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Participants in NHS and HPFS have been followed via biennial self administered questionnaires on health and lifestyle habits, anthropometrics, environmental exposures, and medical conditions.In 1986, diet in both cohorts was assessed with a validated 136 item semiquantitative food frequency questionnaire.

Thus, using prospective, validated data on dietary intake collected over 20-30 years, we examined the association of estimated long term intake of gluten with the development of incident coronary heart disease (fatal or non-fatal myocardial infarction).

Objective To examine the association of long term intake of gluten with the development of incident coronary heart disease. Setting and participants 64 714 women in the Nurses’ Health Study and 45 303 men in the Health Professionals Follow-up Study without a history of coronary heart disease who completed a 131 item semiquantitative food frequency questionnaire in 1986 that was updated every four years through 2010.

Exposure Consumption of gluten, estimated from food frequency questionnaires.

After additional adjustment for intake of whole grains (leaving the remaining variance of gluten corresponding to refined grains), the multivariate hazard ratio was 1.00 (0.92 to 1.09; P for trend=0.77).

In contrast, after additional adjustment for intake of refined grains (leaving the variance of gluten intake correlating with whole grain intake), estimated gluten consumption was associated with a lower risk of coronary heart disease (multivariate hazard ratio 0.85, 0.77 to 0.93; P for trend=0.002).

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