Knight-Agarwal, Cathy

Mellor, Duane

English

A recent analysis of a massive study observing the effect of food on the health of nearly 200,000 American health professionals suggested eating more gluten was associated with a lower risk of type 2 diabetes.But is it really this simple

University of Canberra Research Repository

Academic rigour, journalistic flairReports gluten can prevent type 2 diabetes come from a study that didn’t really prove this. from www.shutterstock.com.auMarch 14, 2017 4.07pm AEDTA recent analysis of a massive study observing the effect of food on the health of nearly 200,000American health professionals suggested eating more gluten was associated with a lower risk of type 2diabetes.But is it really this simple?Can gluten be linked to diabetes?A considerable amount of published research has looked at the potential links between coeliac diseaseand type 1 diabetes (a chronic condition where the pancreas produces little or no insulin). This has ledto the discovery that they often share similar genetic markers linked to the immune system.Another recent study found that although coeliac disease was more common in people with type 1diabetes there were no more cases of coeliac disease in people with type 2 diabetes (which usuallypresents in adulthood, and is typically associated with lifestyle factors) than the general population.AuthorsDuane MellorAssociate Professor in Nutrition andDietetics, University of CanberraCathy Knight-AgarwalClinical Assistant Professor of Nutritionand Dietetics, University of CanberraDoes gluten prevent type 2 diabetes? Probably notHowever, while studies in animals suggest gluten may increase risk of developing type 1 diabetes,human studies do not. A large review investigating when infants are first given gluten and their risk ofdeveloping type 1 diabetes found no link, unless infants were fed solids in their first three months,which is much younger than the six months recommended by the World Health Organisation.And in animal studies of type 2 diabetes, it has been suggested gluten may increase the risk ofdeveloping diabetes.How reliable are the study results?Mice studies are interesting, but we need to look at data from people. This is typically done in eitherclinical trials, which can assess causality (that one thing caused the other), or by observing groups,which identify associations only (two things happened together, but one didn’t necessarily cause theother).This new study fits into the latter. The study looked at data from three big studies that started 40years ago with the Nurses’ Health Study, and continued with Nurses’ Health Study II (1989) and Health Professionals Follow Up Study (1986). These looked at the effect of nutrition on long-termhealth.The latest news, suggesting gluten may lower risk of type 2 diabetes, was reported at an AmericanHeart Association conference last week. The full research paper is not readily available, so we have torely on a press release from the AHA.This reported that the 20% of people with the highest intake of gluten had a 13% lower risk ofdeveloping type 2 diabetes compared to those eating less than 4g a day (which is equivalent to lessthan two slices of bread).So, it could seem that gluten intake is protective against developing type 2 diabetes.However, a more likely explanation could be that this is an effect of other things in foods that alsocontain gluten. Perhaps, eating wholegrains - including wheat, barley and rye could be responsible forthe reported results. They are key dietary sources of gluten and are rich in fibre and a number ofvitamins (such as vitamin E) and minerals (such as magnesium).Evidence of this can be seen in an earlier analysis of the same data, which found that those consumingthe most wholegrain had a 27% reduced risk of developing type 2 diabetes.It’s also plausible that the foods people were eating that didn’t contain gluten were more likely to bediscretionary foods, such as French fries, and that could be a factor. This was also seen in anotheranalysis of this data, which found the highest consumers of French fries had a 21% increased risk ofdeveloping type 2 diabetes.Foods that contain gluten often also contain other good things. from www.shutterstock.comAvoiding gluten can mean losing important nutrientsSo, any conclusions regarding effects of gluten in prevention of type 2 diabetes cannot be drawn fromthis study. The authors acknowledge this in the conference media release. The observed effect is likelyto be related to other factors in foods consumed or not consumed.The study also suggests that for people who do not have a clinical reason to avoid gluten (such ascoeliac disease, wheat allergy or other gluten sensitivities), restricting the intake of foods that couldhave other benefits can be harmful. They need to look for replacement sources of fibre and othernutrients.Avoiding gluten is an increasing trend, possibly linked to media attention associated with popularalternative dietary messages such as “paleo”, or following the latest fad diets observed in celebritiesand athletes. This may not be a problem if nutrients are replaced by other foods. But that can bechallenging, particularly if there are diet or food restrictions in such plans.To get the best out of this way of eating, it’s important to have a comprehensive understanding of dietand nutrition, which may require a visit to a dietitian or other healthcare professional.Including foods containing gluten, unless you have a medical reason to exclude them, can be thesimplest way to benefit from the fibre and other nutrients they contain. If you wish to remove glutenfrom your diet, you should look to include healthy, naturally gluten-free grains such as quinoa orbuckwheat.Although this study is interesting, it’s important to remember that without a medical reason, goinggluten free is unlikely to result in any therapeutic benefits. But if you do, you need to ensure you don’treplace these foods with discretionary foods high in fat, salt and sugar.Diabetes Coeliac disease Gluten Gluten avoidance

Does gluten prevent type 2 diabetes? probably not.

https://researchsystem.canberra.edu.au/ws/files/46773499/Does_gluten_prevent_type_2_diabetes_Probably_not.pdf

Does gluten prevent type 2 diabetes? probably not.

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