Brar P et al. (2006) Change in lipid profile in celiac disease: beneficial effect of gluten-free diet. Am J Med 119: 786–790

Celiac disease is often accompanied by low cholesterol levels, and it has been proposed that the standard treatment for celiac disease—a gluten-free diet—raises cholesterol levels, thereby worsening the risk of cardiovascular disease in these patients. A new study, however, has found that adoption of a gluten-free diet does not increase the cardiovascular risk of celiac disease patients, and might even lower it.

Brar et al. retrospectively reviewed the lipid profiles of 132 adults with celiac disease obtained before and ≥6 months after adoption of a gluten-free diet. All patients had biopsy-confirmed celiac disease that responded favorably to the diet. Although patients' total cholesterol levels rose significantly after adopting the gluten-free diet (P <0.0001), this rise was mainly caused by an increase in levels of HDL cholesterol (P <0.0001), although there was also a trend towards increased LDL cholesterol levels. When the data for men and women were analyzed separately, however, the trend towards increased levels of LDL cholesterol did reach significance in men (P = 0.02). In addition, patients' LDL cholesterol:HDL cholesterol ratio decreased by a mean of 0.36 (P <0.0001).

These results suggest that cardiovascular risk is not increased in celiac disease patients who adopt a gluten-free diet. As it has previously been shown that the risk of coronary heart disease decreases as levels of HDL cholesterol increase, it is possible that the demonstrated increase in levels of HDL cholesterol might have a protective effect in this population.