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 20 June 2018

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News

Heavy metals remained higher in persons following a gluten-free diet

February's publication of Clinical Gastroenterology and Hepatology determines the accumulation of heavy metals in people on a gluten-free diet.

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Specific foods such as fish and rice have high concentrations of metals such as arsenic, mercury, lead, cadmium, and cobalt.

Many gluten-free diets include these foods, so we evaluated whether a gluten-free diet was associated with increased metal bioaccumulation.

Dr Murray and colleagues from Minnesota, USA, performed a population-based, cross-sectional study using data collected from the National Health and Nutrition Examination Survey (NHANES), from 2009 through 2012, collecting information on the diagnosis of celiac disease and adherence to a gluten-free diet.

The research team tested National Health and Nutrition Examination Survey blood samples to identify individuals with undiagnosed celiac disease, using assays for immunoglobulin A tissue transglutaminase followed by a confirmatory test for endomysial antibody.

Among a total of 11,354 National Health and Nutrition Examination Survey participants, celiac disease was diagnosed in 55 participants, based on test results or a reported clinical diagnosis.

The researchers collected National Health and Nutrition Examination Survey data on blood levels of lead, mercury, and cadmium from subjects who were on a gluten-free diet and participants who were not on a gluten-free diet.

Levels of total arsenic in urine samples were available from 3901 subjects not following a gluten-free diet and 32 individuals following a gluten-free diet.

National Health and Nutrition Examination Survey participants were asked questions about fish and shellfish consumption.

The team performed multivariate logistic regression analyses to associate gluten-related conditions with blood concentrations of mercury, cadmium, and lead and urine concentration of total arsenic, adjusting for demographic characteristics, as well as for rice consumption or seafood intake.

Geometric means were reported for urinary concentrations of total arsenic and blood concentrations of mercury, cadmium, and lead for demographic groups and subjects with gluten-related conditions.

Subjects on a gluten-free diet had higher concentrations of total arsenic in urine samples
Clinical Gastroenterology and Hepatology

The team found that persons following a gluten-free diet had significantly increased total blood mercury levels compared with persons not on a gluten-free diet, as well as increased blood levels of lead and cadmium.

Urine samples from subjects on a gluten-free diet had higher concentrations of total arsenic than urine samples from subjects not on a gluten-free diet.

The doctors found after controlling for demographic characteristics, levels of all heavy metals remained significantly higher in persons following a gluten-free diet, compared with those not following a gluten-free diet.

After exclusion of persons with celiac disease, people without celiac disease on a gluten-free diet had significantly increased blood concentrations of total mercury
than persons without celiac disease and not on a gluten-free diet and higher blood concentrations of lead and higher urine concentrations of total arsenic.

The researchers noted that blood samples from persons without celiac disease avoiding gluten had higher levels of cadmium than persons without celiac disease and not following a gluten-free diet, but this difference was not significant.

Dr Murray's team concluded, "In an analysis of data collected from National Health and Nutrition Examination Survey, persons on a gluten-free diet had significantly higher urine levels of total arsenic and blood levels of mercury, lead, and cadmium than persons not avoiding gluten."

"Studies are needed to determine the long-term effects of accumulation of these elements in persons on a gluten-free diet."

Clin Gastroenterol Hepatol 2018: 16(2): 244-251
23 February 2018

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