients in either group, the more likely they were to have risk factors or frank cardiovascular disease, but this was still less common in those with CD.
It is possible that the risks are different depending on whether or not the people with celiac disease are on a gluten-free diet or not, and may also be related to their overall general health and level of activity. Genetics may also play a role.
Further research is needed. If you have celiac disease, you still need to be aware of the risk factors for stroke and heart disease. When you substitute other grains and flours for wheat, rye or barley, you may wind up selecting something like nut flour that is higher in calories and fats. If you have risk factors for cardiovascular disease, including a family history, you may need a dietitian to help sort out how to manage your diet.
You still need to maintain other healthy behaviors, such as exercising regularly and not smoking. Trying to manage celiac disease may be overwhelming at times, but you can’t neglect other aspects of your health.