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. 2021 Mar 11;113(3):622-629.
doi: 10.1093/ajcn/nqaa291.

Genetic, lifestyle, and health-related characteristics of adults without celiac disease who follow a gluten-free diet: a population-based study of 124,447 participants

Thomas J Littlejohns  1 , Amanda Y Chong  2 , Naomi E Allen  1 , Matthew Arnold  3 , Kathryn E Bradbury  4 , Alexander J Mentzer  2 , Elizabeth J Soilleux  5 , Jennifer L Carter  1   6
Affiliations

Genetic, lifestyle, and health-related characteristics of adults without celiac disease who follow a gluten-free diet: a population-based study of 124,447 participants

Thomas J Littlejohns et al. Am J Clin Nutr. .

Abstract

Background: The number of gluten-free diet followers without celiac disease (CD) is increasing. However, little is known about the characteristics of these individuals.

Objectives: We address this issue by investigating a wide range of genetic and phenotypic characteristics in association with following a gluten-free diet.

Methods: The cross-sectional association between lifestyle and health-related characteristics and following a gluten-free diet was investigated in 124,447 women and men aged 40-69 y from the population-based UK Biobank study. A genome-wide association study (GWAS) of following a gluten-free diet was performed.

Results: A total of 1776 (1.4%) participants reported following a gluten-free diet. Gluten-free diet followers were more likely to be women, nonwhite, highly educated, living in more socioeconomically deprived areas, former smokers, have lost weight in the past year, have poorer self-reported health, and have made dietary changes as a result of illness. Conversely, these individuals were less likely to consume alcohol daily, be overweight or obese, have hypertension, or use cholesterol-lowering medication. Participants with hospital inpatient diagnosed blood and immune mechanism disorders (OR: 1.62; 95% CI: 1.18, 2.21) and non-CD digestive system diseases (OR: 1.58; 95% CI: 1.42, 1.77) were more likely to follow a gluten-free diet. The GWAS demonstrated that no genetic variants were associated with being a gluten-free diet follower.

Conclusions: Gluten-free diet followers have a better cardiovascular risk profile than non-gluten-free diet followers but poorer self-reported health and a higher prevalence of blood and immune disorders and digestive conditions. Reasons for following a gluten-free diet warrant further investigation.

Keywords: UK Biobank; cross-sectional study; genome-wide association study; gluten free; health; lifestyle.

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Figures

FIGURE 1
FIGURE 1
Flowchart for final analytic sample size.
FIGURE 2
FIGURE 2
Association of hospital inpatient diagnoses by ICD-10 chapter with following a gluten-free diet. Models are adjusted for age, sex, ethnicity, Townsend deprivation score, education, smoking, alcohol, physical activity, and BMI. Information on cancers was obtained from cancer registry data and not hospital inpatient records. Bold values indicate associations that are significant at the Bonferroni corrected level P < 0.003 (allowing for 17 tests). ICD-10, International Classification of Diseases, 10th revision.
FIGURE 3
FIGURE 3
Manhattan (A) and QQ plot (B) of GWAS of gluten-free diet with age and sex as covariates. The solid line indicates genome-wide significance; the dashed line indicates suggestive significance. GWAS, genome-wide association study.
See this image and copyright information in PMC

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References

    1. Singh P, Arora A, Strand TA, Leffler DA, Catassi C, Green PH, Kelly CP, Ahuja V, Makharia GK. Global prevalence of celiac disease: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2018;16:823–836.e2. - PubMed
    1. Kim H-S, Patel KG, Orosz E, Kothari N, Demyen MF, Pyrsopoulos N, Ahlawat SK. Time trends in the prevalence of celiac disease and gluten-free diet in the US population: results from the National Health and Nutrition Examination Surveys 2009–2014. JAMA Intern Med. 2016;176:1716–7. - PubMed
    1. Markets and Markets . Gluten-free products market by type (bakery products, snacks & RTE products, pizzas & pastas, condiments & dressings), distribution channel (conventional stores, specialty stores, drugstores & pharmacies), and region—global forecast to 2023. [Internet]. [cited 21 November, 2019]. Available from: https://www.marketsandmarkets.com/Market-Reports/gluten-free-products-ma....
    1. Kim H, Demyen MF, Mathew J, Kothari N, Feurdean M, Ahlawat SK. 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. 2017;62:2440–8. - PubMed
    1. Perrin L, Allès B, Buscail C, Ravel C, Hercberg S, Julia C, Kesse-Guyot E. Gluten-free diet in French adults without coeliac disease: sociodemographic characteristics, motives and dietary profile. Br J Nutr. 2019;122:231–9. - PubMed

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